Knoxville Hospital and Clinics is dedicated to making our pricing publically available so that you can make more informed decisions about your healthcare costs.

We provide a variety of resources to help you better understand the costs of your medical care and assist you in planning ahead for medical expenses.

Patient Price Estimator

Knoxville Hospital and Clinics's Patient Price Estimator provides approximate out-of-pocket costs for a specific medical procedure or service at Knoxville Hospital and Clinics.

PATIENT PRICE ESTIMATOR

Please Contact Us

Please contact Knoxville Hospital and Clinics Price Estimation Team at priceline@fmdh.org or call (641) 842-1423 for more information about Knoxville Hospital and Clinics pricing. Our agents are happy to assist you in understanding your costs for a medical procedure or visit.

F.A.Q.

Dear Valued Customer:

More than ever before, consumers are expressing an interest in knowing their potential out-of-pocket expenses prior to receiving medical care.

The Knoxville Hospital & Clinics (KHC) is responding to this interest by offering a variety of resources to assist our valued patients in making decisions regarding their necessary medical care as follows.

  1. A complete price list of all medical services offered by KHC (click this link)
  2. A listing of the Centers for Medicare & Medicaid Services (CMS) 300 required “Shoppable Services”. A shoppable service is defined as a service that can be scheduled by a health care consumer in advance (click this link).
  3. Additionally, KHC can assist you in pricing the services you require, using a simple consumer friendly decision tree process (click this link).
  4. There is also an option to verify your insurance coverage eligibility to ensure that your health plan offers KHC as a participating provider in order to maximize your covered benefits while also minimizing your personal out-of-pocket costs. (click this link)
  5. To calculate the potential out-of-pocket costs for the services ordered by your health care provider (click this link).
  6. KHC’s Quality Scores are also available for viewing (click this link)

If you would like to schedule your treatment or if you have any general clinical questions, please contact KHC’s scheduling department at (641) 842-1443 or (click this link).

Important Reminder: At KHC, our clinical staff acts in your best interest by providing the level of service and care necessary to ensure the best possible clinical outcomes. And, we totally understand that medical care is an expensive and oftentimes unplanned expense that can cause financial hardship. Simply electing to forego receiving necessary medical care on the basis of cost alone can be a risky choice.

With this in mind, if at any time you feel you are unable to afford your medically necessary health care procedures, our Financial Counseling Staff is available at (641) 842-1423 or (click this link), to discus the various options available to assist you in receiving the care you need.

We appreciate your interest in our services and encourage you to partner with the Knoxville Hospital & Clinics, a health care provider who is committed to quality care and patient satisfaction.

Pricing Lists

To make medical pricing more transparent, all U.S. hospitals are required to provide the following pricing lists. The pricing is listed by the Current Procedural Terminology (CPT) code used by insurance companies. The lists are in a spreadsheet format.

PLEASE NOTE: The pricing lists below show charges prior to contract negotiations with individual insurance providers. They may be useful for comparing pricing with other hospitals, but they DO NOT indicate actual costs to patients.

STANDARD CHARGES
(CHARGEMASTER PRICING)
7/2/2021

This list shows preliminary pricing for thousands of different services and medical procedures performed at Knoxville Hospital and Clinics.

AVERAGE CHARGES
BY PATIENT GROUP
02/07/2018 to 08/28/2020, 7/2/2021

This list shows pricing by types of patient groups, referred to as MS-DRGs (Medicare Severity Diagnosis Related Groups).

SHOPPABLE SERVICES
PRICING
02/07/2018 to 08/28/2020, 7/2/2021

This list shows Knoxville Hospital and Clinics pricing for the most common 300 medical services. It includes gross charges, discounted cash prices, and payer-specific negotiated charges.

The Knoxville Hospital & Clinics (KHC) out-of-pocket cost “estimate” does not always reflect the “exact” amount you will owe for the services you are scheduled to receive. The reason being, the actual expenses for identical procedures can and will vary from patient to patient because your provider’s treatment choices are based on your unique health care needs. Therefore, the amount shown is a close estimate of the minimum amount you would have to pay, not taking into account any extraordinary circumstances that could arise during your course of treatment.

