CT imaging
CT abdomen and pelvis with contrast
CPT 74177
$1,596 - $3,490
from 4 insurers · median $1,947
Typical for a hospital with this service line
Brenham, TX
25
Beds
1,168
Inpatient discharges a year
$59.4M
Net patient revenue a year
Baylor Scott & White Hospital - Brenham is a 25-bed hospital in Brenham, TX.
The 24 services Baylor Scott & White Hospital - Brenham most likely performs, ranked by likely volume and what it is paid. Each service names one insurer. * marks hidden insurer names; A, B and C rank the remaining rates from low to high and reset for each service.
Book a demo to see hidden insurer names, more payer rates, and hospital data, or start a free trial.
CT imaging
CPT 74177
$1,596 - $3,490
from 4 insurers · median $1,947
Typical for a hospital with this service line
CT imaging
CPT 70450
$557 - $1,997
from 4 insurers · median $1,556
Typical for a hospital with this service line
Digestive procedures
CPT 43239
$1,340 - $4,563
from 3 insurers · median $3,723
Typical for a hospital with this service line
CT imaging
CPT 74176
$1,158 - $2,601
from 4 insurers · median $1,796
Typical for a hospital with this service line
Digestive procedures
CPT 45385
$1,712 - $4,563
from 3 insurers · median $3,723
Typical for a hospital with this service line
Cardiology and vascular testing
CPT 93306
$487 - $2,982
from 4 insurers · median $1,637
Typical for a hospital with this service line
Digestive procedures
CPT 45380
$1,712 - $4,563
from 3 insurers · median $3,723
Typical for a hospital with this service line
CT imaging
CPT 71275
$906 - $2,581
from 4 insurers · median $1,796
Typical for a hospital with this service line
X-ray and bone density
CPT 71046
$311 - $393
from 4 insurers · median $316
Typical for a hospital with this service line
MRI imaging
CPT 70553
$1,862 - $3,190
from 4 insurers · median $2,185
Typical for a hospital with this service line
Digestive procedures
CPT 45378
$1,302 - $4,563
from 3 insurers · median $3,723
Typical for a hospital with this service line
Medicine & Surgery
CPT 47562
$8,241 - $9,751
from 3 insurers · median $9,412
Typical for a hospital with this service line
Mammography
CPT 77067
$170 - $357
from 4 insurers · median $218
Typical for a hospital with this service line
MRI imaging
CPT 72148
$1,158 - $2,472
from 4 insurers · median $1,980
Typical for a hospital with this service line
MRI imaging
CPT 70551
$1,158 - $2,472
from 4 insurers · median $1,967
Typical for a hospital with this service line
Gynecology
CPT 58571
$9,312 - $13,293
from 4 insurers · median $9,656
Typical for a hospital with this service line
Ultrasound
CPT 76705
$447 - $774
from 4 insurers · median $614
Typical for a hospital with this service line
MRI imaging
CPT 73721
$1,158 - $2,472
from 4 insurers · median $1,921
Typical for a hospital with this service line
Medicine & Surgery
CPT 66984
$2,156 - $8,185
from 4 insurers · median $3,719
Typical for a hospital with this service line
Cardiology and vascular testing
CPT 93971
$360 - $1,117
from 4 insurers · median $828
Typical for a hospital with this service line
Gynecology
CPT 58661
$6,143 - $8,412
from 4 insurers · median $7,764
Typical for a hospital with this service line
Laboratory and pathology
CPT 80053
$12 - $147
from 4 insurers · median $105
Typical for a hospital with this service line
Ultrasound
CPT 76830
$352 - $697
from 4 insurers · median $552
Typical for a hospital with this service line
Ultrasound
CPT 76856
$447 - $746
from 4 insurers · median $592
Typical for a hospital with this service line
Median rate as a percent of Medicare across the outpatient services above, and how many services sit above or below the same insurer's median at nearby hospitals. * marks hidden insurer names. These table labels track the same insurers across services; the labels on each service card reset.
| Insurer | Services | Median % of Medicare | Above nearby | Below nearby |
|---|---|---|---|---|
| Insurer A* | 19 | 812% | 0 | 0 |
| Insurer B* | 24 | 547% | 0 | 0 |
| Insurer C* | 24 | 481% | 0 | 0 |
| Insurer D* | 24 | 372% | 0 | 0 |
How we chose these services: 0 appear in this hospital's own Medicare claims, 0 are common here based on CMS Medicare volume, and 24 are typical for the service lines it reports to CMS. Rates come from insurer and hospital price transparency files as of October 2026. Rates under a quarter of Medicare or over 20 times Medicare are left out as likely physician-fee rows or file errors. Book a demo to see all 300 CMS shoppable services for Baylor Scott & White Hospital - Brenham, or start a free trial.
