Hospital Pricing Transparency
Price transparency is an effort to make the necessary information available and easy to understand to help consumers compare provider costs and anticipate their own expenses.
Our Policy
People deserve meaningful information about the price of their hospital care. Lexington Medical Center is committed to sharing information that will help you make important decisions about your health care plans.
Standard Negotiated Prices
Lexington Medical Center has developed machine-readable files of the standard prices we have negotiated with third-party payors. The information provided is intended to meet the file format requirements of the Centers for Medicare & Medicaid Services (CMS).
Click below to download the file containing our Standard & Negotiated Charges
Understanding Your Charges
Understanding what you will have to pay for health care services is very complicated. Unlike most bills you receive, it is very difficult for you to determine exactly what you will have to pay for an item or service. It is even hard for your hospital to estimate prior to your care what you may be billed since every patient’s care is different and is determined after you are admitted.
Insurance Coverage
The amount of money you will be responsible for personally is generally determined by your insurance coverage or managed care company, not by the hospital. This amount is determined directly by your contract with your insurer.
The best source of information about what you will have to pay will come from your insurance company, as they are already aware of what services are covered, who they will pay to deliver the care, and the amount for they will hold you responsible to pay. Also, all doctors, hospitals or ser-vices may not be covered by your insurance plan. Unfortunately, we do not have this information available to us before you receive care from our hospital.
Medicare/Medicaid Coverage
Medicare and Medicaid pay hospitals according to a set fee schedule. Their fees represent a discount from the hospital’s billed charges. Numerous factors, such as co-insurance and deductibles, affect your own financial responsibility. A summary of Medicare patient payment requirements is provided at Medicare.gov. Lexington Medical Center wants to provide the care that you need, when you need it, delivered at the highest quality possible, at the most affordable price possible.
Estimating Your Charges
We offer an online tool that includes 300 shoppable services that will help you estimate the hospital fee for your inpatient or outpatient care at our hospital.
Click on the link below to request an estimate
This is a third-party link provided by Experian™ for convenience only. Lexington Medical Center accepts no liability arising out of the use of such third-party links.
Estimates are:
- Available for 300 services and procedures.
- Good for 30 days
- Not a complete estimate of your care cost.
Your actual charges may be different from the estimated charges. This depends on the services you receive, and the coverage provided by your insurance plan(s).
If you need an estimate for a service or procedure that is not on this third-party link, please contact one of our financial counselors at (803) 791-2490 for assistance.
Disclaimer
This information is intended to meet the requirements of The Centers for Medicare & Medicaid Services (CMS) final inpatient prospective payment system (IPPS) for federal fiscal year 2021. The IPPS rule contains a transparency provision that was effective January 1, 2021.
Prices may not reflect the most current charge items or charge amounts of Lexington Medical Center, as additions and changes are frequently made to the listing. These charges may not represent the charges you will receive on your bill for provided services. CMS requires hospitals to update charge data at least annually.
