At Carle, we are committed to helping you make informed choices about your care. That includes helping you know, in advance, an estimate of how much you will be charged for services and goods and what your estimated out of pocket portion may be.
Beginning January 1, 2021, the U.S. Department of Health & Human Services and the Centers for Medicare & Medicaid Services requires hospitals and health systems to post their "current, standard charges." You can download and view these files here:
- Carle Foundation Hospital, updated 1/1/21
- Carle Hoopeston Regional Health Center, updated 1/1/21
- Carle Richland Memorial Hospital, updated 1/1/21
- Carle BroMenn Medical Center, updated 1/1/21
- Carle Eureka Hospital, updated 1/1/21
PDF files are also available here:
Carle Foundation Hospital- Carle Hoopeston Regional Health Center
- Carle Richland Memorial Hospital
- Carle BroMenn Medical Center
- Carle Eureka Hospital
Coming Soon: Estimates Tool
We're working on a tool for patients to get estimates on a wide range of medical services. Although complexities of building this tool and demands on our health system in 2020 resulted in delays, we are committed to providing the most up-to-date, accurate information possible in a timely manner. Carle understands the need for this important tool, and our goal is to have it available mid-January, 2021.- Our Patient Financial Services representatives are available to help you understand charges and provide estimates Monday through Friday, 8 a.m. to 5 p.m. at (888) 71-CARLE or (888) 712-2753.
- For questions about your insurance coverage, please call the telephone number on your member ID card.
- Please be prepared to provide the following:
- Description of service
- Procedure code(s) which you can get from your physician's office
When patients have the opportunity to shop for medical services, they should contact their insurance carrier to understand which services and goods will be covered and which will be the patient's responsibility. Our Patient Financial Services representatives are available to help you understand charges and provide estimates Monday through Friday, 8 a.m. to 5 p.m. at (888) 71-CARLE or (888) 712-2753. If you believe the estimated amount due may create a financial hardship, you may be eligible for the Carle Financial Assistance Program that may offset some or all of your costs. To learn more about this program, click here.
Hospital charges are the amount a hospital bills for a service. Because of varying reimbursements for hospitals, patients most often pay far less than the amount listed.
Most Requested
Estimates
For your convenience, below is a short list of most frequently provided services and their estimated charges. If you have any questions about this information, please give us a call.
Office Visits and Hospital Charges
| description of service | procedure codes* | professional charge** | facility charge** | total charges |
|---|---|---|---|---|
| New Patient Visit | 99201-99205 | $155 - $540 | $275 - $540 | $430 - $1,080 |
| Established Patient Visit | 99212-99215 | $135 - $395 | $290 - $540 | $425 - $935 |
| Physician/Advance Practice Provider Telephone Evaluation | 99441-99443 | $115 - $350 | N/A | $115 - $350 |
| Initial Hospital Admission | 99221-99223 | $355 - $630 | N/A | $355 - $630 |
| Subsequent Hospital | 99231-99233 | $165 - $365 | N/A | $165 - $365 |
| Emergency Exam | 99281-99285 | $235 - $1,230 | $315 - $2,280 | $550 - $3,510 |
| Hospital Discharge | 99238-99239 | $255 - $340 | N/A | $255 - $340 |
Laboratory and Radiology Services
The charges listed below have a draw fee associated with them called a venipuncture. The charge amount for a venipuncture is $42.00. It is billed as a facility charge.
| description of service | procedure codes* | professional charge** | facility charge** | total charges |
|---|---|---|---|---|
| Complete Blood Count (CBC) | 85025 | N/A | $222 | $222 |
| Complete Metabolic Panel (CMP) | 80053 | N/A | $372 | $372 |
| Lipid Panel | 80061 | N/A | $354 | $354 |
| Tuberculosis Test Cell Immune Measure (TB) | 86480 | N/A | $543 | $543 |
| Hemoglobin; glycosylated (A1C) | 83036 | N/A | $233 | $233 |
| Chest X-ray | 71045-71046 8471045 8471046 | $105 - $125 | $460 | $565 - $585 |
| EKG | 93010 93005 8293005 | $214 | $360 | $444 |
| COVID-19 Test | 87635 or U0004 | N/A | $175 | $175 |
Mammograms
| description of service | procedure codes* | professional charge** | facility charge** | total charges |
|---|---|---|---|---|
| Bilateral Screening - Digital | 77067, with 3D Tomography 77063 8477063 8477067 |
$890 | $1,290 | $2,180 |
| Bilateral Diagnostic - Digital | 77066, with 3D Tomography G0279 8477066 8477062 |
$950 | $1,380 | $2,330 |
Colonoscopy
| description of service | procedure codes* | professional charge** | facility charge** | total charges |
|---|---|---|---|---|
| Diagnostic Outpatient | 45378 8245378 |
$2,470 | $2,680 | $5,150 |
Magnetic Resonance Imaging (MRI)
| description of service | procedure codes* | professional charge** | facility charge** | total charges |
|---|---|---|---|---|
| Head - without contrast | 70551 8470551 |
$1,720 | $3,850 | $5,570 |
| Head - imaging performed no contrast followed by with contrast | 70553 8470553 |
$2,340 | $6,310 | $8,650 |
*Each service has a unique procedure code that is associated with the description and cost of the service or procedure performed. These codes are used nationally and help ensure consistency in the billing and reimbursement process. The codes are used to communicate to insurance companies.
The charges listed above are reflective of our most common services provided and are predominantly provided in a hospital provider based setting. In most instances, there will be a bill from Carle Physician Group for "professional charges" as well as a bill from Carle Foundation Hospital for "facility charges". Provider Based Billing is an established nationally-recognized billing model for hospitals and clinics that complies with Medicare regulations. Most insurance companies are familiar with provider based bills and pay claims accordingly.