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Estimate Your Cost of Care

This page has online tools to assist you in creating your own estimate.

Do you find it frustrating to figure out your cost of care? The cost of healthcare is complicated and understanding things like out-of-pocket expenses and how much your insurance will cover for health services and treatments can be confusing. We have dedicated resources in place to help you plan your care and understand the cost of your healthcare services.

We accept most primary insurance plans including Medicare, Medicaid, auto accident, workers’ compensation and commercial insurance. View a list of participating providers and insurance plans in the Mission Health network below.

Insurances Accepted

  • Aetna
  • Blue Cross Blue Shield
  • BMS TPA
  • Cigna
  • Coventry
  • CWI Benefits
  • Crescent TPA
  • Humana
  • Healthgram TPA
  • Key Benefits Administrators TPA
  • MedCost
  • MedCost Ultra
  • MultiPlan PHCS
  • United Healthcare
  • Wellpath
  • Western North Carolina Healthcare Coalition
  • Blue Cross Blue Shield
  • First Carolinacare Insurance
  • Gateway
  • Humana
  • United Healthcare
  • WellCare

Insurance information is only available for Mission Employed and Mission Affiliated physicians. Some insurers may offer plans with limited network and geographical restrictions; however, emergency care is always in network. Consult your providers' office and/or insurance provider for your plan's specifics.

Obtaining an Estimate

Request an estimated payment amount for an upcoming service at:

Talk to a representative by phone. You can speak with a representative by phone for a Preregistration Consultation for services, treatments and health plans that may not be available using the online cost estimator tool. Call 828-213-9634.

What You Need for Your Cost Estimate

During the cost estimating process, our team will attempt to verify your individual and family insurance benefits to provide the most accurate representation of your estimated financial obligation based on your coverage. Please have the following information available when obtaining your estimate:

  1. Description of Services or Current Procedural Technology (CPT) Code – Many surgery and procedure names sound similar. It’s helpful to provide the Current Procedural Terminology (CPT) code, which you can find on your physician’s order. If you cannot provide the CPT code, contact your physician's office for the CPT or a detailed description of the services.
  2. Inpatient vs. Outpatient Status – Your status as inpatient (a patient who stays in the hospital while under treatment) or outpatient (patient who receives medical treatment without being admitted to a hospital) may affect how you are billed, what your insurance will cover and what you will owe for out-of-pocket.
  3. Insurance Information – The amount your insurance will cover varies depending on your insurance company’s benefits and your specific health plan policy. Please have the following insurance plan information available so we can better serve you:
    • Member ID number
    • Group number
    • Policyholder's name
    • Insurance company’s name
    • Insurance company phone number
    • Type of plan (HMO, POS, PPO, Indemnity)

Questions about billing or insurance? Learn more

Important Information Regarding Your Cost Estimate | Before using this cost estimation tool, please carefully consider the following information. By clicking the ‘Yes, I accept’ button below, you are acknowledging that you have read the information below, and that you are accessing this tool solely for the informational purpose of determining your estimated costs associated with healthcare services. You should not avoid getting care that you need based on the informational cost estimates on this site. This tool provides informational cost estimates for non-emergent services. In the case of an emergency, please call 911 or go to the nearest emergency room.

Please keep in mind that the costs provided in this tool are informational cost estimates only and are not a guarantee of what you will actually be charged. The informational cost estimates are informed by the selected healthcare provider’s contract rates/fee schedule with your insurance carrier and are a general price estimate of the selected services. Your actual costs will be different (higher or lower) than the estimates on this cost estimation site for various reasons, such as:
If the services you ultimately receive are different from the services selected during the estimation process (e.g., due to complications, secondary conditions, and/or other unknown factors). For example, for one person, a particular surgery may be relatively straight-forward, while another person can have unforeseen complications that will impact the cost.

  • If the location of where your services are ultimately received differs from what is assumed during the estimation process.
  • If your year-to-date benefit information changes from the time at which you receive the informational cost estimates and the ultimate time at which you receive care.
  • If your healthcare provider’s contract with your insurance carrier changes.
  • If you have a unique insurance plan design that is not currently supported by this tool.

