What is a chargemaster?

A chargemaster is a comprehensive list of charges for each inpatient and outpatient service provided by a hospital —each test, exam, surgery, procedure, room charge or supply is an item within a hospital's chargemaster.

  • Given the broad scope of services provided by hospitals every day, a chargemaster contains thousands of items and services with their associated charges.
  • Health insurance companies contract with hospitals to care for their members. Hospitals are paid the insurance company's negotiated rate which, in general, is significantly less than the amount listed on the chargemaster.
  • An individual hospital's charges vary based on its unique range of services, adoption of new medical technologies, capital investments and other local factors.
  • The insurance company's negotiated rate, not the chargemaster, is the basis for determining the patient's actual out of pocket cost after the satisfaction of a deductible which is the patient's responsibility. As an example, a hospital may charge $4,000 for a particular service. The insurer's negotiated rate with the hospital is $1000. The patient has a deductible of $500 and a co-pay of 20% of the negotiated rate. The patient will owe $700.

Frequently asked questions

 

  • What is not included in the chargemaster?

    Main Line Health's chargemaster does not include services provided by physicians or advanced practice providers, who treat you while you are at the hospital or outpatient setting. You may receive separate bills from the doctors involved in your care. A partial list of the healthcare providers who may bill you separately include: 

    • Your personal physician or advanced practice provider
    • The surgeon who performs your procedure as well as the anesthesiologist
    • The radiologist who reads your x-rays or other imaging studies such as an MRI or CT scan
    • Other physicians who may have been asked to provide a consultation during your time in the hospital

  • Are charges the same for every patient?

    The list of charges is the same for all patients. However, total charges incurred for each individual patient often vary from one patient to the other for several reasons including: 

    • How long it takes to perform the service or how long it takes you to recover in the hospital
    • Whether the service you receive is more, or less complex than expected
    • The kinds of medication you require while you are hospitalized
    • The consumption of other resources such as supplies, pharmacy, etc.

  • How is price information shared with patients and families?

    The chargemaster is not a useful tool for consumers who are comparison shopping between hospitals. Main Line Health employs financial counselors and other resources to help our patients understand their financial obligations. We encourage our patients to refer to the list of 300 shoppable services for reference. Main Line Health is ready to help patients and their families understand their financial obligations at any time during or after the treatment process.

  • Are charges different from payments?

    Yes, charges are very different from payments. Chargemaster amounts are almost never billed to a patient or received as payment for services by Main Line Health. The chargemaster amounts are billed to an insurance company, Medicare, or Medicaid, and those insurers then apply their contracted rates to the charges that are billed. In situations where a patient does not have insurance, our hospitals offer financial assistance and discounted self-pay rates available to our patients.

  • Where can I find more information about hospital chargemaster costs?

    Patients can find more information about the chargemaster, what your care will cost you or Main Line Health's Financial Assistance Policy by visiting mainlinehealth.org/patient-services. You may also contact the Patient Estimate team at 484.337.1970. Access price estimators for shoppable services.