Stanford Health Care - Tri-Valley recognizes the importance of patients’ access to information. We are committed to helping patients make informed decisions about the out-of-pocket cost of their care.
Cost of Care Estimate
Use the Cost Estimator tool to estimate your out-of-pocket cost for some Stanford Health Care Tri-Valley services. For a more accurate estimate of your cost, provide your insurance information when the tool requests it. If you have any questions about the services or the estimated costs, please call the Financial Counseling department at 925-534-6457.
Our online Cost Estimator tool is for a limited number of health services. These services are ones that we are mandated to give cost estimates for. This is because of regulatory laws. We are working to increase the number of services you can get an estimate for.
As of January 1, 2021, under the Centers for Medicare & Medicaid Services (CMS) Price Transparency rule, Stanford Health Care- Tri-Valley offers a comprehensive machine-readable file of our standard charges. This machine-readable file also has information on discounted cash prices and negotiated charges with our health plans. This helps patients make informed decisions about their care and possible costs.
- The list of standard charges is not an estimate of your out-of-pocket costs for services at Stanford Health Care-Tri-Valley.
- Your out-of-pocket costs depend on the actual services that you receive. Costs also depend on Stanford Health Care-Tri-Valley’s negotiated rates with your insurance plan, and your insurance coverage.
- Your insurance determines your co-payment, co-insurance percentage, and annual deductible.
- The actual services and supplies that you receive for your care may vary. It can be different from what was in your initial care plan. You may also get services from doctors or other care providers who are not employed by Stanford Health Care - Tri-Valley. The standard charge and the health plan negotiated charge for these care providers are not reflected in the machine-readable file.
- Services in the machine-readable file are based on data from our past claims and insurance files. They may not include all the services that the hospital offers. This is because there may not be enough information to calculate a payor specific rate at the hospital.
- Contact your health plan’s member services if you have questions about potential out-of-pocket costs for care.
- Comparing health plan negotiated charges in the machine-readable files does not always show accurate differences in costs. Comparing machine-readable files between hospitals may not always show accurate differences in costs. This is because hospitals may not use the same price estimate methods.
Click to view Stanford Health Care Tri-Valley’s machine-readable file of Standard Charges. The file was last updated as of December 22, 2022. The charges are subject to change.
If you have more questions or would like more information about Stanford Health Care – Tri-Valley's options for Financial Assistance, our Patient Billing – Customer Service Office team is available by phone, Monday - Friday, 8 a.m. - 5 p.m. at 1-800-549-3720.
We look forward to supporting your care.
Price Transparency FAQs
In November 2019, CMS published a requirement that hospitals post a machine-readable file containing gross charges, discounted cash prices, payer-specific negotiated charges, and de-identified minimum and maximum negotiated charges. This requirement went into effect on January 1, 2021.
Standard prices include room and board (for inpatients), supplies, pharmaceuticals, nursing care, equipment use, nutrition services and any services performed by non-physician hospital staff.
Physician services related to your hospital stay or visit are not included in the machine-readable file. This includes radiology doctors, anesthesia doctors, pathology doctors and others.
You may use the Cost Estimator tool to estimate your out-of-pocket cost for a limited number of Stanford Health Care – Tri-Valley services. You can also call our Financial Counseling department at 925-534-6457.
Please contact our Patient Billing Customer Service Office at 1-800-549-3720. We are happy to provide you with a price estimate within 1 business day. If your request is urgent, call a financial counselor at 925-534-6457.
Yes, we have complied with this regulation. We complied by posting a machine-readable file. Click to view Stanford Health Care – Tri-Valley’s machine-readable file of Standard Charges.
In addition to the items that CMS has requires us to report, we are committed to helping patients and their families make informed decisions about their care. This includes their out-of-pocket costs. We have financial counselors available to help you with this. To speak with a financial counselor about an out-of-pocket financial cost estimate specific to your visit and care, call the Financial Counseling department at 925-534-6457. You can also view our Billing page for more information.
The charges hospitals are required to publish may not reflect the price you pay. Your out-of-pocket responsibility depends on your insurance plan, coverage, deductibles, co-insurance, and other factors. The actual services, pharmaceuticals and supplies that are provided during your visit may vary from what is anticipated in your initial plan of care. You may also receive services from physicians or other care team members who are not employed by Stanford Health Care – Tri-Valley. The standard charge and the health plan negotiated charge for these care team members is not reflected in the machine-readable file.
There are no specific requirements or guidelines for how hospitals determine their charges. This means, one hospital might combine the charges of some items. Another hospital might list each charge separately. Neither approach is right or wrong. Both comply with the federal rule. They are just different ways of showing the charge for a therapy or procedure. Also, some hospitals, such as Stanford Health Care – Tri-Valley, serve as tertiary and quaternary referral hospitals. This means other hospitals send patients who require more specialized care to these hospitals. As a result, the total charges for our patients normally include more extensive care. This often means there are more line items and higher average charges.
Other reasons why charges may differ among hospitals include:
- The equipment hospitals use to provide services differs in age and how often they are used. This may impact the hospital charges.
- Salary scales may differ by region. They are often higher in urban areas than in rural areas.
- Shortages of nurses and other medical staff may affect regions differently. Where shortages are more severe, staffing costs, and charges, may be higher.
- Hospitals differ in their approach to pricing based on operational costs. Some hospitals try to spread the cost of all services and equipment among all patients. Others establish charges for specific services based on the cost to provide each specific service. Some hospitals may provide certain services at a loss. Other hospitals subsidize the losses. Any of these situations can result in significantly different charges among hospitals for a service.
Yes, these lists can be confusing. At Stanford Health Care – Tri-Valley, we have a team of financial assistance and counselors to help current and future patients understand their potential out-of-pocket costs. Our team does it’s best to personalize these quotes. This helps patients make informed decisions. It also helps patients understand their financial liability, both before and after their care. We also offer financial assistance and discounts for patients who have no insurance. We also help patients who qualify, to enroll in programs such as Medicare and Medi-Cal. To speak with a Stanford Health Care – Tri-Valley staff member about a personalized out-of-pocket estimate specific to your care, call the Financial Counseling department for a cost estimate at 925-534-6457. You may also view our Billing page for more information.
We do our best to provide you with a pricing range based on groups of services historically used to treat a condition. However, estimated prices are not guaranteed. This is because actual treatment received may differ from services used to compile the estimated price range. For example, your physician may order more tests or services to address a medical complication or clinical need that was unforeseen.