Patient Price Information List

Disclaimer: Nor Lea Hospital District 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, Nor Lea Hospital District has partnered with Hospital Pricing Specialists LLC to analyze current charges, based off CMS adjudicated claims through 12/31/18. Nor Lea Hospital District's charges are displayed and compared with the local market charge, consisting of the following hospitals:

Hospital Name
Location

Artesia General Hospital

Artesia

NM

Carlsbad Medical Center

Carlsbad

NM

Covenant Medical Center

Lubbock

TX

Covenant Specialty Hospital

LUBBOCK

TX

Eastern New Mexico Medical Center

Roswell

NM

Lea Regional Medical Center

Hobbs

NM

Lovelace Regional Hospital-Roswell

Roswell

NM

Lubbock Heart Hospital Lp

Lubbock

TX

Roosevelt General Hospital

Portales

NM

University Medical Center

Lubbock

TX

INPATIENT ROOM AND BOARD DAILY CHARGES

Description

Our Charge
Market Charge

Variance

Private Room

$775
$2,455

68% 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

Gait Training - 15 Minutes

$151
$173

13% lower than market

Physical Therapy 1 or More Regions (15 min)

$167
$214

22% lower than market

Physical Therapy Exercise, 15 Minutes

$169
$199

15% 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

$992
$1,289

23% lower than market

Routine EKG - Minimum 12 Leads

$372
$429

13% lower than market

Spirometry - breathing test

$436
$477

9% 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

$539
$801

33% lower than market

Ammonia level

$140
$269

48% lower than market

Amylase (enzyme) level

$97
$231

58% lower than market

Bacterial urine culture; quantitative colony count

$99
$195

49% lower than market

Bilirubin level (Direct)

$59
$120

51% lower than market

Blood Glucose Scan

$19
$43

55% lower than market

Blood Typing, ABO

$68
$110

38% lower than market

Blood Typing, Rh (D)

$66
$102

35% lower than market

Blood creatinine level

$55
$125

56% lower than market

Blood glucose (sugar) level

$49
$114

57% lower than market

Blood potassium level

$53
$127

58% lower than market

Blood test panel for electrolytes (sodium potassium, chloride, carbon dioxide)

$96
$201

52% lower than market

Blood test, basic group of blood chemicals

$142
$219

35% lower than market

Blood test, clotting time

$59
$105

44% lower than market

Blood test, comprehensive group of blood chemicals

$194
$277

30% lower than market

Blood test, lipids (cholesterol and triglycerides)

$139
$257

46% lower than market

Blood test, thyroid stimulating hormone (TSH)

$147
$329

55% lower than market

Calcium level

$54
$126

57% lower than market

Carbamazepine level

$148
$273

46% lower than market

Complete blood cell count - automated differential WBC count

$94
$151

38% lower than market

Complete blood cell count - automated test with out Differential

$77
$158

51% lower than market

Creatine kinase Level (cardiac enzyme) - Total

$83
$168

51% lower than market

Creatine kinase level (cardiac enzyme) - Muscle/Brain

$143
$216

34% lower than market

Creatinine clearance measurement to test for kidney function

$115
$295

61% lower than market

Creatinine level to test for kidney function or muscle injury

$95
$178

47% lower than market

Cyanocobalamin (vitamin B-12) level

$125
$248

50% lower than market

Digoxin level

$127
$255

50% lower than market

Estradiol (hormone) level

$177
$418

58% lower than market

Ferritin (blood protein) level

$123
$246

50% lower than market

Folic acid; serum

$122
$225

46% lower than market

Glutamyltransferase (liver enzyme) level

$71
$169

58% lower than market

Gonadotropin (reproductive hormone) analysis

$114
$197

42% lower than market

Gonadotropin, follicle stimulating (reproductive hormone) level

$148
$307

52% lower than market

Hemoglobin A1C level

$93
$179

48% lower than market

Hepatitis B surface antibody measurement

$156
$227

31% lower than market

Immunologic analysis for detection of tumor antigen (CA 125)