Acceptance varies by plan and service. Confirm coverage with your insurer or the hospital's billing department.

Doctors and services
Accredited by The Joint Commission
Finances
$59.4M net patient revenue
Ownership and leadership
Owned by Baylor Scott & White Health
Brenham, TX 77833
(979) 337-5000
The Joint Commission (since 2025)
Accreditation
None
Medical school affiliation
Private (not for profit)
Ownership type
25
Medicare-certified beds
2022
In Medicare since
Source: CMS Provider of Services file, as reported by the hospital and state surveyors.
What Baylor Scott & White Hospital - Brenham reported to Medicare in its latest cost report, covering Jan 1, 2025 to Dec 31, 2025.
1,168
Inpatient discharges
Medicare 27%, Medicaid 5%
4,441
Inpatient days
49% of available bed days used
130
Employees (full-time equivalent)
Source: CMS cost report (HCRIS) (report 836770). Figures cover the reporting period, which is not always 12 months, and are self-reported.
Inpatient days and discharges Baylor Scott & White Hospital - Brenham reported by payer. Medicare and Medicaid include their managed care plans, shown separately below.
| Medicare | Medicaid | Other | Total | |
|---|---|---|---|---|
| Inpatient days | 1,617 | 186 | 2,638 | 4,441 |
| Discharges | 315 | 62 | 791 | 1,168 |
| Average length of stay | 5.1 days | 3.0 days | 3.3 days | 3.8 days |
| Average daily census | 4.4 | 0.5 | 7.2 | 12.2 |
559
Medicare Advantage days
143 discharges
528
Medicaid managed care days
176 discharges
733
Observation bed days
| Unit | Beds | Inpatient days | Medicare days | Occupancy |
|---|---|---|---|---|
| Adults & pediatrics | 25 | 3,040 | 1,067 | 33% |
| Nursery | 520 |
Source: CMS cost report (HCRIS, Form 2552-10), report 836770, as submitted. Hospitals report these figures themselves; they are not audited financial statements. Worksheet S-3 Part I.
ZIP codes with the most Medicare inpatient stays at Baylor Scott & White Hospital - Brenham in 2025. Market share is this hospital's part of every hospital's Medicare stays from the ZIP code. Its published Medicare stays went from 212 in 2022 to 307 in 2025.
| ZIP code | Stays | Of this hospital's stays | Days | Charges | Market share |
|---|---|---|---|---|---|
| 77833 | 208 | 68% | 747 | $7.1M | 13% |
| 77418 | 22 | 7% | 81 | $649,037 | 4% |
| 77426 | 19 | 6% | 62 | $610,572 | 16% |
| 77835 | 18 | 6% | 62 | $610,261 | 16% |
| 77834 | 14 | 5% | 54 | $404,506 | 18% |
| 78954 | 14 | 5% | 46 | $471,444 | 25% |
| 78932 | 12 | 4% | 52 | $446,840 | 27% |
Source: CMS Hospital Service Area file. Shares are of the 307 stays from ZIP codes CMS publishes; it omits ZIP codes with fewer than 11 stays, so market shares count published stays only.
Staff by profession and the rooms and units Baylor Scott & White Hospital - Brenham reported at its latest Medicare certification survey (2025). Counts are people, not full-time equivalents.
3
Off-site locations
Source: CMS Provider of Services file.
180 clinicians who bill Medicare list Baylor Scott & White Hospital - Brenham as a hospital affiliation. Showing 24 of them. Book a demo to see the commercial rates insurers publish for them, or start a free trial.
Rajpreet Singh, D.O.
Rheumatology Physician
NPI 1043441983
See commercial rates for Rajpreet Singh, D.O.Ricardo Pocurull, MD
Rheumatology Physician
NPI 1568471159
See commercial rates for Ricardo Pocurull, MDErin Fleener, M.D.
