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Patient Price Information List

Disclaimer: Ed Fraser Memorial Hospital determines its standard charges for patient items and services through the use of a chargemaster system, which is a list of charges for the components of patient care that go into every patient’s bill. These are the baseline rates for items and services provided at the Hospital. The chargemaster is similar in concept to the manufacturer’s suggested retail price (“MSRP”) on a particular product or good. The charges listed provide only a general starting point in determining the potential costs of an individual patient’s care at the Hospital. This list does not reflect the actual out-of-pocket costs that may be paid by a patient for any particular service, it is not binding, and the actual charges for items and services may vary.

Many factors may influence the actual cost of an item or service, including insurance coverage, rates negotiated with payors, and so on. Government payors, such as Medicare and Medicaid for example, do not pay the chargemaster rates, but rather have their own set rates that hospitals are obligated to accept. Commercial insurance payments are based on contract negotiations with payors and may or may not reflect the standard charges. The cost of treatment also may be impacted by variables involved in a patient’s actual care, such as specific equipment or supplies required, the length of time spent in surgery or recovery, additional tests, or any changes in care or unexpected conditions or complications that arise. Moreover, the foregoing list of charges for services only includes charges from the Hospital. It does not reflect the charges for physicians, such as the surgeon, anesthesiologist, radiologist, pathologist, or other physician specialists or providers who may be involved in providing particular services to a patient. These charges are billed separately.

Individuals with questions about their out-of-pocket costs of service and other financial information should contact the hospital or consider contacting their insurers for further information.

LOCAL MARKET HOSPITALS

In order to present a meaningful comparison, Ed Fraser Memorial Hospital has partnered with Hospital Pricing Specialists LLC to analyze current charges, based off CMS adjudicated claims through 3/31/2020. Ed Fraser Memorial Hospital charges are displayed and compared with the local market charge, consisting of the following hospitals:

Hospital Name
Location

Ascension St. Vincent's Clay County Hospital

Middleburg

FL

Ascension St. Vincent's Riverside Hospital

Jacksonville

FL

Baptist Medical Center Jacksonville

Jacksonville

FL

Baptist Medical Center Nassau

Fernandina Beach

FL

Lake Butler Hospital

Lake Butler

FL

Lake City Medical Center

Lake City

FL

Mayo Clinic Hospital in Florida

Jacksonville

FL

Orange Park Medical Center

Orange Park

FL

Shands Lake Shore Regional Medical Center

Lake City

FL

Shands Starke Medical Center

Starke

FL

UF Health Jacksonville

Jacksonville

FL

INPATIENT ROOM AND BOARD DAILY CHARGES

Description

Our Charge
Market Charge

Variance

Private Room

$817
$2,679

70% lower than market

Semi-Private Room

$660
$2,432

73% lower than market

OUTPATIENT EMERGENCY DEPARTMENT CHARGES

Emergency Department charges are based on the level of emergency care provided to our patients. The levels, with Level 1 representing basic emergency care, reflect the type of accommodations needed, the personnel resources, the intensity of care and the amount of time needed to provide treatment. The following charges do not include fees for drugs, supplies or additional ancillary procedures that may be required for a particular emergency treatment. They also do not include fees for Emergency Department physicians, who will bill separately for their services.

Description

Our Charge
Market Charge

Variance

Emergency Department Visit - Level 1

$397
$503

21% lower than market

Emergency Department Visit - Level 2

$653
$939

30% lower than market

Emergency Department Visit - Level 3

$1,032
$1,460

29% lower than market

Emergency Department Visit - Level 4

$1,864
$2,281

18% lower than market

Emergency Department Visit - Level 5

$2,643
$3,517

25% lower than market

Emergency Critical Care, First 30 Minutes

$3,665
$4,600

20% lower than market

OUTPATIENT PHYSICAL THERAPY CHARGES

The following charges reflect the most common services offered by our Physical Therapy department. Patients may have additional charges, depending on the services performed.

