Price Transparency
We want to make it easier for you to make decisions about your health care— and understanding your health care costs and out-of-pocket expenses can help.
Please refer to the following information to learn:
- How prices for health care services are determined
- How the price you’re charged for care is calculated
- How out-of-pocket health care expenses are determined
It’s important to remember that your final health care costs can vary due to insurance coverage and your unique care plan. Because of this, the price charged for a specific health care service may differ from what you’re charged on your bill. Please contact your insurance provider directly to learn more about your financial responsibility for specific services.
How are health care prices determined?
Prices for health care services are determined by several factors, including:
- The specific cost of your treatment or procedure
- The location of your treatment or procedure
- The cost of necessary additional services like anesthesia, lab tests, medications or imaging tests
- Additional fees for provider charges, medical equipment, supplies and facility usage
How are health care prices calculated?
Calculating the total price of your health care service, treatment or procedure at VCU Medical Center begins with a review of our hospital’s Charge Description Master (CDM). A CDM is a listing of all billable items and services that could be used during your care.
Next, a hospital bill is produced to summarize the total price of all items and services used during your treatment.
If you have insurance coverage, this bill is submitted to your insurance company for payment. Your insurance company reviews your benefit plan and makes an initial payment on your hospital services based on your plan benefits and any contracts they have negotiated with VCU Medical Center. Any charges that remain after your insurance company makes their payment are considered your out-of-pocket costs.
If you do not have insurance coverage, VCU Medical Center will bill you directly for your care. This bill is developed using the prices on our CDM, which are then adjusted to reflect final charges closer to those negotiated by insurance providers. We do this to alleviate some of the financial burden faced by those who cannot access or afford purchased health insurance coverage.
Access VCU Medical Center's list of standard charges (machine readable file)
How are out-of-pocket health care costs calculated?
Hospital charges are only one component of the cost of your care. The amount you actually owe, or your out-of-pocket cost, depends not only on what the hospital charges, but also on physician or provider fees and your individual health plan coverage. Benefits can differ greatly from plan to plan. Your cost is further affected by deductibles and copayments required under your plan.
Request a good faith estimate
Knowing your expected out-of-pocket costs can help you make informed decisions about your care. VCU Health provides health care cost estimates* based on your individual insurance coverage. If you do not have insurance coverage, you may request an estimate as a self-pay patient.
Please have the following information ready when obtaining an estimate:
- First and last name
- Phone number
- Date of scheduled procedure
- Location of scheduled procedure
- Specific service or procedure to be provided
- Insurance information, such as card holder name, date of birth and policy number
VCU Health offers estimates online and by phone.
Get an estimate using our online tool
Use VCU Medical Center’s online estimating tool to get an estimate of your specific out-of-pocket hospital costs. Your estimate is based on your individual insurance coverage for your upcoming procedure. For assistance with an estimate or to obtain your physician out-of-pocket cost estimate, call (888) 803-2290.
Get your personalized estimate
Get an estimate by phone
Call our team to receive an estimate for your specific out-of-pocket hospital and physician costs. Your estimate is based on your individual insurance coverage for your upcoming procedure.
Call (888) 803-2290 for your estimate.
*Please note: Patients will be billed for all actual hospital and physician charges, whether those charges are greater or less than the estimated amount provided. Estimates reflect historical standards and are subject to change at any point. Please understand that, in many cases, it is impossible to predict your final charges as there may be additional fees for items or services that could not be foreseen during the estimating process.
Helpful health pricing resources
Refer to the following resources for more information on health pricing.