Further, the estimated out-of-pocket patient cost is based solely on the information entered into the pricing tool. In addition, use of the tool itself to obtain an estimated cost is not a guarantee of insurance coverage. Thus, it is omportant to check with your insurance company if you need help understanding your benefits for the services in question.

Other considerations:

  1. For example, if you request an estimate for a surgical procedure, it will likely not include:

    • Pre-Procedure Office Visits
    • Post-Procedure Office Visits
    • Diagnostic Testing
    • Primary Care Physician Fees
    • Surgeon Fees
    • Anesthesiologist Fees
    • Pathologist Fees
    • Radiologist Fees
    • Cardiologist Fees
  2. Whether you have met all or part of your deductible and/or maximum out-of-pocket expenses prior to the services being rendered, may cause the actual amount you owe to be different from the estimate.

  3. Also, the estimation process becomes slightly more complicated when patients see other health care providers in addition to KHC prior to the visit date and claims with those providers are still in process with insurance at the time of the KHC visit.

In order to continue to the Out-Of-Pocket Cost Estimator, please check the following and "understand and agree" at the bottom of the page.

I HAVE READ AND UNDERSTAND THE ABOVE LIMITATIONS AND I FULLY UNDERSTAND.

THIS IS ONLY AN ESTIMATE. MY ACTUAL CHARGES MAY BE DIFFERENT (HIGHER OR LOWER) THAN THE ESTIMATE.

In compliance with the CMS Price Transparency rules taking effect on 01/01/2021 (CMS Price Transparency), please click the link(s) below to view a full list of Hospital charges:

Select Your Insurance
Enter Your Insurance Information – Medicare
(Enter 0 if none)
Enter Your Insurance Information – Commercial Insurance (Excluding Medicare)
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Check Your Eligibility
Check Your Eligibility – Result
Review Your Estimate
Insurance: 
Please click on one of the following Insurance Companies to identify the necessary fields to complete your Eligibility Check:
Aetna
Blue Shield / Blue Cross
Cigna
Humana
UnitedHealthcare
Placeholder page for Facility Scheduling Department.
Placeholder page for Facility Quality Scores.
Placeholder page for Facility Financial Assistance.
Placeholder page for Facility Questions.
Placeholder page for Facility Chat.
Placeholder page for Facility Assistance.

Each hospital has its own policy for setting prices. Hospital charges vary because they reflect the individual hospital’s mission and the Patient population it serves. A hospital that provides highly specialized services, such as trauma units or dedicated intensive care services, like Knoxville Hospital and Clinics , has a different cost structure and pricing than one that does not. Prices are reviewed each year on Jan. 1, and are subject to change during the year. To establish prices, we consider many factors including:

  • The cost of staff, equipment, medications and other supplies involved in Patient care

  • The amount of time our facilities and staff are involved in providing services

  • The cost of administrative expenses such as billing, technology, housekeeping, etc.

  • Insurance company contracts

  • Information provided by the Centers for Medicare and Medicaid Services, the federal agency that manages the Medicare and Medicaid programs

Here’s an excerpt from the AHA’s “Detailed Summary of No Surprises Act”:

https://www.aha.org/system/files/media/file/2021/01/detailed-summary-of-no-surprises-act-advisory-1-14-21.pdf

Not necessarily. In addition to your hospital charges, you could receive separate bills for physician’s fees from your surgeon, anesthesiologist, radiologist, emergency room physician and other specialists. Please contact those offices directly for price information (641) 842-1423.

CPT stands for Current Procedural Terminology. A CPT code is a five-digit code used by all hospitals, physicians, and insurance companies to identify a type of service or procedure. You will see CPT codes located on our pricing lists to help ensure that you are viewing the price information for the specific procedure your physician has ordered.

DRG stands for Diagnosis Related Group. A DRG is only assigned to an inpatient hospital service. DRGs are universal groupings used by Medicare and most insurance companies to clarify the type of inpatient care a Patient receives. Insurance companies use the DRG code, along with a diagnosis/CPT code and the length of the inpatient stay, to determine payment and reimbursement for claims.

Charges for many common, high-volume procedures are listed on our site. Additional service areas are being added regularly. Please contact Knoxville Hospital and Clinics Patient Estimates Team at (Email) or call (641) 842-1423 for estimates information on a procedure not listed.

