Patient Price Information List

Disclaimer: Owensboro Health Muhlenburg Community Hospital determines its standard charges for patient items and services through the use of a chargemaster system, which is a list of charges for the components of patient care that go into every patient’s bill. These are the baseline rates for items and services provided at the Hospital. The chargemaster is similar in concept to the manufacturer’s suggested retail price (“MSRP”) on a particular product or good. The charges listed provide only a general starting point in determining the potential costs of an individual patient’s care at the Hospital. This list does not reflect the actual out-of-pocket costs that may be paid by a patient for any particular service, it is not binding, and the actual charges for items and services may vary.

Many factors may influence the actual cost of an item or service, including insurance coverage, rates negotiated with payors, and so on. Government payors, such as Medicare and Medicaid for example, do not pay the chargemaster rates, but rather have their own set rates that hospitals are obligated to accept. Commercial insurance payments are based on contract negotiations with payors and may or may not reflect the standard charges. The cost of treatment also may be impacted by variables involved in a patient’s actual care, such as specific equipment or supplies required, the length of time spent in surgery or recovery, additional tests, or any changes in care or unexpected conditions or complications that arise. Moreover, the foregoing list of charges for services only includes charges from the Hospital. It does not reflect the charges for physicians, such as the surgeon, anesthesiologist, radiologist, pathologist, or other physician specialists or providers who may be involved in providing particular services to a patient. These charges are billed separately.

Individuals with questions about their out-of-pocket costs of service and other financial information should contact the hospital or consider contacting their insurers for further information.

LOCAL MARKET HOSPITALS

In order to present a meaningful comparison, Owensboro Health Muhlenburg Community Hospital has partnered with Hospital Pricing Specialists LLC to analyze current charges, based off CMS adjudicated claims through 12/31/2021. Owensboro Health Muhlenburg Community Hospital's charges are displayed and compared with the local market charge, consisting of the following hospitals:

Hospital Name
Location

Baptist Health Madisonville

Madisonville

KY

Jennie Stuart Medical Center

Hopkinsville

KY

Methodist Hospital

Henderson

KY

Ohio County Hospital

Hartford

KY

INPATIENT ROOM AND BOARD DAILY CHARGES

Description

Our Charge
Market Charge

Variance

Semi-Private Room

$1,196
$1,414

15% lower than market

CMS SHOPPABLE SERVICE

Description

Our Charge
Market Charge

Variance

Abdominal and pelvic CT scan with contrast for injury, foreign bodies, or tumors [HCPCS 74177]

$1,100
$3,728

70% lower than market

Abdominal ultrasound (complete) [HCPCS 76700]

$974
$1,212

20% lower than market

Colon (large bowel) examination with endoscope for diagnosis (high risk) [HCPCS 45378]

$2,165
$3,428

37% lower than market

Head or brain CT scan without contrast to examine injury, foreign bodies, or tumors [HCPCS 70450]

$1,100
$1,811

39% lower than market

Imaging of brain by MRI without contrast, followed by contrast [HCPCS 70553]

$1,100
$3,267

66% lower than market

Imaging of leg joint by MRI without contrast [HCPCS 73721]

$1,100
$2,383

54% lower than market

Imaging of lower spinal canal by MRI without contrast [HCPCS 72148]

$1,100
$2,432

55% lower than market

Lab analysis of urine specimen by dipstick with microscope (automated) [HCPCS 81001]

$15
$36

58% lower than market

Lab analysis of urine specimen by dipstick without microscope (automated) [HCPCS 81003]

$36
$30

19% higher than market

Lab analysis to evaluate the clotting time in plasma specimen and monitor drug effectiveness [HCPCS 85610]

$17
$91

81% lower than market

Lab analysis to measure complete blood cell count (red cells, white blood cell, and platelets), automated test [HCPCS 85027]

$35
$89

60% lower than market

Lab analysis to measure complete blood cell count (red cells, white blood cell, and platelets), automated test and automated differential white blood cell count [HCPCS 85025]

$26
$95

73% lower than market

Lab analysis to measure the amount of albumin, total and direct bilirubin, alkaline phosphatase, total protein, alanine amino transferase, and asparate amino transferase in blood specimen to evaluate liver function [HCPCS 800