Description

Our Charge
Market Charge

Variance

Application of Electrical Stimulation - 15 Minutes

$118
$221

46% lower than market

Gait Training - 15 Minutes

$70
$189

63% lower than market

PT Evaluation - Moderate Complexity

$160
$487

67% lower than market

PT to Re-Educate Brain to Muscle Function (15 min)

$70
$183

62% lower than market

Physical Therapy 1 or More Regions (15 min)

$118
$222

47% lower than market

Physical Therapy Exercise, 15 Minutes

$70
$226

69% lower than market

Physical Therapy, complex evaluation

$173
$541

68% lower than market

Physical Therapy, re-evaluation

$97
$248

61% lower than market

Physical Therapy, standard evaluation - 20 minutes

$148
$435

66% lower than market

OUTPATIENT OCCUPATIONAL THERAPY CHARGES

The following charges reflect the most common services offered by our Occupational Therapy department. Patients may have additional charges, depending on the services performed.

Description

Our Charge
Market Charge

Variance

Occupational Therapy Evaluation - Moderate Complexity

$160
$492

67% lower than market

Occupational Therapy, standard evaluation - 30 minutes

$148
$451

67% lower than market

Self Care - Home Management Training - 15 Minutes

$99
$216

54% lower than market

Therapeutic Activities Involving Functional Activities (15 min)

$98
$196

50% lower than market

OUTPATIENT PULMONARY THERAPY CHARGES

The following charges reflect the most common services offered by our Pulmonary Therapy department. Patients may have additional charges, depending on the services performed.

Description

Our Charge
Market Charge

Variance

Aerosol Treatment

$142
$239

41% lower than market

Holter Testing - 48-Hour EKG

$461
$1,204

62% lower than market

Routine EKG - Minimum 12 Leads

$180
$524

66% lower than market

Spirometry - medicated breathing procedure

$510
$1,241

59% lower than market

Stress Test with EKG tracing

$1,174
$2,106

44% lower than market

OUTPATIENT SPEECH THERAPY CHARGES

Description

Our Charge
Market Charge

Variance

Speech Therapy

$106
$421

75% lower than market

Swallow Evaluation

$148
$708

79% lower than market

Swallow Treatment

$117
$382

69% lower than market

OUTPATIENT LABORATORY AND PATHOLOGY CHARGES

The following charges reflect our most common laboratory procedures. For all lab specimens collected via blood draw, the venipuncture will be charged separately.

Description

Our Charge
Market Charge

Variance

Acute hepatitis panel

$387
$356

9% higher than market

Ammonia level

$136
$218

38% lower than market

Amylase (enzyme) level

$98
$215

54% lower than market

Arterial Blood Gases Measurement

$247
$385

36% lower than market

Bacterial Blood Culture

$199
$333

40% lower than market

Bacterial Culture, Any Source Except Urine, Blood, or Stool

$220
$398

45% lower than market

Bacterial urine culture; quantitative colony count

$163
$292

44% lower than market

Blood Typing, ABO

$50
$73

32% lower than market

Blood Typing, Rh (D)

$50
$76

34% lower than market

Blood glucose (sugar) level

$96
$109

12% lower than market

Blood potassium level

$82
$106

22% lower than market

Blood sodium level

$49
$51

5% lower than market

Blood test, basic group of blood chemicals

$263
$346

24% lower than market

Blood test, clotting time

$103
$121

15% lower than market

Blood test, comprehensive group of blood chemicals

$267
$485

45% lower than market

Blood test, lipids (cholesterol and triglycerides)

$181
$313

42% lower than market

Blood test, thyroid stimulating hormone (TSH)

$110
$334

67% lower than market

Calcium level

$91
$102

11% lower than market

Carboxyhemoglobin

$112
$100

11% higher than market

Carcinoembryonic antigen (CEA) protein level

$123
$146

16% lower than market

Coagulation function measurement; qualitative

$85
$143

41% lower than market

Complete blood cell count - automated differential WBC count

$113
$116

3% lower than market

Complete blood cell count - automated test with out Differential

$102
$170

40% lower than market

Cortisol Measurement

$122
$120

2% higher than market

Creatine kinase Level (cardiac enzyme) - Total

$136
$193

30% lower than market

Creatine kinase level (cardiac enzyme) - Muscle/Brain

$132
$262

50% lower than market

Creatinine level to test for kidney function or muscle injury

$207
$212

2% lower than market

Cyanocobalamin (vitamin B-12) level

$123
$138

11% lower than market

Detection test for clostridium difficile toxins (stool pathogen)

