How much does a CT scan cost? $930 or $8010? maybe $267?

Posted by on Jan 4, 2013 in Blog | 24 comments

This post is by Peggy Zuckerman and originally appeared at www.ClearHealthCosts.com

Which is better — a CT scan for $930 or $8,010?

Is there a difference? How do you choose? Do I get fries with that?

I need CT scans of my chest, pelvis and abdomen, or at least I did. Eight years ago, I was diagnosed with Stage IV cancer, got healthy, but still need pre-emptive CT scans.

Metastases were all over my lungs, and the kidney dug out of my belly, so I get “CT scans of the chest, pelvis and abdomen, with and without contrast. Compare to previous scans.”

Consistency of scans is important, so I am scanned at the same place, prepped by the same nurses, and have reports from the same radiologists. Only billing is inconsistent.

My EOB showed three scans, three CPT codes, three “retail” prices, totaling $8,010, and three insurance prices discounted by $6,613. Good so far.

Insurance pays their portion, less some amount, giving the provider $770. I am billed the balance of $626, worth $1,396 to the provider.

Before my next appointment, Medicare decided that pelvis and abdomen scans done simultaneously are one procedure. Unsure where the abdomen ends and pelvis begins, and where the kidney fits, and how low the lungs go, this made sense. It did not affect my scans nor my report.

Not happy, and not about to pay, I asked the cash price of the scans. Just $930!

Calls to the insurance company, the third party whomever, the billing department and trips to the billing office, and subsequent calls to the state insurance office. And the letters to the collection company and the whining…

My best offers were “charitable assistance, paying the bill over two years,” and “just tell Medicare to change the codes back.” That I offered to pay my fair share and that I wasn’t a Medicare patient meant nothing. And have you ever “just told” Medicare anything?

Time for another scan: “I’ll take the cash triple CT,” and asked to be billed directly. The $930 scan was a bargain after the days spent fighting for my $626 scans.

Murphy’s Law applied, so my insurance was billed, not me. Thus, another $4,074 bill to me. And the trips and calls started again.

What does the typical CT scan really cost, per the hospital’s published reports to the American Hospital Directory? My provider states a single “CT without Contrast” to be $198, but $60 at their satellite center. With contrast, the figures go to $283 and $89, respectively. Assuming I get three of the $283 scans, it costs $849 — close to the cash price. Maybe I should get my scans from the satellite center at $89 x 3, for $267, really a deal!

As the three CPT codes became two, (72191 +74160= 74177) the beloved discounts didn’t accompany those codes. With the $1,000 maximum daily payout by the insurance company, my $8,010 scans were calculated to charge me $4,074! Now the scan was worth $5,074?

No wonder there is such anger and distrust with the medical system, and not only with the insurance companies. The providers play the same game with the payer — whether the individual, Medicare or Medicaid, or an insurance company. The least empowered figure is naturally the individual, but in the long run, the anger and the cynicism generated drives a wedge between the patient and his individual providers.

The doctor who prescribes a CT scan and its cost has no idea — even the provider has no idea. And who is most vulnerable, and most likely to put off the scan? Me.

 

24 Comments

  1. A sure-fire way to lower your costs even more is to not get the CTs in the first place. There is no evidence that CT surveillance 8 years out will improve your survival. Therefore, a reasonable physician could conclude that you don’t “need” a CT scan.

    Don’t let the scare tactics of the American healthcare industry control your life.

  2. As I see it – the charges over a year were consistent. The total charges on both occasions were $8010. What changed was your insurance coverage and the benefit design. Complain about your insurance and coverage. Of course, its possible that YOU made a decision to purchase insurance that provided fewer benefits. If that is the case – you should realize, you always pay for what you get.

