How to Find Out How Much Your Procedure Costs

With the rise of HSA (health savings accounts) and high deductibles people are paying more attention to their medical bills. When more of the costs of medical treatment are coming out of our own pockets we tend to pay greater attention to the amounts we are paying. One of the better ways to control how much you are paying is to do a little shopping around.

Shopping around for medical treatment is a largely unknown concept as most people find a doctor that they like and stay with that doctor… and I couldn’t agree more. It is worth paying a little extra for your care if you have a good bond and you trust your doctor. However, there are plenty of medical costs and procedures that don’t really need to be done at a certain office. Outside testing and bloodwork is the first thing that comes to mind, although make sure to ask the ordering doctor if the test needs to be performed at a certain facility. No sense in doing any of this if the procedure or test has to be done at a specific facility.

If you do not have any medical coverage, then it more important to make sure your dollar goes as far as it can. When you have insurance you will end up paying the insurance negotiated rate – which will be the same from facility to facility, regardless what their billed price is. Network status of the facility can affect this. In network facilities are preferable to out of network facilities as the rates will be better, and out of network facilities can balance bill you.

Balance billing is the practice of billing the patient the remained of the total price after insurance pays their portion. So this means much more costly. Avoid out of network facilities, if all else is equal.

It can be a daunting task to try and do cost comparisons for procedures/tests. You will often need to have the CPT codes for each procedure/test you need done. If needed, you should be able to get these codes from either the ordering physician or the testing facility.

Hospitals, insurance companies, drug stores, and drug companies may list their prices on their Web sites. Very likely you will have to do a little digging to find the prices out. Call the hospital or clinic and ask for their prices. Financial coordinators/counselors, billing agents, and sometimes the front staff are the best people to talk with to get pricing information. It may not be easy, but perseverance pays off.

Although, doing price comparisons can be a huge pain in the you know what, the dividends could be well worth it. When appropriate, I recommend you shop around to see what the going rate is – the money you save could be your own.

These resources may help some:
Your state hospital association

Your state or territory health department