Is $3,500 a reasonable price for a CT scan?

[J_J_]

I recently went to the hospital for a CT scan ordered by my doctor and this is what the local hospital charged me per scan.

I was in there for a total of 10 minutes.

They actually decided to do two, instead of the one ordered by my doctor, and have sent me a bill for $7,000.

Does anyone know....Is this really the going rate?

And...Is there anything I can do about them deciding to do two instead and charge me $7,000?

(I had no insurance at the time-but I am on Obamacare now)

Everyone complains about the insurance companies charging too much, but the hospitals are grossly overcharging patients.

No wonder insurance is so high.

Our health care costs will not come down until there are regulations stopping hospitals from gouging us.

[closeupready]

1. Seems kind of on the low side - $10,000 was the going rate a couples years ago.

And yes, hospitals are GROSSLY overcharging. No question about it, in my mind.

A male friend of mine was given a pregnancy test during a routine visit.

[Orrex]

6. But think of how surprised he'd have been if he WERE pregnant.

Can't be too safe!

[restorefreedom]

12. ba da chaaaaa. nt

[NorthCarolina]

2. The for-profit middleman must be paid though...

AND they have stockholders that must be financially appeased.

[elleng]

3. Don't know, as I've never PAID for one,

and sure don't recall reading statement from insurance co.

[zipplewrath]

4. There are a multitude of rates

That sounds a bit like the "retail" rate. When you are paying outside of an insurance company, it pays to negotiate both prior to and after a bill. Mostly they want to get paid, how much can be negotiated.

[CanSocDem]

5. My friend had one in Mexico recently.

It cost him $1,000.00. He wasn't healthy enough to fly back to Canada, where it is FREE.


.

[safeinOhio]

8. That would be 2K leaving

5K to pay for a great vacation.

[kacekwl]

7. Unfortunately it seems cheap from what I've experienced.

Sadly many people have to make ridiculous amounts off of sick people.

[DawgHouse]

9. I don't know if it's reasonable but it is expensive. This site is helpful to look up costs.

http://fairhealthconsumer.org/index.php

[Cleita]

10. Try to negotiate with the hospital.

I had an acquaintance who incurred a 25 thousand dollar hospital bill due to an emergency and she had no insurance. She managed to get them to lower the debt to them and a monthly payment plan. Many health care providers are willing to make a deal because some payment is better than none. They know if they go to a collection agency, they will only get half anyway if that much.

[JCMach1]

11. hell to the no... they go for about $300 in Dubai...

take the other $2700, get a vacation and a CT Scan...

[restorefreedom]

13. its insane, the greed test for profit model

and a perfect example why we need sp healthcare

[SheilaT]

14. Hospitals charge the highest rates to those with no insurance.

They will also negotiate rates.

The reason people would carry very high deductible policies in the past (the kind I believe are no longer permitted) is that at least you'd be paying the lower insurance-negotiated rates for whatever you had done. Yes, you'd be out of pocket perhaps 10k before anything would be paid for, but you'd actually get a lot for that 10k.

[csziggy]

15. The cost varies widely

This Consumer Reports article covers the subject thoroughly:

That CT scan costs how much?
Health-care prices are all over the map, even within your plan’s network
Consumer Reports magazine: July 2012
<SNIP>
She went to the emergency room of a hospital in the Cigna network and was given blood tests, a CT scan, and an IV. She went home with a couple of medications, and the pain let up after a few hours.

“A few days later, I got a call from the hospital billing office,” she recalls. “They said, ‘Your total bill is $14,600, including $9,000 for the CT scan, and with your insurance you’ll owe $6,500. But if you want to pay the uninsured rate in cash right now, you can have a discount and it will be a little more than $3,000.’ So I gave them my bank account number and they pulled out the money right away. All I could think was, ‘What the heck just happened?’?”

What the heck happened remains unclear; as we went to press, Cigna was still investigating why the hospital didn’t charge Collier the lower network price or submit a claim to the health plan.

