How to Compare Prices Between Doctors (in the United States)

It’s difficult to compare prices between doctors.  Insurance providers have estimator tools, but the prices they give are often for slightly different procedures than the one you’re looking for.  Even if they do have your exact procedure/test listed, the price ranges they list are usually outdated and nowhere near accurate.

One of my colleagues at work had a method he used to get more accurate price estimates.  I’ve slightly modified it to fit my needs, and am listing it here in case it helps someone else:

  1. Call doctor and get diagnosis and/or procedure/CPT codes.
  2. Call facilities, get routed to billing, and ask for estimates.
  3. Call insurance and also ask for estimates.
  4. Pick facility and schedule an appointment.  This may involve calling the doctor back to get a referral or move a referral.
  5. Once scheduled, call again and ask for an estimate (since facilities are sometimes better able to provide estimates once your visit is scheduled.)

This is a lot of work, but may save you hundreds or even thousands of dollars.

cpt-professional-2020
CPT Professional 2020 (CPT / Current Procedural Terminology (Professional Edition)) – You don’t actually need this book to figure out what CPT code you need to reference, but the person in your doctor’s billing office probably will.

Also:

  • Even if you think you might not be eligible, apply for financial aid anyway.  Especially if you have a family.  You might be surprised that you qualify.  And apply before you pay your bill.  It’s much tougher to get retroactive financial aid for a bill you previously struggled to pay.
  • Ask what the uninsured cost is.  It can be cheaper than what would normally billed to your insurance, but then it doesn’t count towards your deductible either.

 

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