Erie County Medical Center is committed to pricing and billing transparency and has posted, in machine readable format, on our website; ECMCC’s Charge Master, a list of standard hospital charges for each service or item and a list of charges by Diagnostic Related Group (DRG). In addition, to assist the consumer we have provided a summary of the most frequently used charges along with the AMA CPT Code for services below.
ECMC’s charges are the same for all patients; however, a patient’s responsibility will vary depending on many factors. In addition to public programs such as Medicare and Medicaid, there are many health plans and employers that self-insure for employee health benefits. Each of these payers offer a range of coverage products and each coverage product can have a different definition of what is and is not covered, what the patient cost sharing (co-payments, deductibles or both) as well as payment methodologies and rules. There is no national standard set of requirements and rules; ECMC must follow each plan’s specific requirements. In addition, ECMC must comply with payers’ requirements for pre-authorization, admission notification, utilization review all of which impact the patients’ ultimate financial responsibility.
Recognizing that the list of standard charges and the charges by DRG may not provide the information you are seeking and to assist with your understanding and determining your unique financial responsibility, ECMC has established a dedicated point of contact. Patients can access this to obtain a price for any service by calling 716.898.3272 (8:00am – 4:00pm, M-F) or by email at firstname.lastname@example.org.
ECMCC maintains programs for patients that cannot afford to pay for services. These programs include a non interest bearing loan program through a third party, a sliding fee schedule based on income and family size, grant programs for specific treatments, and a financial counseling team that will assist in these matters or enrollment in a government sponsored insurance program.
The charges reflected in the attached files and the summary reflect the fees for hospital services and not the services of professionals including physicians, nurse anesthetists and others. Consumers can expect a charge from a treating emergency room physician, an anesthesiologist or nurse anesthetist, a radiologist, a hospitalist physician, a psychiatrist among others.
A summary price list for the most frequently used services is provided below for the consumer’s convenience. These prices reflect the standard hospital charge. Patients can contact us via the link above to obtain a specific price to the service they are seeking.
The following prices are current as of January 1, 2021.
Room and board charges are for daily nursing care and related occupancy cost. Additional charges apply for procedures and diagnostic tests performed, certain supplies and drugs as well as professional services.
|Intensive Care Units||$5,474.00|
|Intensive Care Step Down Unit||$3,008.00|
|Chemical Dependency Detoxification||$1,350.00|
|Chemical Dependency Rehabilitation||$938.00|
Trauma and emergency room charges are based on the intensity and level of care provided as well as any required activation of the dedicated trauma team. Additional charges apply for procedures and diagnostic tests performed, certain supplies and drugs as well as professional services.
|Critical Care Initial 30-74 Minutes||$4,935.32|
|Critical Care Ea. Additional 30 min||$1,308.62|
|Trauma Team Activation||$9,639.00|
Many cases may not require an inpatient admission, however a patient may require additional services for observation care. In many cases a patient’s insurance carrier will not approve an inpatient admission as a covered service, however, they will approve an observation stay. Patients can consult with ECMCC care management staff and their insurance carrier related to this determination. A patient can be directly sent for observation care or sent to observation care following an emergency visit. Additional charges apply for procedures and diagnostic tests performed, certain supplies and drugs as well as professional services.
|Direct Admit to Hospital Observation - one time||$518.18|
|Hospital Observation Service Per Hour||$76.13|
ECMCC maintains a dedicated CPEP program for patients requiring this care that is charged separately from any emergency visit that may apply.
|CPEP Brief Visit||$1,189.65|
|CPEP Full Visit||$2,170.57|
Operating room charges are determined based on time and the determination of a major or minor procedure. Anesthesia charges are determined based on time. Additional charges may apply for supplies, implantable devices, drugs as well as professional services.
|OR Time up to 30 minutes||$1,903.44|
|OR Time each additional 30 minutes||$756.84|
|Minor Procedure Time 30 Minutes||$883.74|
|Minor Procedure Time each additional 30 minutes||$713.79|
|Anesthesia up to 30 minutes||$317.96|
|Anesthesia each additional 30 minutes||$110.31|
The following are the most common charges for physical therapy services.
|Evaluation Low Complexity||$251.75|
|Evaluation Moderate Complexity||$300.66|
|Evaluation High Complexity||$334.18|
|Therapeutic Exercise each 15 min||$139.51|
|Neuromuscular Re-Education each 15 min||$139.51|
|Gait Training each 15 min||$120.05|
The following are the most common charges for occupational therapy services.
|Evaluation Low Complexity||$247.66|
|Evaluation Moderate Complexity||$307.39|
|Evaluation High Complexity||$357.98|
|Therapeutic Exercise each 15 minutes||$139.51|
|Therapeutic Activity each 15minutes||$160.06|
|Manual Therapy each 15 minutes||$126.20|
The following charges do not include professional charges for interpretation of the results of these procedures.