$174
$163

7% higher than market

Digoxin level

$102
$159

36% lower than market

Drug test(s); includes specimen validity testing, per day; 8-14 drug class(es)

$163
$709

95% lower than market

Estradiol (hormone) level

$404
$174

132% higher than market

Ferritin (blood protein) level

$89
$161

45% lower than market

Folic acid; serum

$145
$134

8% higher than market

Glutamyltransferase (liver enzyme) level

$48
$119

60% lower than market

Hemoglobin A1C level

$72
$134

46% lower than market

Hemoglobin Measurement

$46
$77

40% lower than market

Hepatitis C Antibody Measurement

$99
$134

26% lower than market

Iron Binding Capacity

$86
$216

60% lower than market

Iron level

$58
$107

46% lower than market

Ketone bodies analysis, qualtitative

$99
$192

48% lower than market

Kidney Function Blood Test Panel

$263
$306

14% lower than market

Lactate dehydrogenase (enzyme) level

$91
$155

41% lower than market

Lactic acid level

$103
$149

31% lower than market

Lipase (fat enzyme) level

$83
$248

66% lower than market

Liver enzyme (SGOT), level

$46
$139

67% lower than market

Liver enzyme (SGPT), level

$46
$125

63% lower than market

Liver function blood test panel

$320
$319

Approximately equal to market

Magnesium Level

$141
$146

3% lower than market

Measurement C-reactive protein

$62
$146

58% lower than market

Measurement of antibody (IgE) to allergic substance

$22
$37

41% lower than market

Natriuretic peptide (heart and blood vessel protein) level

$348
$304

15% higher than market

PSA (prostate specific antigen) measurement

$109
$214

49% lower than market

PSA Measurement; Free

$96
$60

59% higher than market

Parathormone

$278
$301

8% lower than market

Coagulation assessment blood test

$116
$199

41% lower than market

Pathology examination of tissue using a microscope, intermediate complexity

$160
$475

66% lower than market

Phenytoin level

$163
$261

37% lower than market

Phosphate level

$52
$121

57% lower than market

Prostate Cancer Screening Test

$105
$151

30% lower than market

Protein Measurement, Serum

$117
$117

1% higher than market

Red Blood Cell Concentration Measurement

$46
$66

30% lower than market

Red blood cell sedimentation rate, to detect inflammation; non-automated

$77
$199

61% lower than market

Red blood count, automated test

$46
$184

75% lower than market

Rheumatoid factor level

$64
$71

11% lower than market

Special stained specimen slides to examine tissue including interpretation and report

$74
$201

63% lower than market

Stool culture - salmonella and shigella species

$193
$394

51% lower than market

Strep Test

$67
$104

36% lower than market

Syphilis Detection Test

$66
$107

37% lower than market

Testosterone (hormone) level

$180
$175

3% higher than market

Thyroid Hormone, T3 Measurement, Free

$66
$113

42% lower than market

Thyroid hormone, T3 measurement - Total

$118
$148

22% lower than market

Thyroxine (thyroid chemical) measurement - Free Thyroxine

$142
$128

11% higher than market

Thyroxine (thyroid chemical) measurement - Total

$65
$228

72% lower than market

Tissue or Cell Analysis by Immunologic Technique

$188
$309

39% lower than market

Total Protein Level, Urine

$86
$117

26% lower than market

Troponin (protein) analysis

$181
$190

5% lower than market

Uric acid level, blood

$52
$182

71% lower than market

Urinalysis with Examination, using Microscope

$103
$213

52% lower than market

Valproic acid level

$97
$208

53% lower than market

OUTPATIENT MEDICINE CHARGES

Description

Our Charge
Market Charge

Variance

Determination of lung volumes using gas dilution or washout

$426
$1,130

62% lower than market

Heart rhythm analysis, interpretation and report of 48-hour EKG

$461
$982

53% lower than market

Hydration Infusion into a Vein

$61
$192

68% lower than market

Infusion (Additional) for Therapy, Diagnosis or Prevention

$180
$287

37% lower than market

Infusion into a Vein for Therapy, Diagnosis, or Prevention

$55
$193

72% lower than market

Infusion of Drug or Substance into Vein for Therapy or Diagnosis

$212
$829

74% lower than market

Injection Beneath the Skin for Therapy, Diagnosis, or Prevention

$80
$227

65% lower than market

Injection of Same Drug into Vein for Therapy or Diagnosis

$80
$253

68% lower than market

Multiple measurements of oxygen saturation in blood using ear or finger device

$159
$219

27% lower than market

Sleep Monitoring with CPAP

$3,090
$5,965

48% lower than market

Sleep monitoring of patient (6 years or older) in sleep lab

$2,719
$5,887

54% lower than market

Training in use of orthotics (supports, braces, or splints) for arms, legs and/or trunk each 15 minu

