Many patients are concerned about the cost of health care services. We understand this uncertainty can be stressful and make it hard to plan your personal or household finances. University of Missouri Health Care’s intent is to make pricing information more accessible to you. We hope the information below will make it easier for you to make decisions about your health care.
Our goal is to help you learn more about health insurance and out-of-pocket costs. Today's health care market requires everyone to pay more than we have in the past. Knowing your share of the cost and what you'll be expected to pay is very important and will help you avoid selecting care that is of limited benefit.
Quality matters, too
Though the cost of health care is important, it shouldn't be your only consideration. You should consider many factors when choosing a hospital. Among the most important factors are quality of care and patient safety.
MU Health Care focuses on creating a health care environment known for excellent, safe and effective patient-and-family-centered care. We follow rigorous quality, patient safety and service practices throughout all our hospitals and clinics and have received several awards and honors for this, including the 2014 University Health System Consortium Quality Leadership Award.
Things to consider
Cost is linked to your insurance coverage
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:
- The technical name of the procedure
- The insurance codes (see below)
- The tests you may need before the procedure
- The expected length of your hospital stay if you will be hospitalized
- The follow-up care you will need such as rehabilitation or therapy
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:
- ICD-9 or ICD-10 code. ICD stands for international classification of diseases. These codes identify your health condition or diagnosis. For example, 250.0 means diabetes with no complications and 493.0 is the code for asthma.
- CPT code. CPT stands for current procedural terminology. Providers often use these codes on medical bills to identify the charge billed to you or your insurance plan for each service and procedure.
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:
- CPT code of the service estimated
- Total estimated charges
- Total estimated patient responsibility to include community discounts
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:
- CPT code of the service estimated
- Total estimated charges
- Total estimated patient responsibility to include community discounts or payor contracts
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.
See 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 April 2023
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.
Our commitment to price transparency and information
Please know that it is our policy to provide you with information upon your request about hospital standard charges for services obtained across MU Health Care hospitals and clinics. This complies with Affordable Care Act Section 2718c of the Public Health Service Act.
In addition to this requirement, CMS FFY 2019 IPPS guidance requires hospitals to make available online a list of standard hospital charges. It also requires hospitals to make available a list of average charge for inpatient episodes of care listed by Diagnosis Related Grouping (DRG). DRG is a classification of inpatient care as defined by Medicare.
Please note the following key points when reviewing the list of charges.
- The information contained in the Charge Description Master (CDM) listing is specific to MU Health Care (hospitals and clinics). The charge information provided does NOT include physician and professional fees (CRNAs, APNs, PAs, etc.). Physicians and professional providers bill separately for their professional service.
- The charges in this CDM were valid on March 1, 2024, and will be updated annually. Charges may have changed since that date due to changes in technology, the addition or elimination of services or supplies including the underlying acquisition costs of the supplies and drugs to the hospital.
- The CDM includes all standard items that are available and potentially chargeable to MU Health Care patients, insurers, guarantors. The charges contained in this CDM are the same for all patients of MU Health Care regardless of insurance carrier or coverage. The charges do not reflect expected payment. What you will pay out of pocket will be based on factors including health insurance, benefit plans, applicable discounts and services provided based on each patient’s needs.
- The bill for a hospital stay or an outpatient service includes many CDM items, including charges for accommodations and/or use of special facilities such as the operating room, supplies, devices, procedures, diagnostic tests such as radiology, laboratory tests, and pharmaceuticals. Due to the wide range of services that may be provided during a patient’s outpatient visit or hospital stay, this CDM should not be utilized to estimate the full estimate or final patient charges in advance of a visit or stay.
At MU Health Care, we are committed to providing meaningful information about how much health care services may cost based on your personal health care coverage:
- If you are insured. If you have some form of insurance or government coverage like Medicare or Medicaid, your health insurance provider should serve as your primary source for price information. This is now a service provided by major insurance carriers. You should contact your insurance company to ensure it covers the services you are seeking.
- If you are uninsured. If you do not have health insurance or coverage, MU Health Care can provide you with a pre-service price estimate for a standard procedure without complications. If there are complications or other unforeseen circumstances, the price may increase. Cost of common outpatient procedures and tests for persons with no insurance are posted on this webpage and include the hospital’s self-pay discount. View cost estimates.
For information on MU Health Care’s (hospital and clinics) standard charges — including Charge Description Master (CDM) file listing the gross (standard) charge, self-pay cost, and payer-specific negotiated charges — please click the button below.
The files below are posted in .json format to meet CMS requirements for price transparency. It is intended to be machine-readable and may not be accessible to some.
Data last updated March 1, 2024.
For information on MU Health Care’s (hospital) average/median charge for inpatient episodes of care listed by Diagnosis Related Grouping (DRG), please click the button below.
Data last updated March 1, 2024.
For more information about hospital costs, quality measures and community health data in Missouri, please visit FocusOnHospitals.com, an online resource provided by the Missouri Hospital Association.
MU Health Care Patient Financial Services
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).