The amount you owe may vary due to a number of circumstances: Additional testing, medications, services or procedures ordered by your physician. The procedure planned may not be the procedure performed based on your physician’s assessment.

Our Patients’ safety and preventing hospital-acquired infections is a major focus at Knoxville Hospital and Clinics . We are proud that we perform better than national benchmarks in the majority of categories of hospital-acquired infection rates. Our Caregivers are dedicated to improving in this area, and it remains a constant priority for Knoxville Hospital and Clinics . For more information on the quality and transparency commitment, please see our website at (WEBSITE LINK) QualityAndTransparencyCommitment.

Click here for a list of insurance plans and whether Knoxville Hospital and Clinics is considered an “in-network” or “out-of-network” provider. Or, call your insurance provider directly to verify that Knoxville Hospital and Clinics is in your network. Knoxville Hospital and Clinics will file claims to any insurance company you authorize, but your employer and insurance company determine your level of coverage. An insurance contract between your insurance company and Knoxville Hospital and Clinics doesn’t guarantee that your claims will be paid in full. You’re responsible for payment of services not authorized by your insurance company and any balance remaining after insurance payments and adjustments have been applied.

Yes. In an emergency, always go to the closest hospital. Your insurance provider generally will cover emergency department costs or recommend a transfer to an “in-network” hospital when it is safe to do so. If you choose to go to an “out-of-network” hospital in a non-emergency, you may be required to pay a larger deductible or a greater portion of your bill. Call your insurance company to find out your health plan’s “out-of-network” options.

We will do our best to provide you with an estimate price based on our hospital’s charges for comparable services and your insurance information, if applicable.

We do our best to provide you with an accurate estimate. However, your actual bill might vary, and our estimates are not guaranteed because the services each patient requires can vary, and your bill will be dependent on your individual circumstances at the time your services are rendered. Your health plan may require a co-payment or deductible that will be due during appointment registration. Check with your provider on the amount that you will be responsible for at this time. Following your healthcare services, your insurance provider will send you an Explanation of Benefits (EOB), which will detail the amount it has paid, any non-covered or denied amounts, and the remaining balance that you are responsible for paying to Knoxville Hospital and Clinics . Review this EOB, compare it to your Knoxville Hospital and Clinics billing statement, and call your insurance provider or a Knoxville Hospital and Clinics Customer Service if you have questions or concerns.

Your personal physician or other physicians providing you with services related to your hospital stay or visit will bill you separately. This can include fees related to specialists, anesthesiologists, pathologists, and radiologists.

Independent laboratory and radiology services will also bill you separately for reading and interpreting EKG’s, X-rays, EEG’s and lab work.

Prices can vary widely depending on whether your hospital is in- or out-of-network for your specific health plan. Out-of-network hospitals have not been able to negotiate a discounted price with your insurer, thus making you potentially responsible for higher personal payments.

Even if your hospital is in-network, you may receive care from an out-of-network physician. If possible, always find out if all physicians who will treat you are within your health plan’s network. This includes but is not limited to: anesthesiologists for surgery or pregnancy delivery along with pathologists, radiologists or consulting doctors. If they are not within network, ask if they will accept in-network payment for services provided to you. If you’re concerned that your doctor may be out-of-network, contact your insurance company.

Yes, services and procedures may be different based on age and level of health (for example, uncontrolled diabetes and high blood pressure).

Yes. Knoxville Hospital and Clinics Financial Assistance Specialists assist individuals and families that have health insurance but who need additional financial resources to cover medical bills. We can identify and help you apply for programs including Medicaid, Social Security, and other financial assistance.

We can help you determine if you are eligible for government programs, a product on the Health Insurance Marketplace, or financial assistance through Knoxville Hospital and Clinics ’s Community Financial Aid program. Please note: emergency services will never be delayed or withheld on the basis of a patient’s ability to pay.

For general care, if you do not have health insurance, call the Knoxville Hospital and Clinics Patient Financial Services Department at (641) 842-1423. The Knoxville Hospital and Clinics Financial Assistance Specialist will review payment and financial assistance options that may be available to you. Discounts vary and are based on family income and size. To receive discounts and payment plans, or to apply for other financial aid programs, you will need to fill out an application and meet certain requirements.

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