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Patient Price Information List

Disclaimer: Hampton Regional Medical Center 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, Hampton Regional Medical Center has partnered with Hospital Pricing Specialists LLC to analyze current charges, based off CMS adjudicated claims through 3/31/2020. Hampton Regional Medical Center's charges are displayed and compared with the local market charge, consisting of the following hospitals:

Hospital Name
Location

Abbeville Area Medical Center

Abbeville

SC

Allendale County Hospital

Fairfax

SC

Beaufort Memorial Hospital

Beaufort

SC

Coastal Carolina Hospital

Hardeeville

SC

Colleton Medical Center

Walterboro

SC

Edgefield County Hospital

Edgefield

SC

MUSC Health University Hospital

Charleston

SC

INPATIENT ROOM AND BOARD DAILY CHARGES

Description

Our Charge
Market Charge

Variance

Private Room

$947
$1,383

32% lower than market

Intensive Care Unit

$1,735
$3,840

55% 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

$237
$306

23% lower than market

Emergency Department Visit - Level 2

$327
$450

27% lower than market

Emergency Department Visit - Level 3

$573
$727

21% lower than market

Emergency Department Visit - Level 4

$881
$1,159

24% lower than market

Emergency Department Visit - Level 5

$1,308
$1,833

29% lower than market

Emergency Critical Care, Each Additional 30 Minutes

$495
$1,213

59% lower than market

Emergency Critical Care, First 30 Minutes

$1,955
$3,158

38% 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

$95
$128

26% lower than market

Gait Training - 15 Minutes

$77
$117

34% lower than market

PT Evaluation - Moderate Complexity

$150
$311

52% lower than market

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

$92
$121

24% lower than market

Physical Therapy 1 or More Regions (15 min)

$114
$156

27% lower than market

Physical Therapy Exercise, 15 Minutes

$105
$132

21% lower than market

Physical Therapy, complex evaluation

$175
$334

48% lower than market

Physical Therapy, re-evaluation

$188
$190

1% lower than market

Physical Therapy, standard evaluation - 20 minutes

$125
$272

54% 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

Self Care - Home Management Training - 15 Minutes

$88
$124

29% lower than market

Therapeutic Activities Involving Functional Activities (15 min)

$92
$136

32% 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

CPAP Initiation & Management

$300
$660

55% lower than market

Routine EKG - Minimum 12 Leads

$260
$281

8% lower than market

Spirometry - breathing test

$253
$292

13% lower than market

Spirometry - medicated breathing procedure

$422
$713

41% lower than market

Stress Test with EKG tracing

$960
$1,417

32% 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

Ammonia level

$122
$165

26% lower than market

Amylase (enzyme) level

$113
$172

34% lower than market

Arterial Blood Gases Measurement

$188
$226

17% lower than market

Bacterial Blood Culture

$141
$268

47% lower than market

Bacterial Culture for Aerobic Isolates

$108
$156

31% lower than market

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

$141
$181

22% lower than market

Bacterial urine culture

$66
$150

56% lower than market

Bacterial urine culture; quantitative colony count

$108
$99

10% higher than market

Beta-2 microglobulin (protein) level

$108
$109

1% lower than market

Bilirubin level (Direct)

$61
$90

32% lower than market

Blood Typing, Rh (D)

$55
$71

22% lower than market

Blood Unit Compatibility Test; Antiglobulin Technique

$143
$215

33% lower than market

Blood Unit Compatibility Test; Immediate Spin Technique

$133
$214

38% lower than market

Blood creatinine level

$54
$76

29% lower than market

Blood gases measurement

$235
$404

42% lower than market

Blood potassium level

$32
$66

52% lower than market

Blood test, basic group of blood chemicals

$147
$173

15% lower than market

Blood test, clotting time

$70
$95

26% lower than market

Blood test, comprehensive group of blood chemicals

$252
$254

1% lower than market

Blood test, lipids (cholesterol and triglycerides)

$186
$175

6% higher than market

Blood test, thyroid stimulating hormone (TSH)

