How much would an outpatient CT Scan cost?

Parent Cafe
1

I was with my older son when he went to the doctor one morning for stomach pains. The doctor ordered a CT scan, which was done at a local hospital that afternoon. the test found nothing wrong.

The bill for that CT scan (not the doctor visit that morning) seems out-of-whack…$5400. Insurance paid its share, but the remaining cost is $2000.

Does that seem right?

If so, not only is this crazy, but it just will cause my son to resist any tests in the future …which bothers me that at some point he could have something serious, but wait too long because he wouldn’t want a repeat of this.

2

No, not initially. Try this site https://healthcarebluebook.com/ You can insert your zip and “CT,” then it lists various types. Sometimes, the insurer also has a similar listing for individual local facilities or docs. Was it mis-coded?

Sometimes, prices are off, but I was charged 465 for a CT (different body part,) which was reduced by the insurer to about 170. Sometimes, final charges can depend on the doc charges to review the scan. But that’s higher than I was charged for an MRI, by thousands.

3

Do you have a PPO? Was this an out of network provider?

There is a plan in my area that calls itself a PPO but it really isn’t. Everything will be out of network.

4

It wasn’t an OON provider.

My son has very good insurance. He’s not on our policy anymore because of age and he’s fully employed.

5

@lookingforward thank you!

Got this result

Abdomen and Pelvis CT (with contrast)
Total Fair Price: $674

That is about what we were told before the test…we were told that it was going to be about $500-600 …so this bill seems crazy.

6

Something seems really off with that original number.

7

There can often be a huge range in radiology charges when done in hospitals. Crazy.

8

Definitely inquire with the insurer, which should be able to investigate it. Hospital charges can be much higher for diagnostic tests, for several reasons. But that’s still exceptionally high.

9

I’d also run it past your insurer. They may not have applied the contract discount. You and have nothing to lose by checking with insurer AND provider.

10

To sort through provider charges online while your loved one is in an emergency room is absurd.

11

I had a CT scan in Feb. full cost prior to insurance $5000 for scan $400 for labs ( bloodwork). It was at an office. Not the ER. I paid $337 after insurance . Not sure where I was at with deductible.

12

This wasn’t done at the ER.

He had gone to his regular physician at his office and that doc ordered the CT Scan …which had to be done at the local hospital. I was with him. We literally left his regular doc office, stopped for a bit to kill the necessary time, then drove to the hospital and ONLY went to the Radiology Clinic

Now that we’ve gone online with his insurance, this is what we see…

We see two totally separate CT scan bills…

One bill (on the insurance website) says:

Radiology Clinic
CT Scan of the abdomen and body… $335.00
Plan Discount… $256.31
Your plan paid… $62.30
Coinsurance/ You owe… $15.74

The second bill (on the insurance website) says:

XXXX Regional Hospital
Pharm services… $958.48 (this is that smoothie he was given to drink for contrast)
Plan Discount… $287.57
Your Plan Paid… $00.00
Deductible/ You owe… $670.92

CT Scan of Part of the Body…$4361.50
Plan Discount…$1595.99
Your plan paid…$ 1779.18
Deductible/You owe…$ 829.08

$444.79 co-insurance + $1500 deductible… $1779.80 owed.

(He has a $1500 deductible…which is fine, but he didn’t think this CT Scan was not only going to meet the deductible, but far exceed it). Our son was concerned about the cost before it was done, and I was there when he asked what the cost would be, and he was told “about $500”. )

This may be typical, I don’t know, but the smoothie was given to him at the doc’s office (hours before we went to the Radiology office), but I think I remember it had the hospital’s name on the Rx label. Maybe this sort of thing is normal? Doc offices having Rxs with Hospital pharmacy labels??

13

This is a pretty typical charge for a CT scan done at a hospital. Is it possible that he had a CT scan of the abdomen and pelvis which would make it more expensive? Our local hospital charges about $8000 for this. Hospitals will always cost more than free standing imaging facilities. At the freestanding the facilities you can negotiate a self-pay rate for a CT scan at about $600. I live in the Midwest in the Chicago area for point of reference. I am also a former medical practice manager so I knew where to send patients for imaging that is more affordable.

14

Jeeze. I just got two MRIs (pelvis and spine) done at a hospital (Univ of Michigan) and the combined billed cost to my insurance was about $1300. Cost to me: $0. These prices are ridiculous.

Has he actually gotten a bill yet? I have BCBS and sometimes there are random things on there that change. I wait until I have both the bill from the doctor/hospital and have the EOB posted on my BCBS portal before I pay anything. Sometimes with tests, the approval from the insurance company comes after the hospital bills the insurance so you end up getting two “bills” for the procedure but only one is the “correct” bill and that is usually the one mailed out to you or posted on your doctor portal. Does that make sense?

15

Holy Moses. My abdominal scan for a kidney infection (CT with contrast, because they did not know what was causing my belly pain), was roughly $2,000 and my share was my $15 copay. That was 3 years ago, Greater Seattle area, at a free standing imaging facility. The recent MRI was $1,000 or so. If they had used the older machine, it would have been less. I paid a $15 copay.

16

Was going to say what Romani did. It’s not unusual for me to see bcbs process in steps.

This made me go back over my bcbs records and I did have an abdom CT in ER. 1800.

17

This is after the dust settled. :frowning:

The first bill was rec’d awhile ago…that’s why the new much higher bill (rec’d today) was shocking.

My son got the first bill rather soon after, and he was very relieved to see the low costs, and his very low portion.

Then, today in the mail comes the big surprise.

He has United Healthcare.

We have BC/BS and have never faced anything like this for a test. H had his second hip replacement in Dec, and our share was around $2500 total…but that was after a really huge bill. Our share of $2500 for hip replacement is very reasonable, as far as we’re concerned. But this??? crazy.

18

I have UHC also. It’s the worst insurance company in the world and am in the process of suing them. We’ve already been to court once where I won.

Having said that though, I have gotten numerous CT scans of the abdomen over the last 6 years. The price you see doesn’t seem out of line to me. My deductible is $450 so I meet that every year in January and then for the rest of the year, pay 20% until my out of pocket max. It seems that the reason your son has to pay so much is he has a high deductible that has not yet been met. I can look through my records and see exactly the cost of my CT scans this year and let you know, but from memory yours doesn’t seem excessive.

I would object to the fact that he was told one price and billed another but I don’t know what you can do about that. I certainly understand how you feel about your son not seeking medical treatment in the future if that’s what is going to happen. My oldest is also reluctant to go to a doctor for the same reason.

19

I hate UHC. DH was looking at a job back at his old Fortune 100 co, and I asked him to reconsider because the co now has it’s healthcare (self insured) managed by UHC.

20

$5400 doesn’t seen excessive? Like someone else, I get them periodically for kidney stones. Mine via ER was 1800 and I’m not in a cheap service area. (That one was on a plan with 0 charges to me for an ER visit.) Much less, under 1k, for others.

It needs to be questioned and possibly contested.

Mom2, when I sent you to the Blue Book, I had missed that this was at the hospital. Apologies.