$67
$205

67% lower than market

Vein Infusion for Therapy, Prevention or Diagnosis, Concurrent with Another Infusion

$109
$400

73% lower than market

OUTPATIENT OBSERVATION CHARGES

Description

Our Charge
Market Charge

Variance

Hospital Observation per Hour

$224
$129

72% lower than market

OUTPATIENT OTHER CHARGES

Description

Our Charge
Market Charge

Variance

Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation

$272
$798

66% lower than market

Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml

$17
$14

669% higher than market

OUTPATIENT PHARMACY AND DRUG ADMINISTRATION CHARGES

Description

Our Charge
Market Charge

Variance

Administration of 1 Vaccine

$177
$199

11% lower than market

Injection of Drug or Substance into Vein for Therapy or Diagnosis

$80
$459

76% lower than market

Injection of New Drug into Vein for Therapy or Diagnosis

$80
$375

79% lower than market

Injection, Adrenalin, Epinephrine, 0.1 mg

$36
$11

241% higher than market

Injection, Cefazolin Sodium, 500 mg

$40
$56

28% lower than market

Injection, Dexamethasone Sodium Phosphate, 1 mg

$6
$13

53% lower than market

Injection, Diphenhydramine HCL, up to 50 mg

$32
$74

57% lower than market

Injection, Fentanyl Citrate, 0.1 mg

$38
$75

62% lower than market

Injection, Furosemide, up to 20 mg

$34
$40

15% lower than market

Injection, Heparin Sodium, per 1000 Units

$49
$46

7% higher than market

Injection, Levofloxacin, 250 mg

$39
$97

59% lower than market

Injection, Metoclopramide HCL, Up to 10mg

$34
$71

61% lower than market

Injection, Midazolam Hydrochloride, per 1 mg

$37
$43

15% lower than market

Injection, Ondansetron Hydrochloride, per 1 mg

$28
$24

14% higher than market

Injection, Vancomycin HCL, 500 mg

$54
$81

64% lower than market

Injection, acetaminophen, 10 mg

$64
$2

2978% higher than market

Injection, amiodarone hydrochloride, 30 mg

$29
$20

48% higher than market

Injection, calcium gluconate, per 10 ml

$45
$44

4% higher than market

Injection, denosumab, 1 mg

$45
$83

45% lower than market

Injection, ertapenem sodium, 500 mg

$343
$256

34% higher than market

Injection, ferric carboxymaltose, 1mg

$2,294
$7

33115% higher than market

Injection, hydrocortisone sodium succinate, up to 100 mg

$54
$90

41% lower than market

Injection, oritavancin, 10 mg

$2,129
$182

1067% higher than market

Injection, regadenoson, 0.1 mg

$147
$358

59% lower than market

Ringers lactate infusion, up to 1000 cc

$42
$189

78% lower than market

Tetanus Vaccine

$117
$179

34% lower than market

OUTPATIENT RESPIRATORY THERAPY CHARGES

The following charges reflect the most common services offered by our Respiratory Therapy department. Patients may have additional charges, depending on the services performed.

Description

Our Charge
Market Charge

Variance

CO Diffusion Capacity

$426
$805

47% lower than market

Nebulizer Treatment

$487
$255

91% higher than market

OUTPATIENT SURGICAL SERVICES CHARGES

Description

Our Charge
Market Charge

Variance

Biopsy of Large Bowel, Using an Endoscope

$3,003
$5,144

42% lower than market

Biopsy of the Esophagus, Stomach, Using an Endoscope

$2,878
$4,626

100% lower than market

Bunionectomy

$4,834
$21,298

100% lower than market

Colonoscopy on High Cancer Risk Patient

$2,689
$4,475

100% lower than market

Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps

$3,003
$4,387

100% lower than market

Colonscopy

$2,794
$4,435

100% lower than market

Colorectal Cancer Screening; Colonoscopy on Non-High Risk Patient

$2,689
$4,435

100% lower than market

Diagnostic Examination of Esophagus, Stomach, and/or Upper Small Bowel with Endoscope