$175
$220

21% lower than market

Carcinoembryonic antigen (CEA) protein level

$151
$166

9% lower than market

Coagulation Function Measurement; D-dimer; quantitative

$210
$244

14% lower than market

Complete blood cell count - automated differential WBC count

$141
$117

21% higher than market

Complete blood cell count - automated test with out Differential

$90
$113

20% lower than market

Cortisol Measurement

$151
$213

29% lower than market

Creatine kinase level (cardiac enzyme) - Muscle/Brain

$120
$117

2% higher than market

Creatinine level to test for kidney function or muscle injury

$69
$90

23% lower than market

Ferritin (blood protein) level

$153
$171

11% lower than market

Hemoglobin A1C level

$95
$148

36% lower than market

Hemoglobin Measurement

$38
$61

38% lower than market

Homocysteine (amino acid) level

$233
$236

1% lower than market

Iron Binding Capacity

$66
$84

21% lower than market

Iron level

$69
$95

27% lower than market

Kidney Function Blood Test Panel

$136
$142

4% lower than market

Lactic acid level

$100
$120

16% lower than market

Lipase (fat enzyme) level

$102
$145

29% lower than market

Liver function blood test panel

$179
$183

2% lower than market

Magnesium Level

$53
$93

43% lower than market

Manual urinalysis test with examination using microscope

$29
$45

35% lower than market

Measurement C-reactive protein

$133
$130

2% higher than market

Natriuretic peptide (heart and blood vessel protein) level

$239
$222

8% higher than market

PSA (prostate specific antigen) measurement

$190
$192

1% lower than market

PSA Measurement; Free

$112
$185

39% lower than market

Coagulation assessment blood test

$87
$101

14% lower than market

Phosphate level

$37
$67

45% lower than market

Prostate Cancer Screening Test

$127
$163

22% lower than market

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

$78
$86

9% lower than market

Red blood count, automated test

$60
$66

9% lower than market

Screening Test for Red Blood Cell Antibodies

$106
$225

53% lower than market

Screening test for Pathogenic Organisms

$137
$189

28% lower than market

Stool culture - salmonella and shigella species

$250
$283

12% lower than market

Strep Test

$111
$162

31% lower than market

Testosterone (hormone) level

$203
$253

20% lower than market

Thyroxine (thyroid chemical) measurement - Total

$84
$125

33% lower than market

Total protein level, blood

$68
$75

9% lower than market

Transferrin (iron binding protein) level

$82
$105

22% lower than market

Troponin (protein) analysis

$164
$213

23% lower than market

Urea nitrogen level to assess kidney function

$45
$93

52% lower than market

Uric acid level, blood

$45
$97

53% lower than market

Urinalysis with Examination, using Microscope

$84
$109

23% lower than market

Urinalysis, Automated Test

$43
$66

35% lower than market

Urinalysis, Manual Test

$56
$30

87% higher than market

Urine Pregnancy Test

$136
$173

21% lower than market

Urine microalbumin (protein) level

$65
$99

35% lower than market

Vitamin D-3 Level

$147
$198

26% lower than market

OUTPATIENT MEDICINE CHARGES

Description

Our Charge
Market Charge

Variance

Application of medication through skin using electrical current, each 15 minutes

$121
$149

19% lower than market

Infusion (Additional) for Therapy, Diagnosis or Prevention

$248
$317

22% lower than market

Infusion of Drug or Substance into Vein for Therapy or Diagnosis

$493
$453

9% higher than market

Infusion of different chemotherapy drug or substance into a vein up to 1 hour

$248
$244

2% higher than market

Injection Beneath the Skin for Therapy, Diagnosis, or Prevention

$151
$186

19% lower than market

Irrigation of implanted venous access drug delivery device

$151
$243

38% lower than market

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

$3,671
$4,228

13% lower than market

