Understanding Your Costs and Coverage

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1 Understanding Your Costs and Coverage Thank you for choosing UW. We know that understanding your healthcare costs can be a challenge we re here to help. Your healthcare costs depend on many factors such as your insurance plan and its cost-sharing features, where you are cared for and the type of services you receive. We have resources available to help you estimate your cost of care, understand the billing process, get the full benefit of your insurance coverage and find contact information. There are ways to prepare for your financial responsibilities before, during and after your medical care. From knowing your insurance coverage ahead of time to reading your Explanation of Benefits to understanding your bill, we want to help you know how best to manage your financial responsibilities. Insurance coverage varies among individual insurers and policies. Most insurers publish benefit information online or in a benefit manual that you can obtain directly from your insurer. We encourage you to call your insurance company before your visit to understand what your insurance will pay, which providers are in network and your out-of-pocket responsibility. Below are estimated prices for clinic visits, and the 50 most common minor surgical procedures performed on an outpatient basis within the HMC Ambulatory Clinics, which are all licensed as outpatient hospital locations. You and/or your insurance company will be charged an outpatient hospital facility charge in addition to a professional charge for physician services when the procedures listed below and certain other outpatient services/procedures are performed in an outpatient hospital-based facility. Although all part of the UW enterprise health system, each of the UW entities is a separate business with its own employees, budget and expense structure. For this reason, the prices of services can and do differ between the entities. HMC Clinic Visit Fees (Facility and Professional) Type of Clinic Visit (15-60 minutes; fee varies based upon duration of visit and number of clinical systems reviewed during visit) Facility Fee (HMC & UWMC OP Clinics) Professional Fee (HMC & UWMC OP Clinics) Professional Fee (ESC/UWNC)* Outpatient New Patient Visit $248 $167 - $368 $167 - $368 Outpatient Established Patient Visit $248 $111 - $242 $111 - $242 Notes: *Professional fees at Eastside Specialty Center (ESC) and UW Neighborhood Clinic (UWNC) include a facility charge component within the professional fee. HMC and UWMC Outpatient (OP) Clinics charge separate facility and professional charges. Please note there may be additional fees for chargeable procedures that are performed during the clinic visit.

2 50 Most Common Outpatient Minor Procedures Specialty Area Pain Procedure CPT Code Procedure Name (AMA Consumer Friendly Descriptor) Insertion of arterial catheter for blood sampling or infusion, accessed through the skin HMC Facility Fee UWP Professional Fee $510 $160 Ophthalmology Injection of drug into eye $1,434 $311 Gastroenterology Gastroenterology Ophthalmology Biopsy of large bowel using an Insertion of catheter into artery on one side of neck for diagnosis or treatment including radiological Biopsy of the esophagus, stomach, and/or upper small bowel using an Removal of cataract with insertion of lens $3,583 $643 $15,448 $1,125 $2,858 $445 $8,868 $1,977 Pulmonary & Critical Care Removal of deep bone implant $2,008 $1, Insertion of catheter into chest artery for diagnosis or treatment including radiological supervision and interpretation Insertion of central venous catheter for infusion, patient 5 years or older $15,448 $1,110 $1,868 $379 Pain Injection of anesthetic agent, other peripheral nerve or branch $764 $ Fusion of spine bones, posterior or posterolateral approach $1,408 Pain Gastroenterology Injection of anesthetic agent, sciatic nerve Insertion of posterior spinal instrumentation for spinal stabilization, 3 to 6 vertebral Removal of polyps or growths of large bowel using an $869 $226 $3,976 $3,583 $815

3 Pain Removal of skin and tissue first 20 sq cm or less Emergent insertion of breathing tube into windpipe cartilage using an Aspiration and/or injection of large joint or joint capsule $572 $193 $996 $444 $524 $145 Dermatology Biopsy of single growth of skin and/or tissue $330 $ Removal of skin and/or muscle $1,072 $177 Diagnostic examination of voice box Head & Neck using flexible $684 $ Gastroenterology Head & Neck Partial removal of middle spine bone with release of spinal cord and/or nerves Diagnostic examination of esophagus, stomach, and/or upper small bowel using an Diagnostic examination of nasal passages using an $3,495 $2,857 $394 $383 $203 UWPN Drainage of abscess $529 $303 Gastroenterology Pulmonary & Critical Care Pain Diagnostic examination of large bowel using an $2,726 $ Donor bone graft for spine $ Insertion of catheter into artery on one side of neck for diagnosis or treatment including radiological supervision and interpretation Irrigation and suction of lung airways to obtain cells using an Injection by continuous infusion of anesthetic agent, sciatic nerve $126 $368 $2,643 $427 $919 $ Removal of foreign material from skin, tissue, muscle, and bone at open fracture and/or dislocation $4,372 $1, Removal of skin and/or muscle first 20 sq cm or less $599 $488

4 Ophthalmology Urology Removal of cataract with insertion of lens Diagnostic examination of the bladder and bladder canal (urethra) using an Repair of wound (2.5 centimeters or less) of the scalp, neck, underarms, trunk, arms and/or legs $8,868 $2,457 $2,493 $321 $438 $ Lengthening of calf muscle $1, Skin graft at trunk, arms, or legs (first 100 sq cm or less, or 1% body are of infants and children) Removal of tissue from 6 or more finger or toe nails $8,485 $2,243 $379 $77 Dermatology Destruction of up to 14 skin growths $217 $218 Rehabilitation Drainage of multiple abscess $1,031 $ Head & Neck Aspiration and/or injection of major joint or joint capsule with recording and reporting using ultrasound guidance Fusion of upper spine bones, posterior or posterolateral approach Fusion of lower spine bones with removal of disc, posterior or posterolateral approach Repair of wound (2.5 centimeters or less) of the face, ears, eyelids, nose, lips, and/or mucous membranes Preparation of graft site at trunk, arms, or legs (first 100 sq cm or 1% body area infants and children) Partial removal of spine bone with release of spinal cord and/or nerves Insertion of posterior spinal instrumentation at base of neck for stabilization, 1 interspace Examination to assess movement of vocal cord flaps using an Removal of fluid from between lung and chest cavity, open procedure $873 $193 $4,499 $5,882 $417 $172 $1,695 $714 $798 $7,953 $1,428 $375 $1,145 $497

5 Rehabilitation Diagnostic Radiology Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance $2,270 $ Spinal tap for diagnosis $1,767 $245