Price Transparency
WakeMed is providing the following information in accordance with federal guidelines outlined by the Centers for Medicare and Medicaid Services (CMS) as part of a national effort to improve price transparency.
At WakeMed, we are committed to supporting price transparency in an effort to help our patients and their families better understand their health care costs. Due to the complexity of hospital billing and the wide variety of insurance plan options, your best option for understanding your out-of-pocket costs for health care services is to speak directly with your insurance company or to request an estimate from our financial services team. For those patients that do not have access to insurance, Medicare or Medicaid, WakeMed offers financial assistance in the form of discounts or reductions to our standard charges.
As a courtesy, we’ve provided some general information to help patients begin to understand the complex world of health care billing.
Shoppable Services
To assist patients in understanding the cost of their care, and in keeping with the requirements of federal law, WakeMed is providing a “shoppable services” price list for common inpatient and outpatient services. A “shoppable service” is a non-urgent service or procedure that you can schedule in advance.
WakeMed Shoppable Services - Raleigh Campus & North Hospital
Allows you to search for common procedures.
WakeMed Shoppable Services - Cary Hospital
Allows you to search for common procedures.
Standard Services
To assist patients in understanding the cost of their care, and in keeping with the requirements of federal law, WakeMed is providing a machine-readable price list for inpatient and outpatient services.
566017737_wakemed-raleigh-campus-and-north-hospital_standardcharges
This is a machine-readable file.
566017737_wakemed-cary-hospital_standardcharges
This is a machine-readable file.
WakeMed offers a price estimator tool by phone and online.
This is not a guarantee of what you will be charged. Your actual charges may differ from the estimated charges for many reasons, including the seriousness of your medical condition, actual time the procedure takes and the services and supplies that you receive.
If you have insurance, your benefits will ultimately determine the amount you owe (including deductibles, co-pay, co-insurance, and out-of-pocket maximums). You should contact your insurer or review your insurance benefits documents to confirm whether WakeMed is considered “in network” for your insurer and to understand the amount your insurer will expect you to pay before you schedule a “shoppable service” at WakeMed.
The shoppable online estimator was developed to help you determine the potential cost for services only. If you proceed with services at WakeMed, you may be given a new estimate with more accurate cost and out-of-pocket information. Please contact 919-350-7808 for more information.
WakeMed shall not be liable for any difference between charges listed in the price lists and the final bill for services. You may be eligible for financial assistance under our patient financial assistance policy. Financial hardship is evaluated on a case-by-case basis.
What is Not Included in the Chargemaster and Shoppable Services list?
The hospital’s chargemaster and shoppable services does not include charges for services provided by the doctor (or doctors) who treat you while you are at the hospital. You may receive separate bills from the hospital and the doctors involved in your care.
Here is a partial list of health care providers who may bill you separately:
- Your personal doctor, if he/she sees you in the hospital
- Emergency room doctors
- The surgeon who performs your procedure
- The anesthesiologist who works with the surgeon
- The radiologist who reads your x-rays or other imaging
- Other specialists who may be consulted by your doctor during your time in the hospital
- The pathologist who reviews your specimens
- Certain laboratory testing
Average Hospital Charges
You can view a comprehensive list of all hospital charges via our chargemaster for Raleigh Campus and North Hospital and the chargemaster for Cary Hospital, which is a comprehensive list of charges for each inpatient and outpatient service or item provided by a hospital – each test, exam, surgical procedure, room charge, etc. This information is provided in accordance with state and federal guidelines but can easily cause confusion for patients looking for answers to questions about actual cost of care or specific hospital bills.
Chargemaster amounts are almost never billed to a patient or received as payment by a hospital. The chargemaster amounts are billed to an insurance company, Medicare, or Medicaid, and those insurers then apply their contracted rates to the services that are billed. In situations where a patient does not have insurance, our hospital has financial assistance policies. If a patient is eligible for financial assistance, a discount will be applied to the charged amount.
Chargemaster FAQ
View a more comprehensive Chargemaster FAQ.
For more information about the cost of your care, we encourage you to contact our Patient Financial Services team or your insurance company.
How to Contact our Patient Financial Services Team with Specific Questions:
- Cost Estimates: To receive an estimate of charges for future service, call 919-350-7808 or fill out this form. Listen carefully to the menu options and choose the one that best meets your needs. Please keep in mind that this is only an estimate. Actual charges may vary depending on the treatment your physician orders for you.
- Billing Questions: WakeMed provides billing customer service by phone at 919-350-8359 or toll free at (877) 498-4490. The call center business hours are Monday - Friday 7:30 am - 5:30 pm.
Get an Estimate
Please keep in mind that this is only an estimate. Actual charges may vary, depending on the treatment your physician orders for you.
Hospital Billing Definitions
It's challenging to explain health care billing without a common understanding of a few frequently used terms. Here are several health care billing terms that relate to price transparency defined. View a full glossary.
- Charge: Hospital charges include many factors such as equipment, supplies, medications as well as the differences in care required to meet individual patient needs. Hospitals are required to determine a set charge for tens of thousands of items. These charges are maintained in the Chargemaster.
- Payment: Payment refers to the amount a hospital receives from a payer for providing care. Three primary types of payers include: the government (through Medicare and Medicaid); commercial insurers such as BCBS, Aetna, Cigna, etc. and; patients. Payment from patients with insurance include out-of-pocket costs such as co-pays, deductibles, coinsurance or non covered amounts by their respective insurance plan.
- DRG (or MS-DRG): A DRG (diagnosis-related group) is the system Medicare and some insurance companies use to classify and categorize charges for inpatient hospitalization. The DRG is based on a patient’s diagnoses and surgery when performed. Medicare and/or other payers use the assigned DRG to pay the hospital a set (fixed) amount – regardless of the actual charges for the patient’s hospital stay.
Financial & Charity Care Policies