Hematology & Oncology Physician
NPI 1295775005
See commercial rates for Erin Fleener, M.D.Mark Floyd, MD
Hematology & Oncology Physician
NPI 1144595539
See commercial rates for Mark Floyd, MDTerry Jenkins, M.D.
Hematology & Oncology Physician
NPI 1063467298
See commercial rates for Terry Jenkins, M.D.Ricardo Gutierrez, MD
Cardiovascular Disease Physician
NPI 1902878044
See commercial rates for Ricardo Gutierrez, MDMarc Schwartz, MD
Cardiovascular Disease Physician
NPI 1275505570
See commercial rates for Marc Schwartz, MDJohn Chennault, D.O.
Family Medicine Physician
NPI 1013945070
See commercial rates for John Chennault, D.O.Marcel Lechin, M.D.
Interventional Cardiology Physician
NPI 1427000496
See commercial rates for Marcel Lechin, M.D.Fernando Colato Zavaleta
Cardiovascular Disease Physician
NPI 1669630737
See commercial rates for Fernando Colato ZavaletaGloria Mays, MD
Cardiovascular Disease Physician
NPI 1720050065
See commercial rates for Gloria Mays, MDAmy Gutierrez, M.D.
Family Medicine Physician
NPI 1851395750
See commercial rates for Amy Gutierrez, M.D.Lane Miller, M.D.
Specialist
NPI 1316986631
See commercial rates for Lane Miller, M.D.Matthew Vassaur, MD
Pain Medicine (Physical Medicine & Rehabilitation) Physician
NPI 1376048009
See commercial rates for Matthew Vassaur, MDKennon Wigley, MD
Cardiovascular Disease Physician
NPI 1215904495
See commercial rates for Kennon Wigley, MDRyan Frieben, M.D.
Urology Physician
NPI 1811247950
See commercial rates for Ryan Frieben, M.D.Christopher Bathurst, MD
Diagnostic Radiology Physician
NPI 1205024775
See commercial rates for Christopher Bathurst, MDElizabeth Ebert, M.D.
Cardiovascular Disease Physician
NPI 1578586715
See commercial rates for Elizabeth Ebert, M.D.Jaime Benton, MD
Family Medicine Physician
NPI 1700878311
See commercial rates for Jaime Benton, MDWilliam Loesch, M.D.
Internal Medicine Physician
NPI 1225296437
See commercial rates for William Loesch, M.D.Bao Le, D.O.
Interventional Cardiology Physician
NPI 1588863898
See commercial rates for Bao Le, D.O.Srinath Vemuri, M.D.
Cardiovascular Disease Physician
NPI 1386808723
See commercial rates for Srinath Vemuri, M.D.William Larkin
Diagnostic Radiology Physician
NPI 1760630065
See commercial rates for William LarkinBarbara Pierce, M.D.
Family Medicine Physician
NPI 1477653962
See commercial rates for Barbara Pierce, M.D.Source: CMS Doctors and Clinicians facility affiliations, released 2026-10-15, with names and specialties from NPPES. Affiliation means the clinician bills Medicare for care at this hospital; it is not employment.
Revenue, expenses and income Baylor Scott & White Hospital - Brenham reported to Medicare for Jan 1, 2025 to Dec 31, 2025. Percentages are of net patient revenue.
| Line | Amount | Share |
|---|---|---|
| Gross patient revenue (charges) | $291.4M | 490.2% |
| Inpatient | $42.3M | 71.2% |
| Outpatient | $249M | 419.0% |
| Contractual allowances and discounts | -$231.9M | -390.2% |
| Net patient revenue | $59.4M | 100.0% |
| Operating expenses | -$52.1M | -87.7% |
| Operating income from patient care | $7.3M | 12.3% |
| Other income | $5.1M | 8.6% |
| Contributions and donations | $202,338 | 0.3% |
| Investment income | $574,831 | 1.0% |
| Other | $4.3M | 7.3% |
| Net income | $12.4M | 20.9% |
| Line | Amount | Share |
|---|---|---|
| Traditional Medicare | $72.8M | 25.1% |
| Medicaid (including managed care) | $17.5M | 6.0% |
| Other payers and self-pay | $200M | 68.9% |
| Total charges | $290.2M | 100.0% |
Source: CMS cost report (HCRIS, Form 2552-10), report 836770, as submitted. Hospitals report these figures themselves; they are not audited financial statements. Traditional Medicare is the program charges on Worksheets D-3 and D Part V; Medicaid is from Worksheet S-10.
