Pricing & Estimates

While we make every effort to ensure the accuracy of our price estimates, the costs associated with diagnostic testing and medical care vary, depending on the medical needs and circumstances of the individual.

Since we can't anticipate all the charges associated with a course of treatment, we can't determine the exact total cost of a procedure in advance. As a result, the final bill may differ from the estimate provided. El Camino Hospital makes no guarantees regarding the accuracy of the pricing information posted here and shall not be held liable for any inaccuracies.

How We Obtain Our Estimates

We obtain data from the most recent year to determine pricing on our most common procedures and inpatient stays. The estimates provided include only charges related to your hospital bill. Doctors and other clinicians who provide services will bill you separately. These may include separate bills from:

• Anesthesiologists, radiologists, pathologists, and other specialists.
• Independent lab and radiology services — those not directly associated with El Camino Hospital, but which may be used by your doctor.

If you have questions about those bills, please call the telephone numbers on their statements for assistance.

Out-of-Pocket Expense Estimates

The portion of your bill that's your responsibility is commonly referred to as your out-of-pocket expense, which varies from person to person and depends on individual insurance policies.

Self-Service Price Estimator Tool

Available online 24/7, you can access this tool from your home computer or through your mobile device to get a price estimate for a medical procedure.

Go to the Price Estimator Tool

Request a Confidential Estimate

El Camino Hospital can provide you with a free, confidential estimate for any diagnostic test or medical procedure performed at the hospital, including tests and procedures not listed on our website.

You can request an estimate using our online request form or by:

• Calling an El Camino Hospital patient pricing representative at 650-988-8275.
• Emailing us at patientpricing@elcaminohealth.org

Please allow two business days for a response.

Your Rights and Protections Against Surprise Medical Bills

Download Your Rights and Protections Against Surprise Medical Bills (pdf)

What is "balance billing" (sometimes called "surprise billing")?

When you see a doctor or other healthcare provider, you may owe certain out-of-pocket costs, like a co-payment, coinsurance, or deductible. You may have additional costs or have to pay the entire bill if you see a provider or visit a healthcare facility that isn't in your health plan's network.

"Out-of-network" means providers and facilities that haven't signed a contract with your health plan to provide services. Out-of-network providers may be allowed to bill you for the difference between what your plan pays and the full amount charged for a service. This is called "balance billing." This amount is likely more than in-network costs for the same service and might not count toward your plan's deductible or annual out-of-pocket limit.

"Surprise billing" is an unexpected balance bill. This can happen when you can't control who is involved in your care - like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider. Surprise medical bills could cost thousands of dollars depending on the procedure or service.

You're protected from balance billing for:

Emergency services
If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most the provider or facility may bill you is your plan's in-network cost-sharing amount (such as co-payments, coinsurance, and deductibles). You can't be balance billed for these emergency services. This includes services you may get after you're in stable condition, unless you give written consent and give up your protections not to be balance billed for these post-stabilization services.

California law also prohibits balance billing for emergency services if you are a member of a health care service plan regulated under the Knox-Keene Act. In addition, California Assembly Bill 72 (AB 72) prohibits an out-of-network physician from billing you for non-emergency services you receive at an in-network hospital.

Certain services at an in-network hospital or ambulatory surgical center
When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers can bill you is your plan's in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can't balance bill you and may not ask you to give up your protections not to be balance billed.

If you get other types of services at these in-network facilities, out-of-network providers can't balance bill you, unless you give written consent and give up your protections.

You're never required to give up your protections from balance billing. You also aren't required to get out-of-network care. You can choose a provider or facility in your plan's network.

When balance billing isn't allowed, you also have these protections:

• You're only responsible for paying your share of the cost (like the co-payments, coinsurance, and deductible that you would pay if the provider or facility was in-network). Your health plan will pay any additional costs to out-of-network providers and facilities directly.
• Generally, your health plan must:
  • Cover emergency services without requiring you to get approval for services in advance (also known as "prior authorization").
  • Cover emergency services by out-of-network providers.
  • Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.
  • Count any amount you pay for emergency services or out-of-network services toward your in-network deductible and out-of-pocket limit.

If you think you've been wrongly billed, contact the California Department of Managed Care (DMHC) at HealthHelp.ca.gov or 888-466-2219, or the California Department of Insurance (CDI) at insurance.ca.gov/01-consumers/101-help/index.cfm or 800-927-4357.

Visit cms.gov/nosurprises for more information about your rights under federal law. The federal phone number for information and complaints is: 800-985-3059.

Visit the following websites for more information about your rights under California's AB 72:

• DMHC: dmhc.ca.gov/portals/0/healthcareincalifornia/factsheets/fsab72.pdf
• CDI: insurance.ca.gov/01-consumers/110-health/60-resources/NoSupriseBills.cfm

Good Faith Estimate

Download You have the right to receive a "Good Faith Estimate" (pdf)

You have the right to receive a "Good Faith Estimate" explaining how much your medical care will cost.

Under the law, health care providers need to give patients who don't have insurance or who are not using insurance an estimate of the bill for medical items and services.

• You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
• Make sure your health care provider gives you a Good Faith Estimate in writing at least one business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
• If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
• Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call our El Camino Health financial counselors at 650-988-8275.