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

$248
$227

9% higher than market

OUTPATIENT OBSERVATION CHARGES

Description

Our Charge
Market Charge

Variance

Hospital Observation per Hour

$21
$53

61% lower than market

OUTPATIENT PHARMACY AND DRUG ADMINISTRATION CHARGES

Description

Our Charge
Market Charge

Variance

Administration of 1 Vaccine

$59
$92

36% lower than market

Cyclophosphamide, 100 mg

$225
$267

16% lower than market

Injection of New Drug into Vein for Therapy or Diagnosis

$254
$234

8% higher than market

Injection, Cefazolin Sodium, 500 mg

$15
$19

24% lower than market

Injection, Magnesium Sulfate, per 500 mg

$58
$54

8% higher than market

Injection, Metoclopramide HCL, Up to 10mg

$29
$28

3% higher than market

Injection, Morphine Sulfate, up to 10 mg

$29
$54

46% lower than market

Injection, Piperacillin Sodium/Tazobactam (1.125 grams)

$14
$45

69% lower than market

Injection, Promethazine HCL, up to 50 mg

$29
$42

31% lower than market

Injection, Vancomycin HCL, 500 mg

$58
$74

22% lower than market

Injection, azacitidine, 1 mg

$8
$14

38% lower than market

Injection, bevacizumab, 10 mg

$244
$250

2% lower than market

Injection, denosumab, 1 mg

$55
$62

11% lower than market

Injection, elotuzumab, 1 mg

$19
$30

37% lower than market

Injection, fosaprepitant, 1 mg

$6
$6

9% higher than market

Injection, tenecteplase, 1 mg

$7,456
$9,967

25% lower than market

Tetanus Vaccine

$127
$159

20% 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

Arterial Puncture

$131
$136

4% lower than market

Nebulizer Treatment

$233
$311

25% lower than market

Pulse Oximetry

$70
$106

34% lower than market

OUTPATIENT SURGICAL SERVICES CHARGES

Description

Our Charge
Market Charge

Variance

Alignment of knee joint under anesthesia

$1,579
$2,834

44% lower than market

Application of Short Arm Splint

$244
$417

41% lower than market

Application of Short Leg Splint (Calf to Foot)

$169
$385

56% lower than market

Application of chemical agent to excessive wound tissue

$190
$590

68% lower than market

Application of long arm splint (shoulder to hand)

$266
$409

35% lower than market

Application of long leg splint (thigh to ankle or toes)

$141
$610

77% lower than market

Application of moveable, hinged short arm splint (forearm to hand)

$244
$262

7% lower than market

Application of non-moveable, hinged finger splint

$242
$352

31% lower than market

Aspiration and/or injection: intermediate joint/bursa

$376
$374

1% higher than market

Aspiration and/or injection: large joint/bursa

$440
$734

40% lower than market

Aspiration and/or injection: small joint/bursa

$333
$1,469

77% lower than market

Aspiration of abscess, blood accumulation, blister, or cyst

$389
$670

42% lower than market

Avulsion of nail plate, partial or complete, simple; each additional nail plate

$804
$990

19% lower than market

Avulsion of nail plate, partial or complete, simple; single

$211
$747

72% lower than market

Biopsy of Large Bowel, Using an Endoscope

$789
$3,525

78% lower than market

Biopsy of breast accessed throught the skin with ultrasound guidance; first lesion

$1,650
$2,220

26% lower than market

Biopsy of the Esophagus, Stomach, Using an Endoscope

$1,579
$3,653

57% lower than market

Biopsy or removal of lymph nodes, open procedure

$3,153
$10,591

70% lower than market

Carpal Tunnel Release

$3,153
$4,843

35% lower than market

Closed treatment of ankle dislocation

$318
$898

65% lower than market

Closed treatment of broken ankle with manipulation, bimalleolar ankle fracture

$1,689
$4,613

63% lower than market

Closed treatment of broken ankle with manipulation, distal fibular fracture

$800
$1,097

27% lower than market

Closed treatment of broken great toe with manipulation

$352
$448

21% lower than market

Closed treatment of broken or growth plate separate of forearm bone at wrist with manipulation

