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Defining the Cost of Care at Hennepin Healthcare

The gross charge for a COVID-19 lab test is $218.00 total ($162.00 for the test and $56.00 for the collection). The gross charge for the antibody test is $141.00 ($105.00 for the test and $36.00 for venipuncture). This is the list price; contractual insurance rates or discounts are not included in this amount and they do not indicate out of pocket costs.

Please note the following for the testing of COVID-19:

  1. At this time, we are not collecting copays for these tests.
  2. Employers and Health insurers must reimburse for all coronavirus testing and related visits based on the cash price that is listed by the provider on this website unless they have a previously negotiated rate or negotiate a new rate that’s less than the cash price.
  3. Contact your insurance company for specific out of pocket cost questions.

This information is subject to change and does not reflect additional charges that could be incurred at the time of service.

Find important information about Coronavirus (COVID-19) on the COVID information page.

This information is intended to make our prices as transparent as possible. These prices include only our Hospital-Based clinics. They do not include the North Loop, Saint Anthony, Richfield, BeWell, and Golden Valley clinics. The prices shown on this site are the gross charges and do not indicate final out-of-pocket costs. Please contact your insurance company to find more information on what your cost will be after insurance.

Insured/Uninsured Patients

Insured Patients

Consult with your insurance company to obtain precise information about what is covered and how much you would have to pay (your financial responsibility and out of pocket cost) for a particular health care service provided at Hennepin Healthcare. For patients with deductibles, the amount charged will be at a negotiated rate and will not necessarily be the list prices seen below.

Uninsured Patients

If you do not have insurance, please contact our Financial Counseling department to help determine eligible coverage for more accurate pricing. Our financial counselors are prepared to help determine what plan you may qualify for and assist you with the application process. You may ask for help at any time, but it is best to seek assistance before or at the time of service. Financial counselors can be reached at 612-873-9500.

Definitions

Definitions

Bundled Charges/Services: Charges that are grouped together, including multiple services. For example, a knee replacement will include the facility fee (hospital stay), anesthesiology charges, physician fee, pre-operative clearance, and supplies.

Claim (insurance): A formal request for reimbursement to an insurance company for medical services. A claim can make up several charges, this is the bill we send to the insurance company at negotiated rates.

Copay: A fixed out of pocket amount set by the insurance plan which is paid by the insured party, usually prior to a visit.

Coinsurance: An out of pocket percentage set by the insurance plan where the percentage of the claim is paid by the insured party.

CPT: Current Procedural Terminology (CPT) is a medical coding set used to identify/categorize medical, surgical and diagnostic procedures.

Deductible: An amount of money set by an insurance plan that must be paid by the insured party before insurance benefits will start paying on claims.

Estimate: An approximation of the cost of healthcare services.

Facility Fee: The price the hospital sets for its portion of services. This could include certain supplies, room use, utilities, equipment, ancillary staff, and does not include professional provider charges.

Gross Charges: The list price. Contractual insurance rates or discounts are not included in this amount.

Guarantor: The person or party responsible for payment of services.

Hospital-Based Fee: the nationally-recognized billing process for services rendered in a hospital outpatient clinic or location. The location does not need to be at a hospital location.

Hospital-Based Location: Hospital-based care is care provided at a location that is clinically integrated with a hospital. This includes any of the clinics located on the downtown Hennepin Healthcare campus. Insurance may pay differently for services in these locations than a Freestanding Location.

Facility Fee: The price the hospital sets for its services.

Fee Schedule: A list of set fees for gross charges.

Freestanding Location: Locations not licensed as Hospital Based. This includes Hennepin Healthcare’s BeWell, North Loop, Richfield, Golden Valley, and Saint Anthony clinics.

Net Charges: The amount charged for service including contractual insurance rates or discounts. This is the amount seen on a claim or statement.

Non-Covered Services: Services not covered or paid for by insurance.

Out of Pocket Cost: The guarantor or insured parties expenses that are not covered by insurance. This includes the deductible, copays, coinsurance and any costs for non-covered services.

Physician Fee: The charge for a provider’s professional services.

Prior Authorization: An insurance company’s pre-service approval that they will help pay for authorized services.

Provider: The physician or other advanced practitioners who provide professional services to the patient.  

Statement: Otherwise known as a bill. This is what is sent to a guarantor for any outstanding balance.

Discounts

Discounts

Discounts are available to patients without insurance. The following are our standard self-pay discounts set by the Attorney General:

  • Provider-Based (excludes freestanding locations - BeWell Clinic, North Loop Clinic, Richfield Clinic, Golden Valley Clinic, Saint Anthony Village Clinic) - 59%
  • Freestanding Locations (BeWell Clinic, North Loop Clinic, Richfield Clinic, Golden Valley Clinic, Saint Anthony Village Clinic) – 34%
  • International Patients - 10%

Hennepin Charity Care: Refer to the Financial Assistance page for more information.
Note: Not all services, such as cosmetic services, include a discount for self-pay patients.

Contact Us Today

If you don’t see the information you want or need help in understanding the cost of your care, we can assist. Our price estimate team is prepared to provide a price estimate. Ask for help at any time, but it is best to seek assistance before the time of service. The Price Estimate department can be reached at:

Phone: 612-873-9500
Email: [email protected]
Online Requests: Price Estimate Form

State Mandated Clinic Price Transparency

Effective 7/1/19, Hennepin Healthcare will post our most common 25 services in our primary care (pediatrics, internal medicine, family medicine, OB/GYN) clinics that are over $25. This information can also be accessed via the State Mandated Clinic Price Transparency poster (PDF). These posters include the price charged by Hennepin Healthcare in provider-based and freestanding locations. It also includes the reimbursement rates for Medicaid, Medicare, and commercial insurance. The amounts posted do not reflect the amount individual patients or their health insurance plan will owe for the services listed. For specific information about the amount owed, patients will need to contact their insurance company.

Fee Schedules

The following fee schedules show the complete list of Hennepin Healthcare fees and their descriptions. These reflect the gross charges (list price), not the amount the patient or insurance would be liable for. These fee schedules are listed in a machine-readable format as required by the government. The Price Estimate section below shows our prices in a more patient-friendly format.

These charges show the fee for the particular care, test and treatment listed. They do not reflect the diagnosis, its severity or the cost of any resulting or corresponding treatment recommended by physicians to treat a condition or diagnosis. Professional charges (physician) are not included in these fee schedules.

When a patient is seen for multiple services, multiple fees can be associated with that visit. It is important to contact your insurance company to determine out of pocket cost and verify if there is a need for prior authorization.

The following documents are in Excel format.

Contact Us

Price Estimate Department

Our price estimate team is prepared to help determine a price estimate. Ask for help at any time, however, it is best to seek assistance before the time of service.

612-873-9500

[email protected]

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