No, if you have in-network insurance coverage your out-of-pocket payment responsibility is based on the benefits of your insurance plan. Your insurance determines the copay, coinsurance, and deductible amounts that you will be responsible for paying out-of-pocket. Copay, coinsurance, and deductible amounts are determined by your insurance company and are not affected by standard charges.
Similarly, your coinsurance and deductible amounts are determined by the contracted payment rates your insurance company has made with the hospital (called the “allowable”), not on the standard charge in the CDM.
Because your insurance plan benefits determine your out-of-pocket costs and payment for your services is based upon contracted rates, the hospital CDM file of standard charges is not a useful tool for determining out-of-pocket cost that you will pay for your health care.