$158
$307

49% lower than market

Ionized Calcium

$176
$268

34% lower than market

Iron level

$68
$213

68% lower than market

Lactate dehydrogenase (enzyme) level

$67
$170

61% lower than market

Lactic acid level

$123
$254

52% lower than market

Lipase (fat enzyme) level

$103
$216

52% lower than market

Liver enzyme (SGPT), level

$58
$157

63% lower than market

Liver function blood test panel

$143
$302

53% lower than market

Magnesium Level

$81
$150

46% lower than market

Natriuretic peptide (heart and blood vessel protein) level

$228
$417

45% lower than market

PSA (prostate specific antigen) measurement

$139
$298

53% lower than market

Partial Thromblostatin Time, Activated

$85
$155

45% lower than market

Phenobarbital level

$123
$220

44% lower than market

Phenytoin level

$136
$246

45% lower than market

Phosphate level

$58
$129

55% lower than market

Prealbumin (protein) level

$162
$266

39% lower than market

Prolactin (milk producing hormone) level

$161
$360

55% lower than market

Red blood cell sedimentation rate, to detect inflammation

$52
$80

35% lower than market

Red blood count, automated test

$58
$94

39% lower than market

Testosterone (hormone) level

$144
$389

63% lower than market

Thyroid hormone, T3 measurement - Total

$181
$235

23% lower than market

Thyroxine (thyroid chemical) measurement - Free Thyroxine

$109
$206

47% lower than market

Thyroxine (thyroid chemical) measurement - Total

$133
$147

9% lower than market

Triglycerides level

$64
$275

77% lower than market

Troponin (protein) analysis

$162
$259

37% lower than market

Urea nitrogen level to assess kidney function

$50
$125

60% lower than market

Uric acid level, blood

$58
$132

56% lower than market

Urinalysis with Examination, using Microscope

$64
$106

40% lower than market

Urinalysis, Automated Test

$43
$53

20% lower than market

Urine calcium level

$93
$176

47% lower than market

Urine microalbumin (protein) level

$112
$223

50% lower than market

Urine sodium level

$94
$135

30% lower than market

Valproic acid level

$141
$281

50% lower than market

Vancomycin (antibiotic) level

$155
$241

36% lower than market

OUTPATIENT MEDICINE CHARGES

Description

Our Charge
Market Charge

Variance

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

$979
$1,755

44% lower than market

Sleep Monitoring with CPAP

$5,706
$6,149

7% lower than market

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

$5,199
$7,293

29% lower than market

OUTPATIENT OBSERVATION CHARGES

Description

Our Charge
Market Charge

Variance

Hospital Observation per Hour

$29
$105

73% lower than market

OUTPATIENT PHARMACY AND DRUG ADMINISTRATION CHARGES

Description

Our Charge
Market Charge

Variance

Administration of 1 Vaccine

$120
$126

5% 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

Nebulizer Treatment

$253
$312

19% 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

Bone Density Scan (DEXA Scan)

$672
$813

17% lower than market

CT Abdomen & Pelvis with Contrast

$5,663
$7,400

23% lower than market

CT Abdomen & Pelvis without Contrast

$4,706
$5,910

20% lower than market

CT Head Brain without Contrast

$2,554
$2,773

8% lower than market

Chest X-Ray; 2 Views

$472
$448

5% higher than market

Chest X-Ray; Single View

$390
$410

5% lower than market

Diagnostic mammography, unilateral

$410
$506

19% lower than market

Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries

$735
$983

25% lower than market

MRI Brain with and without Conrast

$5,412
$6,256

13% lower than market

Myocardial Perfusion, Tomographic

$5,620
$5,918

5% lower than market

Screening Mammography, Bilateral, with CAD

$399
$483

17% lower than market

Ultrasound Abdomen - Limited

$1,021
$996

2% higher than market

Ultrasound Behind Abdominal Cavity - Complete

$1,094
$1,221

10% lower than market

Ultrasound Blood Flow Outside the Brain

$1,617
$1,551

4% higher than market

Ultrasound Head Neck

$962
$1,009

5% lower than market

Ultrasound Heart

$2,936
$3,269

10% lower than market

Ultrasound Pelvis NonOB

$1,148
$1,276

10% lower than market

Ultrasound Veins of Both Arms or Legs

$1,700
$1,998

15% lower than market

Ultrasound Veins of One Arm or Leg

$1,167
$1,432

19% lower than market

Ultrasound of Arteries of Both Legs

$1,558
$1,863

16% lower than market

Ultrasound of Arteries of One Leg

$1,069
$1,473

27% lower than market

X-Ray Ankle, 3 Views

$538
$513

5% higher than market

X-Ray Foot, 3 Views

$520
$482

8% higher than market

X-Ray Hand, 3 Views

$522
$488

7% higher than market

X-Ray Hip and Pelvis, 2 Views

$517
$505

2% higher than market

X-Ray Knee, 4 or More Views

$668
$865

23% lower than market

X-Ray Wrist, 3 Views

$521
$503

4% higher than market

BAESS AND INFORMATION

How You Can Help

Thank you for choosing Nor Lea Hospital District for your healthcare needs. As part of our commitment to delivering EXCELLENT service, 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 Nor Lea Hospital District, 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 Nor Lea Hospital District 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 Nor Lea Hospital District 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 575-396-6611 ext 2756.

If you need more information about the price of a future service, please contact our Price Hotline at 575-396-6611 ext 2756 . A CPT code is strongly encouraged when you call. You can obtain the CPT code from the ordering physician.

Online Payment, Registration, & Scheduling

For the convenience of our patients, a number of online services are available at https://www.nor-lea.org/. Nor Lea Hospital District offers secure online payment.

Nor Lea Hospital District also offers pre-registration and appointment requests through a secure online form at https://www.nor-lea.org/. 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. The patient must agree to apply for other assistance available to pay hospital charges (Medicaid, Medicare, private insurance) before being discharged.

Nor Lea Hospital District's Charity Care Policy

Nor Lea Hospital District provides high quality care to everyone, regardless of their ability to pay.

Nor Lea Hospital District'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.

• Sliding scale fees to provide substantially discounted care for individuals and families who are between 200 and 400 percent of the federal poverty level.

• Hardship policy for those patients who would not otherwise qualify for charity care but have unique circumstances.

In many cases, Nor Lea Hospital District offers interest free loans for up to one year to assist patients.

For more information, please contact our Customer Call Center at 575-396-6611 ext 2756.