$5,372
$4,259

100% lower than market

Diagnostic examination of large bowel using an endoscope

$1,306
$4,042

100% lower than market

Drainage of blood or fluid accumulation

$5,630
$7,414

24% lower than market

Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic balloon dilation of esophagus (less than 30 mm diameter)

$3,003
$6,672

55% lower than market

Removal of cataract with insertion of lens

$1,289
$9,891

87% lower than market

Incision of joint capsule of foot and toe

$1,117
$5,388

79% lower than market

Incision of toe joint capsule

$1,117
$5,225

79% lower than market

Incision to improve eye fluid flow

$1,289
$5,441

76% lower than market

Incision to straighten toe bone; any toe

$4,143
$3,910

6% higher than market

Incision to straighten toe bone; first metatarsal

$2,682
$11,725

77% lower than market

Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography

$1,089
$3,851

72% lower than market

Injection(s) of joint with fluoroscopy or CT; lumbar or sacral; second level

$352
$1,749

80% lower than market

Insertion of Breathing Tube Using an Endoscope

$894
$1,588

44% lower than market

Insertion of Needle into Vein to Collect Blood

$15
$34

56% lower than market

Insertion of catheter for suction of secretions

$138
$266

48% lower than market

Insertion of stomach tube using an endoscope

$3,699
$6,186

40% lower than market

Lumbar Joint Injection

$1,089
$2,235

51% lower than market

Open treatment of broken of lower forearm bone or growth plate separation with insertion of hardware

$6,634
$15,656

58% lower than market

Open treatment of broken upper arm bone; includes internal fixation

$13,705
$31,021

56% lower than market

Open treatment of distal fibular fracture

$5,160
$12,979

60% lower than market

Colonoscopy with removal of polyp(s)

$4,227
$4,620

9% lower than market

Removal of foot bone spur

$4,143
$7,990

48% lower than market

Removal of growth (1.1 to 2.0 centimeters) of the scalp, neck, hands, feet, or genitals

$3,453
$12,919

73% lower than market

Removal of malignant growth (1.1 to 2.0 centimeters) of the scalp, neck, hands, feet, or genitals

$1,668
$3,579

53% lower than market

Removal of polyps or growths of esophagus, stomach, and/or upper small bowel using an endoscope; with hot biopsy forceps; snare technique

$3,003
$6,296

52% lower than market

Repair of fibrous tissue of foot using an endoscope

$3,453
$6,253

45% lower than market

Repair of wound (2.6 to 7.5 centimeters) of eyelids, nose, ears, and/or lips

$1,668
$2,415

31% lower than market

Repair of wound (2.6 to 7.5 centimeters) of the scalp, underarms, trunk, arms, and/or legs

$1,251
$3,432

64% lower than market

OUTPATIENT X-RAY AND RADIOLOGICAL CHARGES

The following charges reflect our most common x-ray and radiological procedures. For all exams requiring contrast, the contrast will be charged separately.

Description

Our Charge
Market Charge

Variance

3 Phase Bone Scan

$1,496
$3,127

52% lower than market

Bone Density Scan (DEXA Scan)