$38
$90

58% lower than market

Lab analysis to measure the amount of lipids (cholesterol and triglycerides) in blood specimen [HCPCS 80061]

$41
$121

66% lower than market

Lab analysis to measure the amount of total calcium, carbon dioxide (bicarbonate), chloride, creatinine, glucose, potassium, sodium, and urea nitrogen (BUN) in blood specimen [HCPCS 80048]

$39
$85

54% lower than market

Lab analysis to measure the amount of total PSA (prostate specific antigen) in serum specimen [HCPCS 84153]

$46
$178

74% lower than market

Lab analysis via blood test to measure a comprehensive group of blood chemicals [HCPCS 80053]

$56
$104

46% lower than market

Physical therapy exercise to develop strength, endurance, range of motion, and flexibility (each 15 minutes) [HCPCS 97110]

$50
$97

49% lower than market

Sleep pattern monitoring of patient in sleep lab, sleep staging with 4 or more parameters of sleep (6 years of age or older) [HCPCS 95810]

$3,485
$5,164

32% lower than market

Spinal x-ray of lower and sacral spine (minimum of 4 views) [HCPCS 72110]

$205
$883

77% lower than market

OUTPATIENT EMERGENCY DEPARTMENT

Description

Our Charge
Market Charge

Variance

Critical care delivery to critically ill or injured patient (first 30-74 minutes) [HCPCS 99291]

$1,479
$2,928

49% lower than market

Emergency department visit for minor problem [HCPCS 99281]

$249
$296

16% lower than market

Emergency department visit for problem of low to moderate severity [HCPCS 99282]

$373
$681

45% lower than market

Emergency department visit for problem of moderate severity [HCPCS 99283]

$591
$1,050

44% lower than market

Emergency department visit for problem of high severity [HCPCS 99284]

$901
$1,543

42% lower than market

Emergency department visit for problem with significant threat to life [HCPCS 99285]

$1,208
$2,090

42% lower than market

OUTPATIENT LABORATORY AND PATHOLOGY

Description

Our Charge
Market Charge

Variance

Cov-19 amp prb hgh thruput [HCPCS U0003]

$125
$291

57% lower than market

Lab analysis by nucleic acid (DNA or RNA) to identify antigen of severe acute respiratory syndrome coronavirus 2 (Covid-19) [HCPCS 87635]

$97
$167

42% lower than market

Lab analysis of blood culture to identify bacteria [HCPCS 87040]

$128
$115

11% higher than market

Lab analysis of urine culture to measure the amount of bacteria [HCPCS 87086]

$33
$59

44% lower than market

Lab analysis to evaluate thyroid hormone in serum specimen [HCPCS 84479]

$28
$85

67% lower than market

Lab analysis to identify antibodies to severe acute respiratory syndrome coronavirus 2 (Covid-19) [HCPCS 86769]

$95
$100

5% lower than market

Lab analysis to identify antibody IgE to allergic substance (each crude allergen extract) [HCPCS 86003]

$4
$143

97% lower than market

Lab analysis to measure the amount of free thyroid hormone, T3 in serum specimen [HCPCS 84481]

$103
$121

15% lower than market

Lab analysis to measure the blood potassium level in blood specimen [HCPCS 84132]

$26
$42

40% lower than market

Lab analysis to measure the magnesium level in body fluids and cells [HCPCS 83735]

$30
$69

56% lower than market

Lab analysis to measure the parathormone (parathyroid hormone) level [HCPCS 83970]

$171
$274

38% lower than market

Lab analysis to measure the phosphate level [HCPCS 84100]

$15
$51

70% lower than market

Lab analysis to measure the total protein level in urine specimen [HCPCS 84156]

$21
$52

60% lower than market

Lab analysis to measure the vitamin D-3 level in serum or plasma specimen [HCPCS 82306]

$145
$221

34% lower than market

Lab blood analysis to identify antigens on red blood cell surface and determine the patient's blood group type (ABO) [HCPCS 86900]

$57
$76

26% lower than market

Lab blood analysis to identify antigens on red blood cell surface and determine the patient's Rh (D) type (Rh positive or Rh negative) [HCPCS 86901]

