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What is CMS Price Transparency?

CMS Price Transparency is a policy initiative by the Centers for Medicare & Medicaid Services (CMS) that aims to help consumers shop and compare prices across hospitals and estimate the cost of care before going to the hospital. Starting from January 1, 2021, each hospital operating in the United States is required to provide clear, accessible pricing information online about the items and services they provide in two ways:

  • As a comprehensive machine-readable file with all items and services
  • In a display of shoppable services in a consumer-friendly format

How are Standard Charges Different from Actual Costs?

Standard charges are the prices that hospitals set for their items and services, such as gross charges, discounted cash prices, payer-specific negotiated charges, and de-identified minimum and maximum negotiated charges. Actual costs are the amounts that patients actually pay for their medical care, which may depend on their insurance plan, their network status, their deductible, their copayment, their coinsurance, and their out-of-pocket limit.

Standard charges may not be a relevant estimate for the actual costs because they do not reflect the discounts or adjustments that may apply to different patients or payers. We encourage our patients to use our Procedure Cost Estimator tool to apply your health plan specific benefits and rates to your estimate.

What Services are Included in my Procedure Estimate?

The estimates provided are only related to your hospital bill. Your surgeon and other physicians providing you with services related to your procedure or hospital stay will bill you separately. This can include fees related to anesthesiologists, hospitalists, pathologists, and radiologists.

For a list of standard charges at Oklahoma Surgical Hospital, please click here.