  3. We get our insurance through the hospital my wife works at. We went into the emergency room for at that same hospital for a kidney stone issue. They asked us while rolling in pain, if they could get an upfront payment and they estimated the cost to be like $350. We tried to explain we have coverage 100%, cause she worked there, besides, I know it was just an arbitrary number, because they didn’t eeven see me yet… slow forward 40 long minutes a nurse comes in to give me intravenous pain med. Finally, I got some relief from the pain and really felt like thats all i needed… but no, they ordered a urinalysis and then a ct to check the size of the stone. When all was said and done, I left the hospital with a pain med prescription, and a prescription for flomax which totaled like $30. and I paid $150 co-pay.. So in essence, I endured all this poking and prodding and waiting and paid $180 just to subdue the pain. 3 weeks later, I get the physician bill $297 (again, arbitrary, I think) & the CT bill for $1100. My stone passed a dat after I left the hospital. I just wanted to illustrate just how broken our system is. We basically paid $1,600 for pain med ! Not to mention the deductions of $300 from my wifes paycheck every 2 weeks. The hospital ordered all these tests probably out of capitalist intentions or to cover for fear of lawsuit if something else happened…. who knows, but all the players in this game are culpable… drug companies for hiding meds to protect ourselves from ourselves, the laywers waiting for something to go wrong, the insurance companies slowing slashing responsibility, Hospitals for charging ridiculous rates.. Whats interesting about all 4 of these entities is they’ll never complain about an outrageous bill or bite the hand that feeds them and try to fix the system. Accordimg to them, the status quo is just fine

    • Ditto experience, except no ER visit. CT, Ultrasound, and some blood work cost me over $2,200 out of pocket with my POS (not “Point of Service”) United Healthcare scam plan I pay for through my work.

      The CT scan from walk in to out the door was less than 10 minutes. I’m really getting tired of these medical terrorists.

    • Jim, you think your experience was bad? Wait till you hear this. I went to the Delray Medical Center in June with pain from a kidney stone in the process of passing. As with you, I was put on an IV drip to quell the pain, then given a CT scan. I got the bill in mid-August, and the co-pay of about $65 was as I expected. But get this. The total bill was — are you sitting down? — $11,566.71. Of that, the CT scan was $8,267.51. I called and asked how they justified that price. The woman said they chose not to answer that. I told her I was writing a letter to the editor of the local newspaper. She said I didn’t have permission to quote her. I told her I didn’t need her permission because the hospital was receiving government money. I am in the process of writing that letter. I think this shows quintessentially the need for Obamacare so people must carry health insurance and use emergency rooms only when necessary, and hospitals no longer would charge paying patients extra to make up for those losses; and to prevent hospitals from charging excessively to make exorbitant profits.

  4. Next time you get a bill–file a lawsuit against the hospital, the insurance company and the doctor and raise allegations of RICO conduct as there are continuous charges against doctors, insurance carriers and hospitals all the time that are settled without and criminal prison time just millions in civil fines paid. This will enable you to show that the entire health system is riddled with corruption and whatever medical service provider that’s trying to screw you will settle with you asap due to the bad publicity. The fact that there is a non-regulated fluctuating price control system in place is enough to get any judge to raise the issue as an acceptable claim. The reason the health care system is not changing is because no citizens are challenging it at the base user level. As soon as people start challenging the costs at the user level things will start to change. try it sometime, all you can save is thousands of dollars.

  5. I had been having stomach and severe back pain. After having an ultrasound in my primary’s office my primary recommended a abdomen ct from a third party. while on the phone making the appointment i explained that i had no insurance and that i would be paying cash. i then asked the price of the procedure . i was quoted 295.00. The day of the ct i explained to the receptionist i was paying cash and asked again how much was the test. again i was told 295.00 and was asked to pay in advance of the test, which i did . I received an invoice the day of the test , thought all was was well. four weeks later i received a bill for an additional 630.50. to me this is like buying a car getting it home and receiving a bill for three times what you were told it would cost.

  6. My doctor had me get a CT scan at the local hospital because I had a pain in my back near where I had a Malignant Melanoma removed years earlier. My insurance company called called and wanted it done at another place because it was cheaper. I said that place was 20 miles away, what about this place thats in my neighborhood? The lady said ok that’s about $450 cheaper. The hospital was about $1000 and the outpatient clinic was $550. Today I find out that the cost was $1576. $1576? where did that come form? I am double covered through Anthem and Medicare. I guess I’ll make some calls tomorrow.