$34
$76

55% lower than market

OUTPATIENT PHYSICAL/OCCUPATIONAL/SPEECH THERAPY

Description

Our Charge
Market Charge

Variance

Physcial therapy exercise of walking training to 1 or more areas (each 15 minutes) [HCPCS 97116]

$96
$130

26% lower than market

Physical therapy evaluation (typically 30 minutes) [HCPCS 97162]

$300
$399

25% lower than market

Physical therapy evaluation (typically 45 minutes) [HCPCS 97163]

$345
$436

21% lower than market

Physical therapy procedure to re-educate brain-to-nerve-to-muscle function (each 15 minutes) [HCPCS 97112]

$133
$181

27% lower than market

Physical therapy techniques to 1 or more regions (each 15 minutes) [HCPCS 97140]

$142
$199

28% lower than market

OUTPATIENT PULMONARY THERAPY

Description

Our Charge
Market Charge

Variance

Amount and speed of breathed air measurement and graphic recording before and after medication administration [HCPCS 94060]

$374
$677

45% lower than market

CPAP (continuous positive airway pressure) mask or breathing tube initiation and management for night time respiratory muscle rest [HCPCS 94660]

$426
$477

11% lower than market

Routine EKG (electrocardiogram) tracing using at least 12 wires [HCPCS 93005]

$208
$294

29% lower than market

Total and timed exhaled air capacity measurement and graphic recording [HCPCS 94010]

$217
$332

35% lower than market

OUTPATIENT X-RAY AND RADIOLOGICAL

Description

Our Charge
Market Charge

Variance

Abdominal and pelvic CT scan without contrast for injury, foreign bodies, or tumors [HCPCS 74176]

$1,100
$2,903

62% lower than market

Abdominal and pelvic CT scan without contrast, followed by contrast for injury, foreign bodies, or tumors [HCPCS 74178]

$1,100
$4,946

78% lower than market

Abdominal ultrasound (limited) [HCPCS 76705]

$694
$856

19% lower than market

Abdominal, pelvic, and/or scrotal arterial inflow and venous outflow ultrasound (limited study) [HCPCS 93976]

$570
$1,205

53% lower than market

Ankle x-ray (2 views) [HCPCS 73600]

$205
$416

51% lower than market

Ankle x-ray (minimum of 3 views) [HCPCS 73610]

$205
$519

61% lower than market

Arm x-ray of forearm (2 views) [HCPCS 73090]

$205
$458

55% lower than market

Arm x-ray of upper arm (minimum of 2 views) [HCPCS 73060]

$205
$465

56% lower than market

Arms or legs veins ultrasound with assessment of compression and functional maneuvers (complete, both arms or legs) [HCPCS 93970]

$1,214
$1,874

35% lower than market

Arms or legs veins ultrasound with assessment of compression and functional maneuvers (limited, one arm or leg) [HCPCS 93971]

$753
$1,198

37% lower than market

Blood flow (outside of the brain) ultrasound on both sides of head and neck [HCPCS 93880]

$1,008
$1,492

32% lower than market

Chest CT scan with contrast to examine injury, foreign bodies, or tumors [HCPCS 71260]

$1,100
$2,268

52% lower than market

Chest CT scan without contrast to examine injury, foreign bodies, or tumors [HCPCS 71250]

$1,100
$1,650

33% lower than market

Chest x-ray (2 views) [HCPCS 71046]

$205
$311

34% lower than market

Chest x-ray (single view) [HCPCS 71045]

$205
$267

23% lower than market

CTA scan of chest blood vessels with contrast to examine injury, foreign bodies, or tumors [HCPCS 71275]

$1,100
$2,748

60% lower than market

CTA scan of head blood vessels with contrast to examine blood clots or aneurysms [HCPCS 70496]

$1,100
$2,344

53% lower than market

CTA scan of neck blood vessels with contrast to examine blood clots or aneurysms [HCPCS 70498]

$1,100
$2,309

52% lower than market

Elbow x-ray, complete study (minimum of 3 views) [HCPCS 73080]

$205
$489

58% lower than market

Facial CT scan without contrast to examine injury, foreign bodies, or tumors [HCPCS 70486]