Computed from Baylor Scott & White Hospital - Brenham's latest cost report.
12.3%
Operating margin
Operating income from patient care / net patient revenue
19.3%
Total margin
Net income / net patient revenue plus other income
22.3%
EBITDAR margin
Net income before interest, depreciation and leases (Worksheet A-7), / total revenue
36% of expenses
Personnel costs
Salaries, direct-care contract labor and core wage-related costs / operating expenses
26.1%
Return on assets
Net income for a year / total assets
30.6%
Return on equity
Net income for a year / fund balance
4.43
Current ratio
Current assets / current liabilities
1.41
Quick ratio
Cash, temporary investments and net receivables / current liabilities
0 days
Days cash on hand
Cash and temporary investments / daily operating expenses excluding depreciation
53 days
Days in patient receivables
Net patient receivables / daily net patient revenue
45 days
Average payment period
Current liabilities / daily operating expenses excluding depreciation
1.35
Asset turnover
Total revenue for a year / total assets
8.4 years
Average age of plant
Accumulated depreciation / depreciation for a year
Source: CMS cost report (HCRIS, Form 2552-10), report 836770, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
What Baylor Scott & White Hospital - Brenham owned and owed at the end of its reporting period (Dec 2025), across all fund types: $47.7M in total assets and a $40.6M fund balance.
| Line | Amount | Of total assets |
|---|---|---|
| Cash and temporary investments | $2,790 | 0.0% |
| Patient receivables, net | $8.6M | 18.1% |
| Inventory | $1.7M | 3.6% |
| Total current assets | $27.2M | 57.0% |
| Property and equipment, net of depreciation | $12.5M | 26.1% |
| Investments and other assets | $8.1M | 16.9% |
| Total assets | $47.7M | 100.0% |
| Current liabilities | $6.1M | 12.9% |
| Total liabilities | $7.1M | 14.9% |
| Fund balance (net assets) | $40.6M | 85.1% |
Source: CMS cost report (HCRIS, Form 2552-10), report 836770, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
Care Baylor Scott & White Hospital - Brenham provided without full payment, as reported on Worksheet S-10 of its cost report.
$5.3M
Cost of charity care
Care for patients approved for charity care and uninsured discounts, at cost
$7.9M
Bad debt
Patient bills written off as uncollectible, at charges
-$1.4M
Medicaid shortfall
Cost of Medicaid patients (charges times the cost-to-charge ratio) minus Medicaid payments; negative means a surplus
$835
CHIP shortfall
Cost of stand-alone CHIP patients minus CHIP payments
$4,522
State and local indigent care shortfall
Cost of indigent care program patients minus program payments
$6.6M
Total unreimbursed and uncompensated care
12.7% of operating expenses
Medicaid, CHIP and indigent care shortfalls plus charity care and the cost of bad debt (Worksheet S-10 line 31)
Source: CMS cost report (HCRIS, Form 2552-10), report 836770, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
Baylor Scott & White Hospital - Brenham's full-year cost reports, by fiscal year end. Reports shorter than ten months are left out.
| Fiscal year ending | Dec 2023 | Dec 2024 | Dec 2025 |
|---|---|---|---|
| Net patient revenue | $42.7M | $47.6M | $59.4M |
| Operating expenses | $39.7M | $43.9M | $52.1M |
| Operating margin | 6.9% | 7.7% | 12.3% |
| Net income | $8.8M | $6.7M | $12.4M |
| Total assets | $34.9M | $35.8M | $47.7M |
| Discharges | 1,147 | 1,093 | 1,168 |
| Inpatient days | 3,851 | 4,297 | 4,441 |
| Medicare Advantage days | 712 | 647 | 559 |
| Beds | 25 | 25 | 25 |
| Employees (FTE) | 166 | 165 | 130 |
Source: CMS cost report (HCRIS, Form 2552-10), report 836770, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
Each cost center Baylor Scott & White Hospital - Brenham reports, largest first. Total cost includes its share of overhead; the cost-to-charge ratio is total cost / charges.
