She got a foot MRI, for cash, at $450, and considers it a bargain.
The story involves a young woman I know who needed an MRI to diagnose a complicated foot injury. Two X-rays about five days apart showed that it wasn’t broken, but it was swollen and painful (the foot in question had been run over by a car). So the doctor recommended an MRI just to be sure — there are a lot of bones in your foot, and if one is broken it’s better to know and fix it. A friend who’s an orthopedist also concurred that an MRI or CT scan was recommended, so the young woman decided it was not one of those unnecessary MRI experiences we hear about — that MRI’s are overused and often superfluous.
What happened next was interesting. She’s insured in one state, and the accident took place in another state, where she goes to school. (I am not naming her because she asked me not to, and that seemed fair.)
At the emergency room (in the state where the accident took place), they recommended a follow-up within a week. A weekend intervened, so she followed up in five days, at which point an orthopedist (in the state where she’s insured) did the second X-ray and recommended the MRI.
The doctor wanted the MRI done immediately, and she needed to return to school. The insurance company said they’d need to pre-authorize an MRI, and that would take several days, most parties predicted. Also, they didn’t promise to pay: they just said they’d need to pre-authorize. So she could seek to pre-authorize, return to school, and then return to an MRI clinic in the doctor’s neighborhood, so he could see the MRI and results immediately — rather than wait for them to be delivered to him, with whatever delays might attend. Also complicating matters: the insurance point, since she’s insured in one state (where the doctor practices) and the accident took place in another state (where she goes to school). Her policy doesn’t cover her across state lines, except in an emergency — so it covered the emergency room, but not follow-up care.
What to do?
Phone calls were made to two self-standing radiology clinics. In each case, the caller said “what’s your cash price” for that specific MRI. The receptionist said “are you insured?” The caller said “I’d like your cash price.”
One clinic said they charge $900 in cash. The other said they routinely charge $600.
Then the first place called back to say “If you can be here at 7 this evening, it will be $450.”
It sounds a little like surge pricing on Uber: It makes sense, of course, that off hours would be less expensive. We haven’t heard of a lot of this, but we expect to hear more.
Beyond that, the price seemed right. We have heard of people getting an MRI for $350, or for $6,200. We have also heard of people who were charged $2,800 and change for an MRI, while the insurance company paid $400 or so and the individual paid $1,900. Here’s a blog post about our California survey results, for example.
The decision was made: seeking pre-authorization would delay any treatment beyond the date recommended by most orthopedists for follow-up by a fracture. Waiting on the phone and urging pre-authorization to take place is a time-consuming thing. Requiring her to return to school and then travel back to the doctor’s neighborhood would be expensive and time-consuming. And $450 is a reasonable price.
The upshot? She got a $450 MRI for cash. And it kind of looks like a bargain.