$1,100
$1,886

42% lower than market

Finger(s) x-ray (minimum of 2 views) [HCPCS 73140]

$205
$409

50% lower than market

Foot x-ray (2 views) [HCPCS 73620]

$205
$467

56% lower than market

Foot x-ray, complete study (minimum of 3 views) [HCPCS 73630]

$205
$509

60% lower than market

Hand x-ray (minimum of 2 views) [HCPCS 73130]

$205
$503

59% lower than market

Head and neck ultrasound [HCPCS 76536]

$397
$924

57% lower than market

Hip x-ray of both hips with pelvis (3 to 4 views) [HCPCS 73522]

$205
$1,216

83% lower than market

Hip x-ray of hip with pelvis (2 to 3 views) [HCPCS 73502]

$205
$428

52% lower than market

Hip x-ray of hip with pelvis (single view) [HCPCS 73501]

$205
$369

44% lower than market

Imaging of arm joint by MRI without contrast [HCPCS 73221]

$1,100
$2,428

55% lower than market

Imaging of brain by MRI without contrast [HCPCS 70551]

$1,100
$2,321

53% lower than market

Imaging of head blood vessels by MRA without contrast [HCPCS 70544]

$1,100
$2,596

58% lower than market

Imaging of middle spinal canal by MRI without contrast [HCPCS 72146]

$1,100
$2,302

52% lower than market

Imaging of scrotum by ultrasound [HCPCS 76870]

$672
$856

21% lower than market

Imaging of spinal canal by MRI without contrast, followed by contrast [HCPCS 72156]

$1,100
$3,390

68% lower than market

Imaging of upper spinal canal by MRI without contrast [HCPCS 72141]

$1,100
$2,315

52% lower than market

Knee x-ray (1 or 2 views) [HCPCS 73560]

$205
$448

54% lower than market

Knee x-ray (3 views) [HCPCS 73562]

$205
$519

61% lower than market

Knee x-ray (4 or more views) [HCPCS 73564]

$205
$675

70% lower than market

Lower leg x-ray (2 views) [HCPCS 73590]

$205
$449

54% lower than market

Neck CT scan of the soft tissue of the neck without contrast to examine injury, foreign bodies, or tumors [HCPCS 70490]

$1,100
$1,963

44% lower than market

Pelvis CT scan without contrast to examine injury, foreign bodies, or tumors [HCPCS 72192]

$1,100
$1,634

33% lower than market

Pelvis x-ray (1 or 2 views) [HCPCS 72170]

$205
$446

54% lower than market

Rib cage x-ray of ribs on both sides of body including chest (minimum of 4 views) [HCPCS 71111]

$205
$1,056

81% lower than market

Rib cage x-ray of ribs on one side of body (2 views) [HCPCS 71100]

$205
$532

61% lower than market

Rib cage x-ray of ribs on one side of body including chest (minimum of 3 views) [HCPCS 71101]

$205
$616

67% lower than market

Shoulder x-ray, complete study (minimum of 2 views) [HCPCS 73030]

$205
$487

58% lower than market

Skull CT scan to examine the bones of the eye and ear without contrast to examine injury, foreign bodies, or tumors [HCPCS 70480]

$1,100
$2,150

49% lower than market

Spinal CT scan of lower spine without contrast to examine injury, foreign bodies, or tumors [HCPCS 72131]

$1,100
$2,137

49% lower than market

Spinal CT scan of middle spine without contrast to examine injury, foreign bodies, or tumors [HCPCS 72128]

$1,100
$2,109

48% lower than market

Spinal CT scan of upper spine without contrast to examine injury, foreign bodies, or tumors [HCPCS 72125]

$1,100
$2,115

48% lower than market

Spinal x-ray of lower and sacral spine (2 or 3 views) [HCPCS 72100]

$205
$513

60% lower than market

Spinal x-ray of middle spine (3 views) [HCPCS 72072]

$205
$609

66% lower than market

Spinal x-ray of upper spine (4 or 5 views) [HCPCS 72050]

$205
$765

73% lower than market

Thighbone x-ray (minimum of 2 views) [HCPCS 73552]

