Price Transparency
At Community Hospital of Staunton, we are committed to providing clear and accessible pricing information to the communities we serve. In compliance with federal regulations, we offer a comprehensive list of standard charges for the medical services and procedures we provide. This information is available in a machine-readable format, ensuring transparency in healthcare costs.
Our standard charges include gross charges, self-pay cash prices, payer-specific negotiated rates, and minimum and maximum negotiated payer rates. Hospitals are required to establish uniform base charges before any discounts or adjustments. However, the final cost of a procedure or service can vary based on factors such as a patient’s medical condition, time spent in surgery or recovery, complications requiring additional treatment, or necessary medications or supplies. This pricing information helps patients understand the general cost structure of healthcare services. However, it’s important to note that the listed payer rates represent negotiated reimbursement rates rather than actual out-of-pocket expenses.
Community Hospital of Staunton provides access to detailed standard charge lists for both inpatient and outpatient services, including the chargemaster and DRG/CPT service packages. To make informed financial decisions about your care, we encourage you to review the pricing details below and consult with your insurance provider for personalized cost estimates.
The pricing file below is primarily intended for compliance and may not be the most useful tool for patients seeking to understand their financial responsibility or compare costs between hospitals. For a personalized cost estimate based on your specific care needs and insurance coverage, please contact our Financial Counselor team at 618.391.6920.
When viewing the file, scroll through the spreadsheet to view different line types (CPT codes, DRGs, etc.) and move across columns to see information for different insurance payers. If a field appears blank, it does not necessarily mean data is missing. Try scrolling up or down to locate the relevant CPT/DRG code.
For the most accurate estimate of your out-of-pocket costs, we encourage you to speak with our Financial Counselors or your insurance provider for more details.
The content of these files is subject to change.
Access List of Standard Charges and Payer RatesNotice of Contracted Services
Frequently Asked Questions for Hospital Price Transparency
The patient pays:
If you have health insurance, your out-of-pocket costs will depend on your deductible, copay, and/or coinsurance, as determined by your health plan. Your financial responsibility may also vary if the hospital or physicians are considered "out-of-network," meaning they do not have a contract with your insurance provider. To fully understand your costs, we recommend reaching out to your insurance company for details.
For patients without health insurance, financial assistance programs may be available. Depending on eligibility, you could qualify for a full or partial discount under the Illinois Hospital Uninsured Patient Discount Act or Community Hospital of Staunton’s financial assistance program. To learn more about these options, please contact our Financial Counselor at 618.391.6920.
Health insurance pays:
Insurance providers—including Medicare, Medicaid, workers’ compensation, and commercial health insurance plans—do not pay standard hospital charges. Instead, they cover a pre-negotiated or predetermined amount for services. Patients are responsible only for the out-of-pocket costs outlined in their health plan. If you need assistance understanding your healthcare bill, please call 1.877.444.6382 for support.
A deductible is the set amount a patient must pay out-of-pocket for healthcare services before their insurance plan starts covering costs. Not all services require a deductible, so it’s important to check your specific health plan details.
A copay is a predetermined, fixed fee (e.g., $20) that a patient pays when receiving a covered healthcare service, such as a doctor’s visit or prescription medication. The copay amount varies depending on the type of service and the individual insurance plan.
Coinsurance refers to the percentage of a medical bill that a patient is responsible for paying after meeting their deductible (e.g., 20% of the total cost). This percentage is calculated based on the approved amount for the service. Patients are required to pay both coinsurance and any remaining deductible.
Charge: The total charge represents the initial amount set before any discounts or adjustments. Federal regulations require hospitals to establish uniform charges as a baseline for all billing. The charge for a service depends on the type of care provided and can vary between patients receiving similar treatments due to factors such as complications, additional procedures, or varying medical needs.
Cost: From a hospital’s perspective, cost refers to the total expense incurred to deliver healthcare services. Unlike freestanding clinics or retail healthcare providers, hospitals must be fully staffed and equipped 24/7 to handle any emergency, which leads to higher operating costs. Several factors contribute to these costs, including:
Offering essential services that operate at a financial loss, such as trauma care, burn units, neonatal care, and psychiatric services.
- Running medical education programs to train healthcare professionals which also incurs significant expenses.
- Treating a higher volume of critically ill patients, where the reimbursement often does not fully cover the cost of care.
- Providing care for a large number of uninsured or underinsured patients, many of whom may be unable to contribute to their medical bills.
Price: The total price reflects the actual amount paid to the hospital, either by insurance companies, government health programs, or the patient. In most cases, the final payment is significantly lower than the original charge due to negotiated rates, insurance adjustments, and financial assistance programs.
While hospital charge information is publicly available, it may not be the most effective tool for comparison shopping between facilities. Pricing structures can differ significantly, not only in how services are described but also in what is included within those charges. A single procedure often involves multiple components across different hospital departments, such as room and board, laboratory tests, imaging, medications, and therapies, making direct comparisons challenging.
Additionally, the insurance rate data provided in the file is based on negotiated rates at the charge, CPT, and DRG levels. However, these rates do not reflect the full scope of reimbursement calculations, such as bundled payments, multiple procedure discounts, or separate rates for outlier cases.
For a more accurate cost estimate, patients should obtain the specific insurance billing codes for their recommended procedure. Ask your physician to provide the exact technical name of the procedure along with the associated ICD and CPT codes, which can help you compare pricing across hospitals more effectively.
If you need a cost estimate for a specific procedure or surgery, please contact our Patient Financial Counselor Office at 618.391.6920 or use our Price Estimator Tool for more details.
Estimates are based on the average charge for a procedure without complications. However, the actual cost may vary, as a physician determines the necessary care based on factors such as your diagnosis, overall health, and individual medical needs. For instance, while one patient may only require a one-day hospital stay, another with an underlying condition may need additional days of care for the same procedure.
Keep in mind that insured patients are responsible only for deductibles, copays, and coinsurance as outlined by their health plan. Uninsured patients or those facing financial hardship may qualify for substantial discounts through our financial assistance programs.