  7. Unfortunately, the unethical, immoral, irresponsible culture that we have allowed to grow stems from the acceptance of lying, deception, manipulation and selfish opinionated arrogance as a way of life. Destruction of absolute truth by misinterpreting relativity and relative perception was used to develop political correctness, demagoguery, and tolerance of bureaucratic idiocy in order to create equality and save the economy through obsessive consumerism.
    Healers and other people-focused services did not originate from profit since it required sacrifice and caring on the part of the service provider. They were generally rewarded through respect for their unique abilities, intelligent actions and good intentions. Unfortunately, honest caring intention is no longer truly valued by most of us. Think of the lies, frivolous lawsuits, negotiating businessmen, politicians, lobbyists and the righteous loud opinionated self-interest groups. Does it surprise anyone that the entire healthcare system is as corrupt as every single other social organization on this planet?
    I am a physician who practiced for over 20 years. I made a decent above average income and loved to treat children and responsible people in need. The story of what happened is long with everyone at fault. Today, most specialized and hospital-based physicians have taken an attitude, if you can’t beat them, join them. They group in large numbers and hire business people to structure compensation and increase revenue. These managers are effective in areas physicians new nothing about, such as lobbying, billing services, contract negotiations, establishing fees and handling patient complaints and hospital relations. They focus on sticking it to the insurance companies, hospitals and Medicare since they have the deepest pockets. In all these situations, the patients are screwed in the middle.
    The truth, however, is that patients, like citizens in an educated democracy have all of the buying and voting power. Although the changes mentioned in paragraph one have divided and weakened the people almost to the point of making their vote insignificant, the same has happened with patients who believe that they are just the victims. Let me tell you, those abusing the power are very much aware of power citizens can wield if they simply stop being divided. This topic is not like others which are more easily manipulated like race, abortion, marriage etc. Everybody wants honest, informed, good healthcare at a reasonable price. There are many examples of this worldwide. Of course, this is opposed by voters who want something or everything for nothing.
    My recommendation is that you defend yourselves by knowing that they are terrified of large scale local or national scrutiny. That is why most, if not all, determined, well informed complaints are usually just written off as a good deed. Remember, just because everyone steals it does not mean it is acceptable. I apologize if this was too wordy and emotional.

  8. Charging differently for the same procedure from the same facility is wrong and is contrary to most state laws. I think everyone should have to state the fees up front. They should be in print and then your insurance company should cover a portion. If a person wants to pay in cash they should be treated as the best customer and it should not be no insurance double the price bonus time.

  9. I can top all of you, unfortunately. A friend went to the local community hospital in Portola, California, complaining of abdominal pain. They did a CT, x-rays, labs, an ultrasound and transferred him by ambulance to the nearest hospital. They billed him $4,700 for the CT, $4,700 for the ambulance and $1,500 for radiology “pro” fees (these are the fees for the doctor to read the radiology reports, way less than an hour’s work). The total bill was $15,000! And MediCare just approves all these charges. My friend is stuck with 20% of a $15,000 bill, while Medicare is paying less than 10%. It is the greatest scam in history, and until the American people insist that their congressional representatives have the same insurance the rest of us have (Medicare or Obamacare), I assure you this rape will continue. Get mad, people. But get mad at those responsible. It is Congress that is allowing you to be fleeced by medical providers, insurance companies and the pharmaceutical and medical equipment companies. What do they care? They have it made. They ALL need to be ousted and Americans need to wise up and insist on representative government again. What we have now is not a democracy, it is an oligarchy. How many of us are going to be financially devastated before we wake up?

  10. We just pay too much across the board in the US. I am an American living in India. My U.S.-trained doctor (who has also practiced in Boston) ordered a CT scan with contrast of my abdomen. Total cost at the best hospital in my city of 8 million: $293.