$205
$454

55% lower than market

Toe(s) x-ray (minimum of 2 views) [HCPCS 73660]

$205
$456

55% lower than market

Ultrasound guidance for needle placement including imaging supervision of procedure and interpretation of results [HCPCS 76942]

$772
$833

7% lower than market

Wrist x-ray, complete study (minimum of 3 views) [HCPCS 73110]

$205
$551

63% lower than market

X-ray of sacrum and tailbone (minimum of 2 views) [HCPCS 72220]

$205
$484

58% lower than market

BILLING PROCESS AND INFORMATION

OUR BILLING PROCESS AND INFORMATION

Thank you for choosing Owensboro Health for your healthcare needs. As part of our commitment to delivering EXCELLENT service, we want to make understanding and paying your bill as easy as possible. Here are some ways you can help us as we work to make the billing process go smoothly.

• Provide us complete and up-to-date health insurance information

In addition to asking for your health insurance card at your visit, we may ask for a photo ID. If you have been seen at Owensboro Health before, please let us know if your personal or insurance information has changed since your last visit.

• Understand and follow the requirements of your health insurance plan

Understanding your health insurance benefits can be a big help to you and to us! Being familiar with your benefits can help you obtain proper authorizations for services, and make it easier to submit referral claim forms when required. Many insurance plans require patients to pay a copayment or deductible amount for services. Please be prepared to make payments at your visit as defined by your insurance coverage.

• Please respond promptly to any requests from your insurance provider

Your insurance benefits are a contract with your insurance company. Owensboro Health is reimbursed by your insurance, and at times we may need your help to communicate effectively with your insurance company. All bills sent to you are due upon receipt*.

*Owensboro Health does not charge interest on any amount not paid in full during the normal course of collection.

Pricing and Billing Information

Owensboro Health’s goal is for each of our patients and their families to have the best healthcare experience possible. That is why we are committed to providing you with information that helps you make well-informed decisions about your care.

If you have questions or need more information about a bill for services you’ve received or for information about the price of a future service, please contact our Customer Service Team at (270) 685- 7500 or (866) 305-3737, or send an email to FinancialAssistance@OwensboroHealth.org. To ensure the most accurate information possible about the price of a future service, a CPT (Current Procedural Terminology) code will be needed when you call. You can get a CPT code from the provider ordering your test or procedure.

Online Payment, Registration and Scheduling

For the convenience of our patients, Owensboro Health offers secure online payment for Owensboro Health Regional Hospital and Owensboro Health Medical Group bills. Please visit our payment portal online at www.OwensboroHealth.org/Billing.

We offer the option to make appointment requests for the Owensboro Health Medical Group providers through MyChart or online at www.owensborohealth.org.

Patients may also pre-register for surgeries, admissions, outpatient procedures and tests prior to their visit by calling Owensboro Health’s Pre-registration Team at (270) 688-5556.

Financial Assistance

As a not-for-profit health system, Owensboro Health is committed to giving back to our communities. One way we do that is by providing financial assistance to individuals and families who cannot pay for medically necessary healthcare services they receive at our facilities.

Owensboro Health offers financial assistance to patients who do not have health insurance, or those who have out‐of‐pocket costs they cannot afford even with insurance coverage. Patients must submit an application for financial assistance and all required supporting documentation and must follow the requirements of the Financial Assistance Policy. The Financial Assistance Policy can be accessed through a link on our Billing page at www.OwensboroHealth.org/Billing .

Owensboro Health's financial assistance policy includes:

• Accommodating financial assistance guidelines that provide free care for individuals and families who earn less than 300% of the federal poverty level.

• Sliding scale fees to provide substantially discounted care for individuals and families who are between 300-400% of the federal poverty level.

Owensboro Health offers convenient interest-free payment plans up to 36 months to assist our patients. If you are uninsured and have income above the criteria for our financial assistance program, Owensboro Health offers a self-pay discount for your charges.

For additional information, please contact our Patient Financial Advocate Team at (270) 685-7501 or (866) 305-3737. You may also print a financial assistance application on our website at https://www.owensborohealth.org/patient-visitor/about-your-stay/billing/financial-assistance/.