Getting a Price Estimate
How Much Will My Care Cost?
Being transparent about the cost of your care is one example of how SSM Health is improving health care. We want all patients to be able to make informed decisions about their healthcare. We provide resources to help patients understand out-of-pocket costs they may incur.
We know navigating health care costs can be confusing and often overwhelming. SSM Health offers two easy ways to get personalized estimates. Patients can call 844-989-6292 or fill out our price estimate request form.
If you need help financing your care, we can start that conversation too.
Getting a Personalized Price Estimate
We are ready to provide you with an accurate and personalized estimate for the cost of your care. Our team wants to provide you with a good experience and a fast response time. To make this possible please have the following information available when calling:
- Patient name and contact information
- Patient insurance information (verify your insurance is accepted)
- Physician ordering test/procedure
- CPT code(s)
What are CPT Codes?
Content Procedural Terminology (CPT) Codes is a coding system for medical procedures. The system allows for compatibility in pricing, billing and utilization review. If you do not know the CPT code for your procedure, contact your ordering physician's office to get them. Once you know the code(s) we can help you complete your request for a price estimate.
What Can Affect My Out-of-Pocket Expenses?
It is important you verify the following with your insurance company:
- The procedure is a covered benefit under their plan
- Does the procedure require pre-authorization
- Is SSM Health considered an in-network provider
Your insurance company will hold you liable for this information. (Our verification process does not include verifying your specific benefits). Estimates are based on rates predetermined through insurance contracts. SSM Health verifies active coverage and possible out-of-pocket expense left at the time of inquiry (deductible, co-insurance & copay).
- Deductible - The amount of money you pay before your insurance begins to pay for medical expenses. This is an annual expense.
- Co-Insurance - Patients pay a percentage of the cost of a covered service. The insurance company pays the remaining percentage of the covered service after the deductible has been met.
- Co-Payment /Co-Pay - This refers to a specific flat fee for each health service.
Items impacting the accuracy of the estimation of liability:
- Accuracy of CPT Codes
- Additional testing ordered by your physician
- Patient remaining for observation/in patient after a procedure
- Cost/quantity of medications
- Changes in patient deductible due to timing of insurance claims processing
Price Transparency Information at SSM Health
Our shoppable services and machine-readable files are available to review. If you have questions or would like a personalized estimate, please call us at 844-989-6292.
Note: All estimates are an approximation of your out-of-pocket hospital billing expenses. This does not include any estimation for professional billing (physicians, pathology, radiologists, etc.). Contact your insurance company if you have questions about how they will process your claim. Any estimation of liability is not considered a guarantee of benefits (or coverage of the test under your specific insurance plan).