  11. In that article it didn’t mention the knee down to the foot & it’s extremities only because you could of done damage to your lower leg from the foot!!

  12. I am Polish. The cost of a standard CT scan ranges in Poland from one hundred to two hundred USD, if you pay directly from your pocket. I don’t think you have your scans taken by a far better equipment than we do.
    Conclusion is easy: The level of greed is reaching the heights.

    Here is the price list of the services provided by a medical center:
    http://www.helimed.pl/tomografia_komputerowa/tomografia_komputerowa_cennik.html

    1 USD = ca 3.2 PLN

    Doctors here make about 3 000 to 5 000 USD monthly (specialists).
    The average salary by non-doctors is 600 – 1000 USD monthly

  13. In 2007, the Washington Post reported that “8 out of 10 medical bills contain errors” that are generally not in our favor.

    Under HIPAA, it is our right to obtain an ITEMIZED statement of all your medical charges submitted to your insurance company. Doctors submit a CMS-1500 form and hospitals a UB-4. These itemized statements contain coding based on your treatment diagnosis. Coding can be mistakenly key punched through error, or it can purposely contain errors that hospitals knowingly can get away with. Insurance companies seldom question billing. Consequently, we may be hit with charges that we shouldn’t.

    In an era where cost-sharing of medical expenses is likely only to increase, we need to be more savvy consumers and demand disclosure of our bills just as we do our grocery bills. There are medical billing advocates out there that can help you fight for corrections, if you are unable to do so.

    Most bankruptcies have been tied to medical debt. There is something wrong with that picture.

    healthcarebluebook.com can give you an idea of what the cost of procedures should cost you. There is a similar site out there for an estimate on CTscans and MRI cost that allow you to shop per zip code for the lowest prices…I just don’t know it off the top of my head. –Teri the Gerontologist

    • I found this page because I was doing a search on how much it cost to have a CT done. I feel enraged and powerless, even though most commenters suggest the people have the power and we just need to stand up to all the unethical practices going on in the health/insurance industry. While I do agree, it would be an insurmountable task for almost anyone…guess we need Erin Brockovich. Anyways, without further dribble, I went in for diverticulitis (didn’t know I had that) and just received my UnitedHealthcare EOB. It says the inpatient facility CT scan is $11,293! That’s half of the total bill :( Can you say fleece?!?!

      But thank you for providing the healthcarebluebook site! I will use it and try to find the similar site for CT & MRI costs. I don’t want to be one of the statistics that ends up in bankruptcy from medical bills, but as a stay-at-home mom on my husband’s salary the last 33 years, I feel it’s in our future.

  14. I am grateful for, & thank you so much, for your sharing. I, too, hope my experience serves you/others:
    Web-surfing for a less expensive brain CT without contrast (my insurance doesn’t cover) to send abroad, I found your post! Fortunately, I doubt I will need more than that one CT, though I’ve had for 4+ years, an incredibly stubborn HL+ non-HL.
    What finally has helped the tumors stay down (and without supplements, chemo, radiation) were four telephone counseling consultations with a seasoned specialist in Canada applying a scientific knowledge base called the New Medicine / the German New Medicine. I now recommend the GNM to everyone able to take an analytical look at the psyche basis of illness and who needs a better chance to leave sickness and the so-many-times-associated fear of the unknown behind, permanently. (GNM addresses the psyche basis for much disease.)
    I so very wish this knowledge were run-of -the-mill in the U.S., but money keeps it out (it would reduce need for care by perhaps up to 90%), and their costs, accordingly). That said, the GNM has been a God-send for me and for my family after the psychological and financial nightmare of living with cancer. We are tremendously relieved, and we are grateful to God for all blessings. May God bless you and your dear ones as well.
    [... If you try this, by the way, I do advise you seek an expert with the most years' clinical practice possible, as did I, (I've noticed between all I've read & what I experienced, that this can also make a favorable difference) if you have a more difficult case; I paid $125/hour for a top-rank expert, and that was some of the very best spent money in my life and THE best spent money during my illness — also be SURE to tape-record and re-listen to the sessions — this is so invaluable for the process — Olympus brand, for example, carries a nice, small recorder that will download to a PC. One of the Web sites about the GNM periodically offers a free introductory Webinar (i.e., after which you can ask questions, live). Ask to have yourself added to their E-Mailing list. They must send you a link to enable your participation. There's one as soon as tomorrow, January 19, 2014, 1PM E.S.T. Good luck!]

