Cost Estimator

The amount you pay for care depends on the health insurance plan you have. You and your insurance plan will share the cost of your care. Cost sharing includes copayments, your deductible and coinsurance. The level of benefit determines how much you pay and how much your health insurance plan pays.

Your provider network is another factor in the cost of your care. The price you pay is typically lower when you receive care from an in-network provider. Before making an appointment with an MU Health Care provider, check to make sure the provider is in-network with your health insurance plan. If the provider is not in-network, ask your insurance how this will affect your out-of-pocket costs.

For information on the kinds of questions to ask to make sure you understand your bill, please visit Avoiding Surprises in Your Medical Bills A Guide for Consumers (PDF) by the American Hospital Association (AHA), America’s Health Insurance Plans (AHIP) and Healthcare Financial Management Association (HFMA).

Plan ahead

When possible, schedule health care services and procedures ahead of time. This will allow you to take financial considerations into account. For example, schedule elective procedures in advance so you have time to plan how you will pay for the procedure.

Get the specifics

Before going through a treatment or procedure, ask your health care team for the following information:

What You Need To Know About Insurance Codes

Health care providers and insurance plans use several types of codes to communicate with each other about payment. The codes are designed to make sure they handle billing and payments correctly.

To get a cost estimate, you should have the following code information:

Request a cost estimate

MU Health Care wants to make it easier for you to estimate your costs for care.

If you do not have health insurance, a good faith estimate is available upon request from MU Health Care. The good faith estimate will include the:

If you do have health insurance, a good faith estimate is available upon request from MU Health Care. The good faith estimate with your insurance plan will include the:

Major health insurance plans might also offer online price estimate tool for members. Visit your health plan's website. If the information you need is not available online, you might be able to find it by calling your insurance company's customer service number. This number is on the back of your insurance card. Be sure to have your card available when you call.

Cost information

MU Health Care now has a self-service tool that will allow you to get a good faith estimate for 300 shoppable health care services or items. This will help you understand your potential out-of-pocket costs for health care services provided by MU Health Care. The self-service tool estimate does not include physician or professional service costs, such as provider office fees, or the costs of surgeons, anesthesiologists, emergency room physicians, radiologists, pathologists, consulting physician, nurse practitioners or physician assistants.

If you do not have health insurance, the self-service tool will provide a good faith estimate with MU Health Care's self-pay discount applied. If you do have health insurance, the self-service tool will calculate your good faith estimate based on your plan's benefits (e.g., deductibles, co-pay, co-insurance, out-of-pocket). Be sure to check with your health plan to ensure it is a covered service by your plan and that MU Health Care is in network.

Click the "Cost Estimate" button below to be taken to the good faith estimate self-service tool.

Data last updated Jan. 1, 2022.

COST ESTIMATE

If you need help with a good faith estimate, contact Financial Counseling at 573-884-9900 between 8 a.m. and 4:30 p.m. Monday through Friday.

Know the limitations of an estimate

There's always a chance the bill you receive will turn out to be higher than the estimate. The estimate information provided by MU Health Care will be a best estimate based on the information you provided. It is not a guarantee of what you will be charged.

Please understand that, in many cases, it is impossible to predict final charges due to factors that may vary in your actual services such as:

  • Length of time spent in surgery or recovery
  • Specific equipment, supplies and medications required
  • Additional tests required by your physician
  • Any unusual special care or unexpected conditions or complications

If you have health insurance, your benefits will ultimately determine the amount you owe (including deductibles, copayments, coinsurance and out-of-pocket maximums). If you do not have insurance, you may be eligible for financial assistance.

Know that some services aren't covered by insurance

You'll be responsible for paying the full amount due for any health care service, procedure or product that is not covered by your health insurance plan.

Examples of services, procedures and products not covered by health insurance include:

  • Laser eye surgery such as LASIK or PRK
  • Cosmetic surgery
  • Fertility testing
  • Services or procedures considered experimental by your health plan

Generally, services not covered by your health insurance plan do not count toward your annual out-of-pocket maximum. Check with your health insurance plan for more details.

Cost estimates for uninsured patients

Please note: We cannot give you an exact total cost of care prior to a visit as it depends on the kind, severity and number of problems you address with your doctor privately in the office visit. However, we can give you some general information and definitions.

Terms to know

  • Average (mean): the number resulting from adding up all the numbers and then dividing by the number of numbers.
  • Charge Description Master (CDM). CDM includes all standard items that are available and potentially chargeable to MU Health Care patients, insurers and guarantors. The charges contained in the CDM are the same for all patients of MU Health Care regardless of insurance carrier or coverage.
  • Combined charge. This is the total of University Physician fees and University Hospital fees.
  • Current procedural terminology (CPT) code. A unique number assigned to specific medical services and procedures.
  • Deposit. This is the amount we ask you to pay toward the total charges for your care. We request the deposit at the time of your visit before the visit begins.
  • Diagnosis related group (DRG): any of the payment categories that are used to classify patients and especially Medicare patients for the purpose of reimbursing hospitals for each case in a given category with a fixed fee regardless of the actual costs incurred.
  • Established patient. This is a person who has been seen in the physician’s office or practice group within the past three years. Note: The charges are different depending on if you are a new or established patient.
  • Hospital charge. This is the charge by an MU Health Care hospital for the facility, ancillary testing and supplies.
  • Length of stay (LOS): term to describe the duration of a single episode of hospitalization. Inpatient days are calculated by subtracting day of admission from day of discharge, and based on the number of nights spent in hospital.
  • Median: the number in the middle when arranged in order. The median can be a better representation of the data when the distribution of data is skewed by either low or high numbers.
  • New patient. This is a person who has not been seen in the physician’s office for three years or who has never been seen in that clinic practice group.
  • Physician charge. This is the charge of the health professional that cared for you.
  • Self-pay discount. If you have no health insurance or third-party liability, you will be eligible for the self-pay discount from your total charges (University Hospital 60 percent discount; University Physicians 25 percent discount plus an additional 20 percent discount if paid in full within 30 days).