|Cardiac Stress Test||$525.70|
The following charges do not include professional charges for pathological interpretation of the results of these procedures.
|Complete Blood Cell Count||$50.18|
|Comprehensive Metabolic Panel||$67.91|
|UA with Auto Microscopy||$20.42|
|Basic Metabolic Panel||$50.18|
|Thyroid Stimulating Hormone||$84.36|
|Renal Function Panel||$76.62|
|Hepatic Function Panel||$49.63|
|Toxicology Screen 10 Urine||$260.64|
|Thromboplastin Time Partial||$43.73|
|Lactic Acid Dehydrogenase||$42.45|
|Urea Nitrogen Quantitative||$29.79|
|Infectious agent detection; HIV1 Antigens with HIV2 Antibodies||$77.67|
|Uric Acid Serum||$29.45|
|Surgical Pathology Level IV||$165.22|
|Urine Total Protein Random||$28.53|
|Blood Typing ABO Grouping||$107.73|
|Glucose by Finger Stick||$29.20|
The following charges do not include professional charges for radiologist interpretation of the results of these procedures or for the radiologist performing an invasive procedure.
|CT Abdomen & Pelvis with contrast||$1,328.95|
|CT Head without contrast||$935.20|
|CT Maxillofacial area without contrast||$934.44|
|CT Spine Cervical without contrast||$1,012.69|
|CT Spine Lumbar without contrast||$1,011.59|
|CT Spine Thoracic without contrast||$1,012.69|
|MRI Brain with & without contrast||$3,273.59|
|MRI Brain without contrast||$1,945.32|
|MRI Lower Extremity Joint without contrast||$1,369.18|
|MRI Spine Cervical without contrast||$1,608.19|
|MRI Spine Lumbar without contrast||$2,025.26|
|MRI Upper Extremity Joint without contrast||$1,175.15|
|Myocardial Perfusion Scan||$2,513.66|
|Ultrasound Abdomen Limited||$447.02|
|Ultrasound Guidance for Needle Placement||$511.83|
|Ultrasound Retroperitoneal (Renal)||$482.81|
|XRAY Ankle 3 Views||$290.50|
|Ultrasound Abdomen Complete||$501.25|
|XRAY Chest 1 View||$177.37|
|XRAY Chest 2 Views||$177.37|
|XRAY Foot 3 Views||$282.79|
|XRAY Hand 3 Views||$185.52|
|XRAY Hip 2-3 Views||$263.43|
|XRAY Knee 4+ Views||$301.74|
|XRAY Shoulder 2 Views||$290.50|
|XRAY Spine Lumbar Complete||$390.39|
The chargemaster is a comprehensive standard price list for the services provided by the hospital (medical procedures, lab tests, supplies, medications, etc.). Because it represents the full range of services the hospital provides, there are thousands of items listed. The charges listed are generally not the amount a patient will pay. If you have health insurance, your out-of-pocket expenses will depend on the specific services you receive, your specific health insurance coverage, and your insurance company’s contract with the hospital. Please contact your insurance company for more information.
If you do not have health insurance, you may be eligible for insurance such as Medicaid, Essential Plans & Qualified Health Plans through the NYS Department of Health. You may also qualify for assistance through our Financial Assistance Program. Please contact our Financial Counseling Team at (716) 898-5566 for more information
Yes, hospital charges are standard for every patient, regardless of insurance status. The total charges on your patient bill will reflect the actual services that you receive, which may vary based on several factors, including your length of stay, the time it takes to complete your procedure, medications you receive, and other health conditions that could make your care more complicated.
In addition, your out-of-pocket expenses will depend on your specific insurance coverage and/or eligibility for discounted care based on the hospital’s Financial Assistance Policy.
Patients with health insurance should contact their insurance company to get an estimate of their out-of-pocket expenses for a procedure. Patients without health insurance should contact The Patient Pricing Information Team at (716) 898-3272 or email email@example.com for an estimate as well as information about the hospital’s Financial Assistance Policy.
Yes, the hospital chargemaster reflects hospital services only and does not include any professional fees such as physician services that are billed separately. For estimated professional fees, please contact your physician’s office.
Insurance companies have contracts with the hospital for discounts from charges. In addition, patients with health insurance are responsible for certain cost-sharing requirements such as deductibles, copayments, and/or coinsurance that vary by insurance plan.
Patients without health insurance can apply for support through the hospital to either receive insurance coverage (if eligible) or reduced costs through the hospital’s Financial Assistance Policy. These programs will reduce the amount owed by the patient.
Hospitals set their standard charges for services and items based on internal metrics, including the cost to provide patient care—which varies between hospitals. For example, charges will vary based on the location of the hospital, the availability of specialized services such as trauma and transplant services, whether it is a teaching hospital, its level of underpayment from the Medicare and Medicaid programs, and services provided to the uninsured. Again, these listed charges are generally not what insurance companies or patients without insurance ultimately pay.