  15. I have a CT abdomen and pelvis scan scheduled for $500 cash in Oklahoma. Here’s a tip: pick up a phone and call for prices around your closest metro area, surfing the web is NOT as good as calling each and every place that offers the service you need because prices are usually not published! Call places that specialize in the service you need instead of scheduling it with your hospital. I’m going to save $3,700 just because I called around.

  16. Good info here, I specially like the idea of calling around for prices. I am on Medicare, and 2 mos ago had my “routine” colonoscopy. I had called my insurance to make sure my routine colonoscopy was co-pay free (as preventative procedures, like colonoscopy, mammograms, pap smear,flu, pneumonia &shingles shots,etc) are now co-pay free per the new healthcare law. Insurance company said no co-pay, I told the check-in nurse who wanted $250 that I had no co-pay & to make sure it was coded “routine”, not “diagnostic” & she said she would. I told the prep nurses the same thing, and my Gastroenterologist who did the procedure, all said yes. Two days later I got a bill for $250. Immediately called my insurance company & she said they would take care of it. 3 weeks later got another bill and called the insurance company again. They said they just paid the bill the day before. I have had no more bills, & my account reads $0, so it was taken care of, but I wonder how many people would have just paid the bill not knowing it was a “mistake”…. error or intentional? And would the hospital just keep the money? I suspect so.

  17. My brother suggested I would possibly like this blog.
    He was totally right. This post truly made my day. You can not believe just
    how much time I had spent for this info! Thank you!

  18. Hi, I think this is all a scam. This is rape in a central square in broad day light and no one is doing anything about it. The politicians are all fed by this, and common people don’t have the power to take this on.

    I just got back from living in Europe (Belgium and Netherlands, not exactly poor brethren). I delivered 2 children there and when kids got sick (as they usually do) we used their local hospital for a visit payment of I believe 36 Euros (about $45). Not co-pay, PAYMENT! Ultrasounds in 3D during the later stages of pregnancy were about $70. Always performed by the doctor himself, using the latest 3D GE system (I make ultrasounds for a living).

    It just so happens that my father is a partner (urologist) in private clinic in Greece. Trust me, he makes a good living. We own a house on the beach, and when I was in college he bought be a house here in the US. A visit and an ultrasound (abdominal) scan at his clinic costs about $60. For a major surgery such as prostate removal the total bill is on the order of $5000 including hospital stay in a deluxe private room, tests, and medications. If he can make good money with these prices imagine what the hospitals make here…

    Recently, I returned to the US and went to the emergency with sharp abdominal pain and fever. The doctor ran blood and urine tests, did a general abdominal ultrasound scan and a Doppler (performed by a technician, mind you!). The first bill that came was $5500 (most of it being the ultrasound), I got a couple more of $200-300, and one that just came in for $500, and they keep coming! When I called the hospital they said they bill everything separately and no one knows when it ends! This is outrageous!!!!! In Europe the bill would have been no more than $500! Now I am scared to go to the doctor!

  19. University Hospital in Tamarac FL charged my insurance over $9800.00 for 1 hour in the ER and a CT Scan…

Trackbacks/Pingbacks

  1. DIY CT scanner built for price of one commercial CT scan | NUTesla | The Informant - [...] health care system. He figured he could build a reasonably good X-ray scanner for a fraction of the cost ...
  2. Healthcare Prices Flummox the Experts | Health Policy Blog | NCPA.org - [...] have the time to call around and price shop. And people who have taken the time to do so ...

Leave a Comment