| Department | Salaries | Total cost | Charges | Cost-to-charge | Square feet |
|---|---|---|---|---|---|
| Emergency | $3.2M | $7.2M | $72.7M | 0.10 | 9,099 |
| Operating room | $1.9M | $5.6M | $21M | 0.27 | 17,135 |
| Laboratory | $1.1M | $5.1M | $57.6M | 0.09 | 1,970 |
| Drugs charged to patients | $4.8M | $18.8M | 0.26 | ||
| Delivery room & labor room | $2.3M | $4.6M | $3.9M | 1.17 | 6,484 |
| Radiology-diagnostic | $1.4M | $3.1M | $64.9M | 0.05 | 3,188 |
| Physical therapy | $984,237 | $1.8M | $9.4M | 0.20 | 536 |
| Observation beds (non-distinct part | $1.5M | $2.4M | 0.60 | ||
| Impl. dev. charged to patients | $1.4M | $3.1M | 0.46 | ||
| Respiratory therapy | $509,985 | $996,253 | $4.7M | 0.21 | 567 |
| Medical supplies charged to patient | $830,699 | $1.2M | 0.71 | ||
| Anesthesiology | $93,017 | $500,350 | $7.9M | 0.06 | |
| Electrocardiology | $263,567 | $452,687 | $7.6M | 0.06 | |
| Occupational therapy | $173,834 | $293,867 | $2M | 0.15 | |
| Blood storing processing & trans. | $269,337 | $636,064 | 0.42 | ||
| Speech pathology | $89,125 | $148,043 | $465,360 | 0.32 |
| Department | Salaries | Total cost | Charges | Cost-to-charge | Square feet |
|---|---|---|---|---|---|
| Adults & pediatrics | $2.9M | $9.2M | $10.8M | 0.86 | 12,550 |
| Nursery | $4,025 | $1.2M | $1.1M | 1.06 | 693 |
| Department | Salaries | Direct cost | Paid hours | Average hourly wage | Square feet |
|---|---|---|---|---|---|
| Administrative & general | $2.3M | $11M | 10,183 | ||
| Operation of plant | $2.7M | 3,479 | |||
| Pharmacy | $708,522 | $1.1M | 1,165 | ||
| Cap rel costs-mvble equip | $1.1M | ||||
| Cap rel costs-bldg & fixt | $883,321 | 74,204 | |||
| Dietary | $858,913 | 3,488 | |||
| Nursing administration | $263,877 | $643,726 | 352 | ||
| Housekeeping | $564,651 | 532 | |||
| Social service | $191,508 | $257,078 | |||
| Central services & supply | $93,142 | $204,683 | |||
| Employee benefits department | $125,350 | $159,085 | 783 | ||
| Laundry & linen service | $133,801 |
Source: CMS cost report (HCRIS, Form 2552-10), report 836770, as submitted. Hospitals report these figures themselves; they are not audited financial statements. Worksheets A, B-1, C Part I and S-3 Part II.
Organizations Baylor Scott & White Hospital - Brenham reports to Medicare as owners or with operational control.
Baylor Scott & White Health
Operational/managerial control, since 2014
Scott & White Healthcare
Operational/managerial control, since 2010
Sources: CMS Hospital All Owners.
The officers and board members on Baylor Scott & White Hospital - Brenham's Medicare enrollment and on the IRS Form 990 filed under its tax ID.
Source: CMS Hospital All Owners (PECOS), the people the hospital lists on its Medicare enrollment.
340B drug pricing program
Participating since 2026
340B ID CAH451397-00, registered as a critical access hospital; 1 active contract pharmacies. Authorizing official: Jason Jennings, President.
Source: HRSA 340B Office of Pharmacy Affairs Information System.
Accountable care organization (Medicare Shared Savings Program)
Baylor Scott & White Quality Alliance
ACO A2542, current agreement since 2026. Public reporting page
Source: CMS Shared Savings Program participants, 2026, matched on Baylor Scott & White Hospital - Brenham's legal name.
Baylor scott & white wmc - swing bed
CCN 45Z397, certified 2024, Medicare cost reimbursed
Baylor scott & white wmc - swing bed
CCN 45Z397, certified 2024
Source: Worksheet S-2 Part I of Baylor Scott & White Hospital - Brenham's latest Medicare cost report (HCRIS).
About Baylor Scott & White Hospital - Brenham's rates and hospital price transparency.
For MRI brain before and after contrast (CPT 70553), published negotiated rates at Baylor Scott & White Hospital - Brenham range from $1,862 to $3,190 across 4 insurers. Cigna's rate is $1,862. What a patient pays depends on their plan's deductible, coinsurance and network status.
