empty vials


From the mail, below: A lab bill for $363, but the real cost seems to be $39.25.

Check out the breakdown: a $96 charge is reimbursed by the insurance company at $8.92. A $114 charge is reimbursed at $9.33. A $153 charge is reimbursed at $21.

Since we haven’t yet met our deductible, we pay the entire $39.25.

Who pays the full $363? People who are uninsured. Or people who go to a lab that doesn’t take part in their plan.

The charges and the actual payout for medical procedures often don’t bear any resemblance to each other, making for great confusion in the health-care marketplace. How is a consumer to know whether the charge is right or wrong, or even close? The previous medical test bill I blogged about was similar: $401 = $24.80.

We’re not the first people to notice this. Here’s an essay from costsofcare.org about a $478 bill, written by Brad Wright, a graduate student from North Carolina: “The lab was out-of-network, and I owed $478. While this wasn’t the five-figure medical bill many families face, everything is relative. For me, a graduate student living almost entirely on borrowed money, the bill changed how I bought groceries, socialized with friends, and commuted to school. For six months, I fought to scrape together enough money to make monthly payments. The experience, while costly, taught me a lot about our fragmented health care system, how little patients or providers know about the real cost of health care, and how hard it is for patients to make price-based decisions when the system isn’t designed with that in mind.”

Do you have a crazy bill? Anonymize it, scan it and send it to us at info [at] clearhealthcosts [dot] com.

lab test hospital statement

Jeanne Pinder

Jeanne Pinder  is the founder and CEO of ClearHealthCosts. She worked at The New York Times for almost 25 years as a reporter, editor and human resources executive, then volunteered for a buyout and founded...