$591
$1,188

50% lower than market

Breast Ultrasound - Complete

$434
$1,259

66% lower than market

Breast Ultrasound - Limited

$645
$683

6% lower than market

CT Abdomen & Pelvis with Contrast

$4,945
$5,503

10% lower than market

CT Abdomen & Pelvis with and without Contrast

$5,160
$6,905

25% lower than market

CT Abdomen & Pelvis without Contrast

$4,391
$4,915

11% lower than market

CT Abdomen with Contrast

$2,473
$4,039

39% lower than market

CT Abdomen with and without Contrast

$2,473
$4,947

50% lower than market

CT Abdomen without Contrast

$2,172
$3,780

43% lower than market

CT Angiogram Abdomen with and without Contrast

$2,538
$4,694

46% lower than market

CT Angiogram Chest with and without Contrast

$2,528
$4,274

41% lower than market

CT Angiogram Head with and without Contrast

$2,523
$4,806

48% lower than market

CT Angiogram Neck with and without Contrast

$2,523
$4,850

48% lower than market

CT Arm without Contrast

$1,836
$3,162

42% lower than market

CT Chest with Contrast

$2,341
$4,090

43% lower than market

CT Chest with and without Contrast

$2,459
$4,292

43% lower than market

CT Chest without Contrast

$2,064
$3,348

38% lower than market

CT Cranial Cavity without Contrast

$1,886
$4,017

53% lower than market

CT Face with Contrast

$2,794
$3,684

24% lower than market

CT Face without Contrast

$2,806
$3,410

20% lower than market

CT Head Brain with and without Contrast

$2,334
$4,392

47% lower than market

CT Head Brain without Contrast

$1,886
$3,350

44% lower than market

CT Leg with Contrast

$2,070
$3,475

40% lower than market

CT Leg without Contrast

$1,856
$3,140

41% lower than market

CT Neck with Contrast

$2,211
$3,985

45% lower than market

CT Neck with and without Contrast

$2,438
$4,703

48% lower than market

CT Neck without Contrast

$1,766
$3,339

47% lower than market

CT Pelvis with Contrast

$2,473
$4,055

39% lower than market

CT Pelvis without Contrast

$2,220
$3,635

39% lower than market

CT Scan of Abdominal Aorta and Both Leg Arteries with Contrast

$1,985
$5,898

66% lower than market

CT Spine Cervical without Contrast

$1,800
$3,398

47% lower than market

CT Spine Lumbar without Contrast

$1,902
$3,355

43% lower than market

CT Spine Thoracic without Contrast

$1,820
$3,268

44% lower than market

CT scan of heart blood vessels and grafts with contrast dye

$1,985
$3,290

40% lower than market

CT scan of lower leg blood vessels with contrast

$2,528
$6,466

61% lower than market

Chest X-Ray; 2 Views

$375
$551

32% lower than market

Chest X-Ray; Single View

$346
$359

3% lower than market

Diagnostic mammography, bilateral

$342
$499

31% lower than market

Imaging guidance for procedure, up to 1 hour

$523
$846

38% lower than market

Imaging of Abdomen and Chest

$729
$1,057

31% lower than market

Imaging of Abdomen; 2 Views

$508
$655

22% lower than market

Imaging of Abdomen; Single View

$346
$409

15% lower than market

Imaging of Liver and Bile Duct System with Use of Drugs

$1,790
$3,298

46% lower than market

Imaging of Liver and Bile Duct System without Use of Drugs

$1,753
$3,482

50% lower than market

Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries

$699
$942

26% lower than market

MRI Arm Joint without Contrast

$3,180
$5,081

37% lower than market

MRI Arm without Contrast

$3,180
$3,968

20% lower than market

MRI Brain with and without Conrast

$5,026
$4,950

2% higher than market

MRI Brain without Contrast

$3,180
$4,029

21% lower than market

MRI Leg Joint without Contrast

$3,180
$4,813

34% lower than market

MRI Leg without Contrast

$3,180
$3,813

17% lower than market

MRI Orbit, Face, Neck without Contrast

$3,180
$4,869

35% lower than market

MRI Spine Cervical without Contrast

$3,180
$3,844

17% lower than market

MRI Spine Lumbar with and without Contrast

$5,026
$4,872

3% higher than market

MRI Spine Lumbar without Contrast

$3,180
$3,875

18% lower than market

MRI Spine Thoracic without Contrast

$3,180
$3,862

18% lower than market

Myocardial Perfusion, Tomographic

$6,894
$7,152

4% lower than market

Nuclear Medicine Study of Lung Ventilation and Blood Circulation in the Lungs

$1,947
$3,627

48% lower than market

Parathyroid Planar Imaging

$1,358
$2,938

54% lower than market

Physical Therapy, ultrasound therapy - 15 minutes

$109
$181

41% lower than market

Screening Mammography, Bilateral, with CAD

$294
$511

42% lower than market

Stomach emptying study

$1,491
$3,058

51% lower than market

Ultrasound Abdomen - Complete

$771
$2,099

63% lower than market

Ultrasound Abdomen - Limited

$752
$1,271

41% lower than market

Ultrasound Behind Abdominal Cavity - Complete

$752
$1,541

51% lower than market

Ultrasound Blood Flow Outside the Brain

$1,184
$1,880

37% lower than market

Ultrasound Head Neck

$752
$1,165

35% lower than market

Ultrasound Heart

$2,013
$3,460

42% lower than market

Ultrasound Joint Soft Tissue - Complete

$752
$977

23% lower than market

Ultrasound Joint Soft Tissue - Limited

$485
$642

24% lower than market

Ultrasound Pelvis NonOB

$752
$1,434

48% lower than market

Ultrasound Pelvis through Vagina

$1,222
$1,152

6% higher than market

Ultrasound Pleural Effusion Chest

$729
$939

22% lower than market

Ultrasound Scrotum

$752
$1,215

38% lower than market

Ultrasound Veins of Both Arms or Legs

$1,184
$1,824

35% lower than market

Ultrasound Veins of One Arm or Leg

$752
$1,276

41% lower than market

Ultrasound examination of the heart performed during rest, exercise, and/or drug-induced stress with