This cost estimation site may not capture all services offered by Mission Health. For any questions about services offered by Mission Health, please contact 828-213-9634. Further, the informational cost estimates may not include certain physician charges (e.g. office visit, surgeon, anesthesiologist, emergency room physician, radiologist, pathologist, consulting physicians, etc.).

Nothing on this site guarantees eligibility, coverage, or payment, or determines or guarantees the benefits, limitations or exclusions of your insurance coverage. Your insurance coverage will ultimately determine the amount you owe (including deductibles, co-pay, co-insurance, and out-of-pocket maximums). In all cases, you will be responsible for the cost of services not covered by your insurance plan. For a complete description of the details of your insurance coverage, please refer to your coverage information from your healthcare insurance carrier.

For more information on how your informational cost estimates were determined, please contact 828-213-9634.

When using this cost estimation tool, your information will be transmitted over a medium that may be beyond the control and jurisdiction of Mission Health. Accordingly, Mission Health or any of its affiliates assume no liability for or relating to the delay, failure, interruption, corruption or loss of any data or other information transmitted in connection with use of this cost estimation tool.

DISCLAIMER

The attached machine-readable file contains certain charge and rate information for items and services that may be offered by Mission Health. This information is subject to the following:

 

  1. The file does not contain information concerning patient’s expected copayments, deductible amounts, or coinsurance obligations. For payment estimates specific to the amount you may owe for items and services you may receive at this hospital, please call 828-213-9634.
  2. This file does not contain information concerning financial assistance and other discounts that may be available to qualifying patients.
  3. The file was last updated on the date indicated in the file and does not reflect any changes to charges, rates, network participation, or other data elements following the date shown.
  4. Rates are based upon the specific facts and circumstances of the care provided to an individual patient. These may include, among other things, (1) the patient’s length of stay, (2) the severity of illness, (3) other items and services furnished to the patient (i.e., drugs and implants that vary by the product used), and (4) the overall cost of a stay.
  5. Comparisons of rates within the file between payers or comparison of files between hospitals will not reflect distinctions in prices due to variations in pricing methodology. For example, if an item or service is priced as a case rate (a set rate for an episode of care) with a particular payer or for a particular hospital, but as a per day rate with a different payer or hospital, then these rates cannot be compared without first determining the patient’s length of stay and then applying the applicable contractual enhancements (e.g., stoploss or trauma activation).
  6. The values in this file reflect a single unit of pricing (e.g., case rates, percent of charges [fee schedule or Medicare], DRG Base Rates, Daily Rates, etc.) and do not reflect variations that may occur based upon pricing structures that, among other things, (1) price day 1 differently from day 4, (2) apply weights to the negotiated rate, or (3) are subject to add-ons based upon individual patient circumstances.
  7. For ER Levels 1 through 5, the file reflects an average rate of the combined levels that are priced using the same methodology. For example, if levels 1 - 4 are case rate and level five is a percent of charge, levels 1 - 4 will be reflected as an average, combined rate and level 5 will be separately listed as a percent of charge.
  8. For commercial products that are included on the same agreement and with the same payment methodology, the file will reflect an average rate for the agreement.
  9. The file does not include information for non-hospital items and services, including the rates for care provided by physicians and other professionals that are not Mission Health employees.
  10. The minimum and maximum results in the file represent the high and low dollar value by service description and reimbursement type (i.e., percent of charge/Medicare/fee schedule or dollar amount) and may or may not include identical coding for the service description. Because items and services are priced differently by payers (i.e., case rate, daily rate, base rate), the minimum and maximum rates may not reflect the highest or lowest dollar value for a given service across all payers. For example, the maximum rate for an item may show Payer A’s rate (the highest rate shown), but when the payers’ rates are applied to an actual patient stay, Payer B’s rate may in fact be the maximum rate for that particular stay.

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