Blue Cross paid $1,650 for my $8,000 MRI
Well, this world of medical billing and costs is really wild.
I wrote a few weeks ago about getting bills that totaled just under $8,000 for an MRI (actually I got two tests while in the machine although I didn’t know this at the time)
Last week, the hospital sent me a more detailed bill that shows how much of what they charged Blue Cross actually paid. The total charge from Newton Wellesley Hospital (two tests plus fee to read the test) was $7,876. Blue Cross paid $1,650 (that’s $1,360 for the tests and $290 in physician’s fees).
Two things jump out at me.
1) the difference between what Newton Wellesley charges anyone who pays cash, and what they pay the largest insurer in Massachusetts is $6,226. Patients who pay cash for these tests are getting a really horrible deal if they don’t shop around.
2) the difference between what Blue Cross pays Newton Wellesley and what Blue Cross paid the cheapest place I found for an MRI, Shields, is not much. Shields would have been paid, $1,221 for the two tests (they read their own with no extra charge at some facilities including the one closest to me). So I could have saved Blue Cross (and my fellow members) $429 by going to Shields.
OK, I’ll be honest. If that’s my $429, it means a lot more than if that’s the amount I’m saving Blue Cross. But the difference for Blue Cross is a lot less than the thousands in charges that the two facilities post. Is the message that insurers are negotiating aggressively, that hospitals are giving in or that these charges are just an altered reality. How are we supposed to make sense of this world?