$1,689
$2,147

21% lower than market

Closed treatment of dislocated finger joint with manipulation

$355
$792

55% lower than market

Closed treatment of dislocated finger joint with manipulation under anesthesia

$738
$1,530

52% lower than market

Closed treatment of dislocated hand joint with manipulation

$707
$1,044

32% lower than market

Closed treatment of distal radial fracture; without manipulation

$616
$595

4% higher than market

Closed treatment of nasal cartilage dividing nasal passages

$2,751
$3,827

28% lower than market

Closed treatment of shoulder dislocation with manipulation under anesthesia

$1,689
$1,716

2% lower than market

Collection of blood specimen from a completely implantable venous access device

$131
$133

1% lower than market

Colonoscopy on High Cancer Risk Patient

$1,579
$3,471

54% lower than market

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

$2,366
$3,957

40% lower than market

Colonscopy

$1,183
$2,883

59% lower than market

Complex control of nose bleed

$244
$426

43% lower than market

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

$930
$3,064

70% lower than market

Diagnostic examination of large bowel using an endoscope

$3,153
$3,017

5% higher than market

Drainage of abscess or blood accumulation in pelvis or hip joint

$3,309
$4,885

32% lower than market

Drainage of abscess, cyst, or blood accumulation of dental bone

$800
$848

6% lower than market

Fine needle aspiration; without imaging guidance

$389
$523

26% lower than market

First degree burn treatment

$211
$936

77% lower than market

Gallbladder Removal Using an Endoscope

$4,727
$20,292

77% lower than market

Insertion of temporary bladder catheter

$135
$139

3% lower than market

Removal of one knee cartilage using an endoscope

$2,364
$13,551

83% lower than market

Needle biopsy of liver, accessed through the skin

$869
$1,160

25% lower than market

Removal of 1 or more breast growth, open procedure

$3,153
$12,263

74% lower than market

Removal of 2 to 4 thickened skin growths

$211
$335

37% lower than market

Colonoscopy with removal of polyp(s)

$2,366
$3,641

35% lower than market

Removal of fluid from between lung and chest cavity, open procedure

$1,230
$2,696

54% lower than market

Removal of fluid from chest cavity

$766
$1,225

37% lower than market

Removal of foreign body from ear canal

$149
$566

74% lower than market

Removal of growth (1.1 to 2.0 centimeters) of the face, ears, eyelids, nose, lips, or mouth

$2,366
$3,005

21% lower than market

Removal of growth (over 4.0 centimeters) of the scalp, neck, hands, feet, or genitals

$4,727
$6,459

27% lower than market

Removal of malignant growth (0.6 to 1.0 centimeters) of the face, ears, eyelids, nose, or lips

$788
$1,517

48% lower than market

Removal of malignant growth (0.6 to 1.0 centimeters) of the scalp, neck, hands, feet, or genitals

$788
$3,139

75% lower than market

Removal of malignant growth (0.6 to 1.0 centimeters) of the trunk, arms, or legs

$717
$1,052

32% lower than market

Removal of malignant growth (1.1 to 2.0 centimeters) of the face, ears, eyelids, nose, or lips

$786
$1,226

36% lower than market

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

$788
$3,517

78% lower than market

Removal of malignant growth (1.1 to 2.0 centimeters) of the trunk, arms, or legs

$788
$3,654

78% lower than market

Repair of Wound (2.6 to 7.5 centimeters)

$298
$599

50% lower than market

Repair of Wound (7.6 to 12.5 cm)

$359
$516

30% lower than market

Repair of groin hernia patient age 5 years or older

$3,940
$20,794

81% lower than market

Repair of wound (12.6 to 20.0 centimeters) of the scalp, neck, underarms, genitals, trunk, arms and/

$458
$842

46% lower than market

Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth

$474
$905

48% lower than market

Repair of wound (2.6 to 7.5 centimeters) of forehead, cheeks, chin, mouth, neck, underarms, genitals

$1,056
$1,389

24% lower than market

Repair of wound (5.1 to 7.5 centimeters) of face, ears, eyelids, nose, lips, and/or mouth

$515
$571

10% lower than market

Repair of wound (5.1 to 7.5 centimeters) of the face, ears, eyelids, nose, lips, and/or mucous membr

$392
$770

49% lower than market

Repair of wound (7.6 to 12.5 centimeters) of the face, ears, eyelids, nose, lips, and/or mucous membranes

