Summary: A surprising number of providers are listing cash prices publicly. Why? Because of the growing unhappiness over high deductibles, high co-insurance, and generally high out-of-pocket costs. Among the most recent: St. