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$5,500 for a CAT Scan

A

Atrail

Diamond Member
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
 
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
 
my wife went to the emergency room last year

ultrasound + catscan + emergency room fee + doctor fee = over $10,000
 
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.
 
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.
Click to expand...

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

 
Originally posted by: miri
my wife went to the emergency room last year

ultrasound + catscan + emergency room fee + doctor fee = over $10,000
Click to expand...

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.
 
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.
 
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.
 
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.
 
Originally posted by: gingerstewart55
Was the bill only for the CT scan or did it include the radiologist's reading fee, contrast, etc., etc.?
Click to expand...

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.
 
$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.
 
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.
 
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.
Click to expand...

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.
 
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)
 
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.
 
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.
 
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