$451
$831

46% lower than market

Repair of wound (over 30.0 centimeters) of the scalp, underarms, trunk, arms, and/or legs

$1,962
$2,890

32% lower than market

Replacement of stomach or large bowel tube using fluoroscopic guidance with contrast, accessed throu

$768
$1,130

32% lower than market

Rotator Cuff Repair

$3,500
$13,683

74% lower than market

Shaving of shoulder bone using an endoscope

$614
$9,173

93% lower than market

Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique

$2,366
$2,415

2% lower than market

Simple wound repair of face, including ears; 2.5 cm or less

$284
$608

53% lower than market

Simple wound repair of face, including ears; 2.6 cm to 5.0 cm

$322
$755

57% lower than market

Simple wound repair of scalp, neck, external genitalia; 2.5 cm or less

$271
$624

57% lower than market

Spinal tap for diagnosis

$590
$997

41% lower than market

Treatment of elbow dislocation

$915
$1,254

27% lower than market

Ultrasound measurement of bladder capacity after voiding

$590
$582

1% higher 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

Bone Density Scan (DEXA Scan)

$507
$501

1% higher than market

Bone and/or joint imaging

$1,082
$1,058

2% higher than market

Breast Ultrasound - Limited

$551
$583

6% lower than market

CT Abdomen & Pelvis with Contrast

$5,138
$5,002

3% higher than market

CT Abdomen & Pelvis without Contrast

$4,056
$4,327

6% lower than market

CT Abdomen without Contrast

$2,095
$2,114

1% lower than market

CT Angiogram Chest with and without Contrast

$2,783
$3,864

28% lower than market

CT Angiogram Neck with and without Contrast

$2,476
$3,318

25% lower than market

CT Arm without Contrast

$1,834
$1,796

2% higher than market

CT Chest without Contrast

$2,060
$2,251

8% lower than market

CT Cranial Cavity with Contrast

$2,218
$3,164

30% lower than market

CT Cranial Cavity without Contrast

$1,728
$2,256

23% lower than market

CT Head Brain with Contrast

$1,860
$2,417

23% lower than market

CT Head Brain with and without Contrast

$2,182
$2,807

22% lower than market

CT Head Brain without Contrast

$2,113
$1,893

12% higher than market

CT Neck with Contrast

$2,106
$2,569

18% lower than market

CT Neck with and without Contrast

$2,270
$2,476

8% lower than market

CT Neck without Contrast

$1,802
$2,345

23% lower than market

CT Pelvis with Contrast

$2,290
$2,686

15% lower than market

CT Scan of Abdominal Aorta and Both Leg Arteries with Contrast

$4,169
$4,423

6% lower than market

CT Spine Cervical without Contrast

$2,172
$2,366

8% lower than market

CT Spine Lumbar without Contrast

$2,219
$2,170

2% higher than market

CT scan of arm before and after contrast

$1,603
$1,598

Approximately equal to market

CT scan of cranial cavity before and after contrast

$2,603
$3,188

18% lower than market

Chest X-Ray; 2 Views

$373
$345

8% higher than market

Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels

$657
$951

31% lower than market

Diagnostic mammography, bilateral

$424
$378

12% higher than market

Diagnostic mammography, unilateral

$324
$298

9% higher than market

Fluoroscopic guidance for insertion of needle

$323
$824

61% lower than market

Follow-up or limited ultrasound examination of heart

$705
$837

16% lower than market

Imaging for Evaluation of Swalling Function

$350
$635

45% lower than market

Imaging for bone age assessment

$308
$295

4% higher than market

Imaging of Abdomen and Chest

$428
$441

3% lower than market

Imaging of Abdomen; 2 Views

$315
$420

