$5,500 for a CAT Scan

Atrail

Diamond Member
Apr 20, 2001
4,326
0
0
My wife had a pain in her side went to doctor, she thought it might be appendix.
The doctor ordered a test. Went to hospital to have test performed. She drank some liquid and sat around for a couple hours and had the test done.

$5,500 was billed to the insurance.

Does anyone have any insight into if that is a reasonable charge?
Looking online at the claim our copay is quite a bit, we have not received the official bill from the insurance company yet.

That just seems unreasonably high, is there any recourse?

Thanks for any input

It wasn't her appendix, she is doing fine now btw
 

phoenix79

Golden Member
Jan 17, 2000
1,598
0
0
Yes, that is abnormally high. I had one done last year and looking through my EOB's it looks like they charged about $500.00
 

miri

Diamond Member
Jun 16, 2003
3,679
0
76
my wife went to the emergency room last year

ultrasound + catscan + emergency room fee + doctor fee = over $10,000
 

Uppsala9496

Diamond Member
Nov 2, 2001
5,272
19
81
CAT scans are expensive.
The insurance company has negotiated rates and if not, will negotiate down (we pay $X for this service, and that is all you are getting).
I bet the final bill is under a grand.

I had a CAT scan about 4 years ago and paid $25 after the insurance took care of it.

Just to give you a heads up, my mom goes in for some experimental breast cancer treatment every 3 weeks. Her bill is over $80,000 each visit. When all is said and done with the insurance, it is around $4,500.
It does help that the University hospital (U of Chicago) she goes to is the one she works for, but it's still amazing how much they knock of the bills.
She has been going every 2-3 weeks now for about 2 years.
 

ManBearPig

Diamond Member
Sep 5, 2000
9,173
6
81
Originally posted by: Uppsala9496
CAT scans are expensive.
The insurance company has negotiated rates and if not, will negotiate down (we pay $X for this service, and that is all you are getting).
I bet the final bill is under a grand.

I had a CAT scan about 4 years ago and paid $25 after the insurance took care of it.

Just to give you a heads up, my mom goes in for some experimental breast cancer treatment every 3 weeks. Her bill is over $80,000 each visit. When all is said and done with the insurance, it is around $4,500.
It does help that the University hospital (U of Chicago) she goes to is the one she works for, but it's still amazing how much they knock of the bills.
She has been going every 2-3 weeks now for about 2 years.

Holy crap, thats over like, $160k over two years.
 

phoenix79

Golden Member
Jan 17, 2000
1,598
0
0
I had a serious accident in 06 and wound up with over 150k in hospital bills. In the end the hospital only got about 35k total. This is normal but that much for a CAT is ridiculous.
 

Pliablemoose

Lifer
Oct 11, 1999
25,195
0
56
Welcome to insurance supported hospitals where they charge up the ass for procedures because of all the illegals/uninsured getting free health care and the hospital having to eat the tab.

 

pulse8

Lifer
May 3, 2000
20,860
1
81
Originally posted by: miri
my wife went to the emergency room last year

ultrasound + catscan + emergency room fee + doctor fee = over $10,000

Yup. I went to the emergency room a few years ago and had a cat scan. I was there for 5 or 6 hours and they charged the insurance company ~$11k. They negotiated it down to about $8500, but still.
 

iliopsoas

Golden Member
Jul 14, 2001
1,844
2
0
Your insurance was probably billed an inflated number. That figure will then be negotiated down. Typically a CT scan will cost less than $1000, more in the $500-800 range.
 

theeedude

Lifer
Feb 5, 2006
35,787
6,197
126
It's the out of control US health care system.
Wouldn't surprise me if your ensurer tried to weasel out of paying it for some BS reason.
Mine didn't want to pay because the hospital sent them the report in an electronic format instead of paper. Yes, this is in the 21st century, where supposedly these companies want to reduce paperwork costs, when in reality they just want to reduce the costs they cover with any bureaucratic excuse they can scrape up.
 

BoomerD

No Lifer
Feb 26, 2006
66,304
14,716
146
I had a CT scan in 2005 of my low back after a procedure and IIRC, the insurance was billed about $3500.
MRI's on the other hand have run between $1400 and $2200.
 

SpazzyChicken

Senior member
Feb 8, 2002
843
1
0
Originally posted by: gingerstewart55
Was the bill only for the CT scan or did it include the radiologist's reading fee, contrast, etc., etc.?

Exactly. What does that bill include? Did you schedule the scan, or did you walk into the ER? (Trauma scans usually are more $$$)

But as everyone else has stated, unless you have health insurance from Gil on the Simpsons, they will have a negotiated rate that is much less. And what you pay will depend on your co-pay/deductible.
 

jhu

Lifer
Oct 10, 1999
11,918
9
81
$5500 was billed to the insurance company. the hospital probably already negotiated a price with your insurance company beforehand. basically, the hospital can bill whatever it wants, but the insurance company will only pay up to a certain amount and that's all the hospital will get.

same thing happens when the patient is a medicare patient. if a lab charges $20 for a test, but medicare will only reimburse $5, the lab will only get $5.
 

alkemyst

No Lifer
Feb 13, 2001
83,769
19
81
Your insurance should be able to tell you what they deemed reasonable. I have found this is about 25% or less.

A CT Scan of the Abdomen would run $550 to $1100 (in/out of network) on my plan once my insurance negotiates.

I'd pay at most 20% of that.
 

alkemyst

No Lifer
Feb 13, 2001
83,769
19
81
Originally posted by: Pliablemoose
Welcome to insurance supported hospitals where they charge up the ass for procedures because of all the illegals/uninsured getting free health care and the hospital having to eat the tab.

QFT...add that to the insured getting screwed by those using the ER as a method to ditch work too.

I think it's around 1 out of every 10 patients actually pays the hospital now.
 

Uppsala9496

Diamond Member
Nov 2, 2001
5,272
19
81
My wife just gave birth to our daughter on the 16th. Two nights in the hospital, and a little tougher of a pregnancy. I'm going to guess our bill is over $15,000. I'm fortunate enough to have excellent insurance through work where all pre/post natal bills are FREE. Not one single co-pay or anything.

(I used to underwrite medical insurance, so I'm familiar with medical billing practices - that was 7 years ago though, and medical inflation is insane)
 

TwiceOver

Lifer
Dec 20, 2002
13,544
44
91
VERY high. I had all that done, appendix actually taken out, two nights in the hospital, plus the ER visit... All for the low low price of $6400. I got a kick ass cup though.
 

Rubycon

Madame President
Aug 10, 2005
17,768
485
126
Good lord that's a heck of a cat. Must've taken forever (bad clusters) hence the bill. ;)
 

lokiju

Lifer
May 29, 2003
18,526
5
0
I had an few MRI's done two years ago due to a back injury but didn't pay a cent out of pocket as it was all covered by insurance.

Your co-pay is that much?

That seems crazy high if that's the case.