For CT abdomen and pelvis with contrast (CPT 74177), published negotiated rates at Baylor Scott & White Hospital - Brenham range from $1,596 to $3,490 across 4 insurers. Aetna's rate is $3,490. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Colonoscopy with polyp removal (CPT 45385), published negotiated rates at Baylor Scott & White Hospital - Brenham range from $1,712 to $4,563 across 3 insurers. Blue Cross Blue Shield's rate is $1,712. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Screening mammography, bilateral (CPT 77067), published negotiated rates at Baylor Scott & White Hospital - Brenham range from $170 to $357 across 4 insurers. Aetna's rate is $218. What a patient pays depends on their plan's deductible, coinsurance and network status.
Baylor Scott & White Hospital - Brenham reported 1,168 inpatient discharges and 4,441 inpatient days from Jan 1, 2025 to Dec 31, 2025.
Baylor Scott & White Hospital - Brenham reported 130 full-time-equivalent employees on payroll from Jan 1, 2025 to Dec 31, 2025.
Baylor Scott & White Hospital - Brenham reported $59.4M in net patient revenue on $291.4M of gross charges for Jan 1, 2025 to Dec 31, 2025, an operating margin of 12.3%, and net income of $12.4M.
Baylor Scott & White Hospital - Brenham reported $6.6M of unreimbursed and uncompensated care for Jan 1, 2025 to Dec 31, 2025, including $5.3M of charity care at cost.
Yes. HRSA's 340B database lists Baylor Scott & White Hospital - Brenham (340B ID CAH451397-00) as a participating critical access hospital since 2026, with 1 active contract pharmacies.
180 clinicians who bill Medicare list Baylor Scott & White Hospital - Brenham as a hospital affiliation in CMS's Doctors and Clinicians data. The largest groups are family medicine physician (34), family nurse practitioner (20), internal medicine physician (13).
Yes. CMS's Provider of Services file lists The Joint Commission as the accrediting organization for Baylor Scott & White Hospital - Brenham, effective 2025.
In its Medicare enrollment, Baylor Scott & White Hospital - Brenham reports Baylor Scott & White Health as Operational/managerial control.
In CMS's 2025 Hospital Service Area file, the most Medicare inpatient stays at Baylor Scott & White Hospital - Brenham came from ZIP codes 77833 (208), 77418 (22), 77426 (19).
Baylor Scott & White Hospital - Brenham has 25 beds, including its psychiatric, rehabilitation and other subprovider units, in its latest Medicare cost report.
Baylor Scott & White Hospital - Brenham is located at Brenham, TX 77833. Its main phone number is (979) 337-5000.
Baylor Scott & White Hospital - Brenham's CMS Certification Number (CCN), also called its Medicare provider number, is 451397.
Under 45 CFR Part 180, every US hospital must publish a machine-readable file of its standard charges, including gross charges, discounted cash prices and payer-specific negotiated rates, in the CMS template format. PayerPrice can help hospitals publish and maintain these files.
A chargemaster (charge description master, or CDM) is a hospital's master list of billable items, with codes, descriptions and gross charges. A chargemaster review looks at those lines for accuracy and pricing. PayerPrice can help hospitals review their chargemaster; contact us to discuss your needs.
For hospital finance and compliance teams
The data on this page comes from the files hospitals and payers publish. We help hospitals publish theirs correctly, and take a fresh look at their chargemaster.
We turn your chargemaster and payer contracts into the CMS template file, then keep it current as rates change.
{
"description": "MRI of brain (no contrast)",
"code_information": [
{ "code": "611", "type": "RC" },
{ "code": "70551", "type": "CPT" }
],
"standard_charges": [{
"setting": "outpatient",
"minimum": 250,
"maximum": 400,
"gross_charge": 1200,
"discounted_cash": 1080,
"payers_information": [
{
"payer_name": "Platform Health Insurance",
"plan_name": "PPO",
"methodology": "fee schedule",
"standard_charge_dollar": 400
},
{
"payer_name": "Region Health Insurance",
"plan_name": "HMO",
"methodology": "fee schedule",
"standard_charge_dollar": 250
}
]
}]
}Your chargemaster sets the gross charge on every claim, and many payer contracts base payment on it through percent-of-charge, lesser-of and stop-loss terms. We audit it line by line and show how your charges and negotiated rates compare with peer hospitals before your next negotiation.
What a review covers