NOTICE OF HOSPITAL PRICE INCREASE FOR SSM HEALTH ST, MARY'S HOSPITAL-JANESVILLE 3400 E Racine St., Janesville, WI 53546 Fiscal Year 1-1-2019 to 12-31-2019 Dollar Percent Increase Increase Charge Element Previous Rate New Rate $2,124.25 1,631.42 Room & Board - $2,103.21 Med/Surg/Gyn Obstetrics Newborn LevelI Newborn Level II Newborn Level III Surgical ICU Medical ICU ICU Intermediate CCU Intermediate 2,277.872,300.65 1,043.98 1,096.18 1,553,74 1 2,070.922,174.47 5,879.975,997.57 5,879.975,997.57 4,047.144,087.61 4,047.144,087.61 $21.03 22.78 52.20 7789 103.55 117.60 117.60 40.47 40.47 35.46 1.0% 1.0% 5.0% 50% 5.0% 2.0% 2.0% 1.0% 1.0% 4.0% Emergency Room Level IV 1,182.05 1,229.33 Labor Level I Level Il Level Ill Level IV 126.45 150.92 164.48 176.83 130.24 155.45 169.41 182.13 3.79 3.0% 4.53 3.0% 4.93 3.0% 5.30 3.0% Delivery Level l Level II 1,685.74 770.03 2,024.63 2,125.86 479.45 84.29 5.0% 101.23 5.0% 13.96 3.0% 465.48 Circumcision Annual Percentage Price Increase is 3%, effective January 1, 2019 The Annual Percentage Price Increase for 2018 was 4%, effective January 1, 2018 This increase will allow SSM Health St. Mary's Hospital Janesville to continue to invest in continually improving technologies and exceptional medical staff to provide gh-quality, high-value care for our community