MERIT HEALTH MADISON

When you receive a bill from MERIT HEALTH MADISON, you are typically seeing the hospital's “chargemaster” rate — its published list price for each service. According to CMS data, MERIT HEALTH MADISON lists chargemaster rates that average 6.6x the corresponding Medicare reimbursement amount across 7 procedures with publicly available pricing data (Source: CMS IPPS Provider Summary, FY2024).

The median hospital in MS has a chargemaster-to-Medicare ratio of 3.8x, with ratios across the state ranging from 1.1x to 14.9x. At 6.6x, this facility’s average ratio is above the state median. 50 hospitals in MS report pricing data to CMS (Source: CMS IPPS Provider Summary).

The procedure with the largest gap between the listed price and Medicare reimbursement at MERIT HEALTH MADISON is SIMPLE PNEUMONIA AND PLEURISY WITH MCC (DRG 193). The listed chargemaster rate is $81,501, while Medicare reimburses $9,736 for the same procedure — a ratio of 8.4x (Source: CMS IPPS Provider Summary, FY2024).

What does this actually mean for your bill? Chargemaster rates are rarely what patients pay. If you have insurance, your insurer has negotiated a separate rate — often 40–60% less than the listed price. If you are uninsured, you may be able to negotiate directly with the hospital or request financial assistance. The chargemaster-to-Medicare ratio is a useful reference point for understanding listed pricing, but it does not represent what most patients will owe out of pocket.

1 of 7 procedures (14%) at this facility have listed rates above the 90th percentile compared to other MS hospitals reporting the same procedure data to CMS (Source: CMS IPPS Provider Summary).

MERIT HEALTH MADISON is a proprietary acute care hospitals facility with a CMS quality rating of 3/5 stars. Note: CMS quality ratings measure patient outcomes and experience, not pricing. A hospital with high listed prices may provide excellent care, and pricing data alone should not be used to evaluate the quality of a healthcare provider.