$1,817
$4,340

58% lower than market

Ultrasound of Arteries of Both Legs

$1,184
$1,401

16% lower than market

Ultrasound of Arteries of One Leg

$414
$1,166

65% lower than market

Ultrasound of pelvis

$544
$863

45% lower than market

Ultrasound of transplanted kidney

$752
$875

14% lower than market

Ultrasound study of arteries and arterial grafts of one arm or limited

$414
$1,110

63% lower than market

Ultrasound study of arteries of both legs at rest and exercise

$699
$1,367

49% lower than market

Whole Body Bone Scan

$1,496
$3,683

59% lower than market

X-Ray Ankle, 2 Views

$428
$590

27% lower than market

X-Ray Ankle, 3 Views

$666
$655

2% higher than market

X-Ray Both Hips and Pelvis, 2 Views

$575
$880

35% lower than market

X-Ray Both Knees

$363
$388

7% lower than market

X-Ray Collar Bone

$693
$566

22% higher than market

X-Ray Elbow, 2 Views

$539
$546

37% lower than market

X-Ray Elbow, 3 Views

$695
$652

7% higher than market

X-Ray Fingers, 2 Views

$346
$520

33% lower than market

X-Ray Foot, 2 Views

$547
$721

24% lower than market

X-Ray Foot, 3 Views

$709
$658

8% higher than market

X-Ray Forearm, 2 Views

$671
$602

42% lower than market

X-Ray Hand, 3 Views

$565
$610

7% lower than market

X-Ray Hip and Pelvis, 2 Views

$330
$613

45% lower than market

X-Ray Knee, 1-2 Views

$722
$617

17% higher than market

X-Ray Knee, 3 Views

$435
$730

46% lower than market

X-Ray Knee, 4 or More Views

$764
$819

7% lower than market

X-Ray Lower Leg, 2 Views

$700
$624

78% lower than market

X-Ray Lower Sacral Spine, 2-3 Views

$729
$739

1% lower than market

X-Ray Lower Sacral Spine, 4 or More Views

$793
$1,147

31% lower than market

X-Ray Middle Spine, 3 Views

$428
$534

20% lower than market

X-Ray Neck Soft Tissue

$346
$475

27% lower than market

X-Ray Neck Spine, 2-3 Views

$346
$672

48% lower than market

X-Ray Pelvis, 1-2 Views

$346
$568

39% lower than market

X-Ray Pelvis, 2 Views

$382
$688

44% lower than market

X-Ray Shoulder, 2 Views

$740
$646

43% lower than market

X-Ray Toes, 2 Views

$346
$512

32% lower than market

X-Ray Upper Arm, 2 Views

$663
$578

42% lower than market

X-Ray Upper Spine, 4-5 Views

$577
$1,065

46% lower than market

X-Ray Wrist, 3 Views

$617
$633

47% lower than market

X-Ray of Middle Spine; 3 Views

$433
$624

31% lower than market

X-ray Ribs One Side, Minimum 3 Views

$448
$745

40% lower than market

X-ray of eye bones, minimum of 4 views

$503
$604

17% lower than market

X-ray of middle and lower spine, 2 views

$415
$617

35% lower than market

X-ray of paranasal sinus, complete, minimum of 3 views

$546
$890

39% lower than market

X-ray of upper spine, 6 or more views

$770
$887

13% lower than market

INPATIENT CARDIOLOGY CHARGES

Description

Our Charge
Market Charge

Variance

Heart Failure with complications

$21,804
$34,745

37% lower than market

INPATIENT MEDICINE CHARGES

Description

Our Charge
Market Charge

Variance

Nutritional or Metabolic Disorders without major complications

$18,359
$27,039

32% lower than market

INPATIENT ORTHOPEDIC SURGERY CHARGES

Description

Our Charge
Market Charge

Variance

Total Knee or Hip Replacement

$66,002
$98,966

33% lower than market

INPATIENT PULMONOLOGY CHARGES

Description

Our Charge
Market Charge

Variance

Chronic Lung Disease with major complications

$21,127
$47,802

56% lower than market

Chronic Lung Disease without complications

$17,512
$27,383

36% lower than market

Pneumonia with complications

$26,529
$39,059

32% lower than market

INPATIENT UROLOGY CHARGES

Description

Our Charge
Market Charge

Variance

Kidney & urinary Infection without complications

$18,860
$29,905

37% lower than market

BILLING PROCESS AND INFORMATION