25% lower than market

Imaging of Abdomen; Single View

$265
$252

5% higher than market

Low dose ct scan (ldct) for lung cancer screening

$445
$649

31% lower than market

MRI Abdomen with and without Contrast

$3,630
$3,640

Approximately equal to market

MRI Arm Joint without Contrast

$3,302
$3,162

4% higher than market

MRI Arm without Contrast

$2,652
$3,000

12% lower than market

MRI Brain with and without Conrast

$4,514
$4,206

7% higher than market

MRI Brain without Contrast

$2,709
$2,962

9% lower than market

MRI Leg Joint with and without Contrast

$4,698
$4,492

5% higher than market

MRI Leg Joint without Contrast

$3,129
$3,520

11% lower than market

MRI Leg with and without Contrast

$3,500
$4,194

17% lower than market

MRI Leg without Contrast

$2,973
$3,028

2% lower than market

MRI Pelvis with and without Contrast

$4,253
$4,863

13% lower than market

MRI Pelvis without Contrast

$2,624
$3,206

18% lower than market

MRI Spine Cervical with and without Contrast

$4,555
$4,433

3% higher than market

MRI Spine Cervical without Contrast

$2,834
$3,397

17% lower than market

MRI Spine Lumbar without Contrast

$3,091
$3,557

13% lower than market

MRI scan of chest before and after contrast

$4,006
$3,980

1% higher than market

Myocardial Perfusion, Tomographic

$4,200
$5,048

17% lower than market

Nuclear medicine study of radioactive material distribution at sites of inflammation in whole body

$2,058
$2,322

11% lower than market

Parathyroid Planar Imaging

$2,657
$2,675

1% lower than market

Radiologic exam, spine, entire thoracic and lumbar, including skull, cervical and sacral spine; 2 or 3 views

$460
$491

6% lower than market

Radiologic examination, abdomen; 3 or more views

$428
$423

1% higher than market

Radiologic examination, chest; 3 views

$358
$359

Approximately equal to market

Radiologic examination, chest; 4 or more views

$368
$477

23% lower than market

Radiologic examination, femur; 1 view

$252
$247

2% higher than market

Radiological supervision and interpretation X-ray of bile and/or pancreatic ducts during surgery

$643
$776

17% lower than market

Screening Mammography, Bilateral, with CAD

$299
$373

20% lower than market

Ultrasound Abdomen - Complete

$990
$1,395

29% lower than market

Ultrasound Abdomen - Limited

$754
$1,023

26% lower than market

Ultrasound Blood Flow Outside the Brain

$836
$1,146

27% lower than market

Ultrasound Guidance for Insertion of Needle

$798
$820

3% lower than market

Ultrasound Head Neck

$754
$727

4% higher than market

Ultrasound Pelvis NonOB

$767
$845

9% lower than market

Ultrasound Pelvis through Vagina

$764
$755

1% higher than market

Ultrasound Pregnant Uterus < 14 Weeks Pregnant

$556
$605

8% lower than market

Ultrasound Pregnant Uterus > 14 Weeks Pregnant

$744
$722

3% higher than market

Ultrasound Veins of Both Arms or Legs

$1,112
$1,472

24% lower than market

Ultrasound Veins of One Arm or Leg

$809
$1,005

19% lower than market

Ultrasound guidance for accessing into blood vessel

$468
$554

16% lower than market

Ultrasound of Arteries of Both Legs

$817
$890

8% lower than market

Ultrasound of Arteries of One Leg

$602
$855

30% lower than market

Ultrasound of pelvis

$676
$682

1% lower than market

Ultrasound of pregnant uterus, 1 or more fetus(es)

$429
$436

2% lower than market

Ultrasound re-evaluation of pregnant uterus, per fetus

$384
$540

29% lower than market

Ultrasound scan of abdominal, pelvic, and/or scrotal arterial inflow and venous outflow