What’s not in doubt is that Collier paid much more for that CT scan than she needed to. Cigna allows plan members to look up some cost information online, and it turns out that an in-network freestanding imaging center near her home offers the same type of CT scan that she had in the hospital, but for a mere $318.
<SNIP>
http://www.consumerreports.org/cro/magazine/2012/07/that-ct-scan-costs-how-much/index.htm

They recommend checking prices at FairHealthConsumer.org (http://fairhealthconsumer.org/) or HealthcareBlueBook.com (http://healthcarebluebook.com/) and negotiating with the providers before getting the service. Even in a case such as above people can often negotiate - but the best recommendation is to NOT pay until the insurance company is finished with everything since they have the most clout to get price reductions.

Also there is a service for some healthcare options, such as lab work and scans, that will give huge reductions in costs. I think it works similar to how GoodRX.com works to get the best cost for medications. Unfortunately, I don't have that link. I heard about it while driving and listening to NPR so couldn't make a note of the site.

[Mosby]

16. They are about $300 in france

You should be able to negotiate yours down to 1500 or less for each.

[aksptth]

17. About Right

I never got a bill for the two or three I've had, but one time I had a puss that had a brain infection and needed a CAT scan. I was quoted a price of around $3,000. I loved Cleetus dearly but had to put him down. I just couldn't justify the cost to most likely be told there was nothing to be done.

[Brother Buzz]

18. I've had dozens of CT scans back when I was uninsured

So I was compelled to shop around. In the Sacramento, California market, $3,500 is on the high side ($3,000 was the average). $1,400 was the bargain with an older, slower, but still competent machine. My overpriced radiologist charged the same to read the results.

[pnwmom]

19. That was one of the problems before Obamacare -- the people without insurance got hit with

the highest prices. This was because the insurance companies negotiated for reduced prices with the hospitals. So the hospitals made up for that by charging higher prices to the private pay people.

I have heard of some people without insurance calling up the billing department and trying to argue them down. I know one woman with financial problems who got her whole bill cancelled that way. I would think you would have a good argument in that your doctor only ordered the one scan.

Good luck!

[Algernon Moncrieff]

27. Absolutely correct, which is my argument against the high deductible insurance Republicans like

American medicine is one of the few capitalistic ventures where the cash buyer is at a huge disadvantage. Most major multi-physician practices don't even want to deal with cash pay. and cash payers always pay the highest rates. The idea behind the ACA (which I still support, but needs tweaks) is to put everyone into groups. Allow them to get access to services at negotiated rates while dramatically reducing unpaid debt to the system.

Shopping around is a huge saver. Also, those with insurance need to read their rules carefully. I had a knee that needed an MRI. The way my insurance's rules worked, if I went to an independent radiologist, I had to come out of pocket to a $500 deductible, then pay 10/90 (making my share about $750); however, if I found an ortho practice with their own in-office MRI, it was billed just like a specialist visit -- a $30 copay.

[pnwmom]

28. That second paragraph of yours deserves its own OP, I think. A lot of people could benefit.

I know it shouldn't be that complicated, but the ACA is better than the nothing millions of people had before. And while we're fixing it, it would be helpful to know how to get the most out of it right now.

[Algernon Moncrieff]

32. Somebody needs to come up with a good, easy to read primer on how to read the policy

Even with Medicare -- the devil is in the details, and knowing what to look for; knowing that "in network" providers charge less than out of network; learning that some exams are free even if you have a deductible under the ACA; learning to pay attention to the particulars of what pharmacies offer the best rates on your drug plan, and when it's smart to take advantage of mail order pharmacy plans.

[pnwmom]

33. Maybe it's already out there somewhere. We should keep our eyes open.

[Hassin Bin Sober]

20. My partner does MRIs and CTs. That sounds about right.

I think I've heard him say more. Like $4k or 5k

Not to take the hospital's side on this, but I've heard him talk about the money they spend on those machines. $million plus. Also, there is some element that burns out (I forget if it is the MRI or CT),he referred to it as a bulb, that costs $100k to replace.

[lancer78]

37. does it burn out

After 30 uses? A hundred? They only need to do 250 scans to make the machine profitable. At 12 scans a day, that is 3 weeks and the machine is paid for.

[Monk06]

21. At $3500 that would pay for the machine after 27 to 47 scans. That is serious return on investment

[dixiegrrrrl]

22. There are several sites that let you compare costs across the country for tests.

They can be very very cheap or very very expensive, according to where you have the test.