How You Can Help

Thank you for choosing Ed Fraser Memorial Hospital for your healthcare needs. At Ed Fraser Memorial Hospital, we are committed to making the billing process as patient-friendly as possible. Here are some ways you can help the billing process go smoothly.

• Please give us complete health insurance information.

In addition to your health insurance card, we may ask for a photo ID. If you have been seen at Ed Fraser Memorial Hospital, let us know if your personal information or insurance information has changed since your last visit.

• Please understand and follow the requirements of your health plan.

Be sure to know your benefits, obtain proper authorization for services and submit referral claim forms if necessary. Many insurance plans require patients to pay a co-payment or deductible amount. You are responsible for paying co-payments required by your insurance provider and Ed Fraser Memorial Hospital is responsible for collecting co-payments. Please come to your appointment prepared to make your co-payment.

• Please respond promptly to any requests from your insurance provider.

You may receive multiple bills for your hospital visit, including your family doctor, specialists, physicians to read x-rays, give anesthesia, or do blood work. Insurance benefits are the result of your contract with your insurance company. We are a third-party to those benefits and may need your help with your insurance. If your insurance plan does not pay the bill within 90 days after billing, or your claim is denied, you will receive a statement from Ed Fraser Memorial Hospital indicating the bill is now your responsibility. All bills sent to you are due upon receipt.

Questions about Price and Billing Information

Our goal is for each of our patients and their families to have the best healthcare experience possible. Part of our commitment is to provide you with information that helps you make well informed decisions about your own care.

To ask questions or get more information about a bill for services you've received, please contact our Customer Call Center at 904-259-3151 ext. 2217.

If you need more information about the price of a future service, please contact our Price Hotline at 904-259-3151 ext. 2217. A CPT code is strongly encouraged when you call. You can obtain the CPT code from the ordering physician.

Online Registration & Scheduling

For the convenience of our patients, a number of online services are available at https://edfraserhospital.com/. Ed Fraser Memorial Hospital offers secure online registration & scheduling.

Ed Fraser Memorial Hospital also offers pre-registration and appointment requests through a secure online form at https://edfraserhospital.com/. Patients may pre-register for surgeries, admissions, outpatient procedures and tests at least three business days in advance. Patients may also pre-register for maternity services up to three months prior to their expected delivery date.

Financial Assistance

We are pleased to offer financial assistance to patients with limited resources and inadequate medical insurance coverage. Eligibility is determined by total family income/assets.

Ed Fraser Memorial Hospital's Charity Care Policy

Ed Fraser Memorial Hospital provides high quality care to everyone, regardless of their ability to pay.

Ed Fraser Memorial Hospital's charity care policy includes:

• Substantial charity care guidelines that provide free care for individuals and families who earn less than 200 percent of the federal poverty level.

In many cases, Ed Fraser Memorial Hospital offers interest free loans for up to one year to assist patients.

For more information, please contact our Customer Call Center at 904-259-3151 ext. 2217.