$1,002
$1,559

36% lower than market

Ultrasound study of arteries and arterial grafts of both arms

$972
$1,120

13% lower than market

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

$311
$820

62% lower than market

Ultrasound study of arteries of both legs at rest and exercise

$581
$1,153

50% lower than market

Vaginal Ultrasound of Pregnant Uterus

$474
$768

38% lower than market

Whole Body Bone Scan

$1,931
$2,246

14% lower than market

X-Ray Both Hips and Pelvis, 2 Views

$416
$442

6% lower than market

X-Ray Elbow, 2 Views

$268
$307

13% lower than market

X-Ray Esophagus

$550
$622

12% lower than market

X-Ray Fingers, 2 Views

$311
$298

4% higher than market

X-Ray Foot, 2 Views

$220
$309

29% lower than market

X-Ray Foot, 3 Views

$370
$422

12% lower than market

X-Ray Forearm, 2 Views

$376
$364

3% higher than market

X-Ray Hand, 2 Views

$285
$282

1% higher than market

X-Ray Hand, 3 Views

$389
$363

7% higher than market

X-Ray Hip and Pelvis, 1 View

$223
$293

24% lower than market

X-Ray Hip and Pelvis, 2 Views

$380
$356

7% higher than market

X-Ray Lower Sacral Spine, 2-3 Views

$479
$515

7% lower than market

X-Ray Lower Sacral Spine, 4 or More Views

$1,004
$579

74% higher than market

X-Ray Neck Soft Tissue

$257
$319

19% lower than market

X-Ray Neck Spine, 2-3 Views

$420
$449

6% lower than market

X-Ray Shoulder, 1 View

$229
$314

27% lower than market

X-Ray Shoulder, 2 Views

$415
$429

3% lower than market

X-Ray Small Intestine without Contrast

$600
$715

16% lower than market

X-Ray Toes, 2 Views

$254
$270

6% lower than market

X-Ray Upper Arm, 2 Views

$357
$390

8% lower than market

X-Ray Upper Digestive Tract without Contrast

$750
$1,097

32% lower than market

X-Ray Wrist, 2 Views

$257
$327

21% lower than market

X-Ray Wrist, 3 Views

$397
$374

6% higher than market

X-Ray of Both Sides of Ribs, Including Chest, Minimum of 4 Views

$477
$710

33% lower than market

X-ray of bones

$300
$307

2% lower than market

X-ray of bones of nose, minimum of 3 views

$376
$467

20% lower than market

X-ray of both collar bones

$407
$529

23% lower than market

X-ray of mandible, minimum of 4 views

$459
$461

Approximately equal to market

X-ray of skull, less than 4 views

$447
$456

2% lower than market

X-ray of upper spine, 6 or more views

$881
$1,005

12% lower than market

X-ray survey of forearm or wrist bone density

$593
$677

12% lower than market

INPATIENT CARDIOLOGY CHARGES

Description

Our Charge
Market Charge

Variance

Heart failure & shock without complications

$11,669
$17,089

32% lower than market

INPATIENT MEDICINE CHARGES

Description

Our Charge
Market Charge

Variance

Blood Infection with major complications

$19,868
$48,973

59% lower than market

Blood infection without major complications

$14,929
$24,917

40% lower than market

Nutritional & misc metabolic disorders with major complications

$16,159
$24,146

33% lower than market

INPATIENT NEUROLOGY CHARGES

Description

Our Charge
Market Charge

Variance

Stroke with complications

$17,850
$27,776

36% lower than market

INPATIENT ORTHOPEDIC SURGERY CHARGES

Description

Our Charge
Market Charge

Variance

Total Knee or Hip Replacement

$30,888
$68,775

55% lower than market

INPATIENT UROLOGY CHARGES

Description

Our Charge
Market Charge

Variance

Kidney failure with complications

$14,939
$18,967

21% lower than market

BILLING PROCESS AND INFORMATION

How You Can Help

Thank you for choosing Hampton Regional Medical Center for your healthcare needs. We want to make understanding and paying your bill as easy as possible. Here are some ways you can help us as we work to make 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 Hampton Regional Medical Center, 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 Hampton Regional Medical Center 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 from your hospital visit, including your family doctor, specialists, physicians that read x-rays, providers that give anesthesia, or physicians that interpret 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 Hampton Regional Medical Center 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 Billing Department at 800-575-1435.

If you need more information about the price of a future service, please contact our Customer Service at 800-575-1435. A physician’s order or CPT code is strongly encouraged when you call to assist us in providing you with the most accurate estimate. You can obtain the CPT code from the ordering physician.