Price Transparency

Patient cost estimator

If the services you receive are covered by your insurance, your benefits will determine how much you will be required to pay out-of-pocket. Our Financial Navigators can offer out-of-pocket estimates based on your insurance plan. Also available is an online Patient Cost Estimator tool providing out-of-pocket estimates of at least 300 common medical services and procedures. Further information is available on our Patient Cost Estimator page.

The standard charge file

Effective 1/1/2021, the Centers of Medicare and Medicaid Services (CMS) issued a regulatory rule requiring hospitals to publish a single, machine-readable file, with all payer-specific negotiated and standard charges.

The comprehensive standard file contains our gross charges, discounted cash price, and payer-specific negotiated charges, including the de-identified minimum and maximum negotiated charge. Please note:

  • The payer-specific negotiated charge is not necessarily at a line-item level as healthcare negotiated charges are generally at a bundled service level.
  • The payer-specific negotiated charge is the base starting rate. The payer-specific charges do not account for patient-specific deductibles, copay’s, or coinsurance.
  • Actual reimbursement for services is dependent on many factors, such as the length of stay, the specific medical services provided, the medications and supplies provided with the service, and other variable factors that vary by payer and pricing methodology. Payer-specific pricing in this file does not incorporate all variable factors. 
  • Payer-specific pricing does not include all alternate rates for claims which may have additional or unexpected services. 
  • Comparisons of rates within the file between payers or comparison of files between hospitals will not necessarily reflect accurate distinctions in prices due to variations in pricing methodology.
  • Services that do not have payer-specific pricing may reflect services that are not reimbursed outside of a bundled/case payment.
  • Pricing does not include charges for all physician services or other professional services that may be rendered.
  • Not all services listed in this file may be currently available at the hospital.

Gross charges and payer-specific negotiated charges are accurate as of the time this file was published. Updates are made throughout the year and may not be reflected in this file.

Terminology

  • “Gross Charge” is the charge for an individual item or service that is reflected on the hospital's chargemaster, absent any discounts.
  • “Discounted Cash Price” is the charge that applies to an individual who pays cash (or cash equivalent) for a hospital item or service.
  • “Payer-specific negotiated charge” is the reimbursement rate that the hospital has negotiated with a third-party payer for an item or service.
  • “De-Identified Maximum Negotiated Charge” is the highest reimbursement rate that a hospital has negotiated with all third-party payers for an item or service.
  • “De-Identified Minimum Negotiated Charge” is the lowest reimbursement rate that a hospital has negotiated with all third-party payers for an item or service.

Financial assistance

Virginia Mason encourages you to apply for financial assistance if you need help paying your charges. We provide financial assistance to eligible patients in keeping with federal and state law. Applications are available from Financial Navigator staff located at our Seattle and Federal Way Medical Centers.