Sticker Shock: an $8,000 MRI?

October 1, 2012 in health care costs, Hospital Bills

In June and July, I had a series of migraines.  I chalked them up to stress and a lack of sleep but I went to see my doctor just in case.

I spoke to my colleague Sacha Pfeiffer about my attempts to shop for an MRI based on price.  I ended up at a hospital I thought would be moderately priced.  Last week, when I got a bill for $7,468 (plus an additional charge for reading the tests), I was stunned.

I only have to pay $25 of this and my insurer, Blue Cross won’t pay this total either.  If you want to hear more about why this charge is so high, listen here.

Have you had a “sticker shock” moment with a health care bill?


3 responses to Sticker Shock: an $8,000 MRI?

  1. You are correct that your insurance company will pay nothing close to this. Even so, $2500 (my guess at what your insurance company will pay) for your MRI is much more expensive than it should be – and more expensive by far than in almost any other country in the world. However, getting excercised over the hospital charges is sort of like being offended by the “full-fare” airline ticket price. That price is out there – and the airline would love to sell tickets at that price – but few, if any, ever have to pay it.

  2. Good point Nick – I think what I’m most exercised over is the confusion. I didn’t know that I was getting two tests, which would really matter if I was paying a portion of the charge with co-insurance or all of the charge (obviously). I also wonder if I would have just one co-pay? Are co-pays by the event (one visit) or the no. of tests?

    I also found the billing and my attempts to clarify what happened REALLY confusing and I’m pretty good at this stuff. Newton Wellesley wouldn’t give me the code for my charge over the phone. So I didn’t know the charge was for two tests, or if I’d been tested and billed correctly until I called my insurer and my doctors.

    I could go on and on, but will spare you.

    Thanks for the note -

  3. A few comments.

    First, patients need to understand some basics about MRI pricing. The national Medicare rate for a MRI Brain (with and without contrast) is $658.29. This is Global and covers both the Technical (equipment, tech, etc.) component and Professional (radiologists) component. Managed care companies pay around Medicare (plus or minus 20%). Note in Boston the Medicare rate is a bit higher b/c costs are generally higher here than the national average.

    Second, there are over 90 American College of Radiology (ACR) MRI accredited facilities
    within 50 miles of Boston. There is an extreme amount of competition in diagnostic imaging and facilities would much rather scan a patient at a lower self-pay rate than let the scanner sit
    empty. Most costs in imaging is fixed and not variable.

    Third, there are many outpatient centers that are owned and operated by the same docs that read in the hospital. So, don’t think you’re getting a poor read in an outpatient setting. It’s true that outpatient centers (independent from hospital ownership) will in most cases work with patients on price.

    Understanding all three points above will result in a properly read scan at a fair price.

    Peter does all this work for you – for free.

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