ANY tests like that , I call our local hospital, then look around for prices near me, then try to negotiate with hospital, all BEFORE the test.
And that is just for the scan...the dr. charges to read the darn things.

Your hospital might be willing to arrange an affordable payment plan for you, and/or to lower the bill. I know our local hospital is good at that.

btw....a bran MRI is 1500.00 here, as is a lumber/pelvic MRI.
Luckliy, we paid only 98.00 each test, thanks to what we ALL should have, Medicare.

Here are some links:

https://www.nerdwallet.com/blog/health/procedure-costs/how-much-does-a-ct-scan-cost/

http://www.comparecatscancost.com/

Any search engine can pull up more info.

[lumberjack_jeff]

23. There are two ways to evaluate a price: cost-based and value-based

Unfortunately, medicine has abandoned cost-based pricing and are now charging us by a simpler formula; how much are you willing to pay to stay alive?

They've managed to keep regulations at bay so far by pretending that their pricing is based on some sort of cost drivers, but it's never been true.

We should do it ourselves. We should pool our resources, build hospitals, hire doctors and buy CT machines and share the costs among ourselves.

[spanone]

24. i just had an MRI w/contrast...about $4,000.00 here's a website that might help

the MRI is a bit more expensive than the ct...according to this site

http://www.diffen.com/difference/CT_Scan_vs_MRI

[Algernon Moncrieff]

25. Reasonable. No, but it's the going rate.

I had to have one about 3 years ago with dye to make my kidneys glow or what the hell ever and they charged my insurance 3 grand.

By the way, I didn't have kidney cancer. They never quite figured out what it was, but it wasn't cancer.

[notadmblnd]

26. I don't know how much my insurance paid for mine

However, the hospital where they did it, charge $99.00 if you pay out of pocket.

[KentuckyWoman]

29. Kinda sorta been there done that - Here's what to do.

1. Hopefully you saved the Dr. order asking for only 1 scan. Even if you have not, see if someone in that office can help you negotiate with the hospital. At the very least contact your doctor's office manager and see if they have the time to simply offer some advice.
2. Contact the finance office of the hospital and let them know you only request and consented to 1 scan.
3. Request the single scan they charge you for be billed to you at the same rate Medicare says is reasonable and customary and allowable. (don't know how they word it these days)
4. Set up a payment plan you can afford for whatever is left.


If you can at all claim for indigent care you can do so. Any hospital that accepts Medicare or Medicaid has a federal and state obligation to work with you..... even when they don't.

If you get no where with the hospital contact your state's insurance commissioner's office to see if they can help. If you really get in a bind you can contact one of the patient advocacy firms that charge 15-30% of whatever they get the hospital to write off.

United Way and Salvation Army sometimes can help you negotiate as well depending on where you live.

Main thing is you want to get out ahead of this. They'll trash your credit/ garnish wages if you don't and might even do so either way. You'll likely get more bills from this test... the radiologist who read the scan will likely bill separately.

I've had great success using this method to negotiate with a provider and also had to go nuclear other times and contact an attorney that specializes in medical collections. So really you never know how it can go..... just treat people with respect and ask for their help.... that usually helps get at least part of it done.

[Hoyt]

30. Depending on type and your location, Medicare wold consider roughly $1000 reasonable for one CT scan

Last edited Tue Dec 22, 2015, 09:39 AM - Edit history (1)

Hospital will often negotiate with uninsured. Good luck.

[TexasBushwhacker]

31. If your doctor ordered ONE I would only pay for one

Why do they cost so much? Because the machines are expensive, they are expensive to maintain, there's the cost of the CT technologist and the radiologist ....

[burrowowl]

34. No! Really!

Scans are a few hundred bucks in Europe.

[Mojorabbit]

35. I have a brain MRI once a year for MS

with and without contrast. Costs me two thousand but I have it done at a outpatient center.

[CBGLuthier]

36. My wife had one for about 200 dollars a few months ago. Of course that was in Mauritius

not the United States of Greed.

[parkia00]

38. I can't belive it costs that much in the US!!!

My mom just went in for a CT scan in a local private hospital (non government subsidized) in Malaysia and it cost less than $100.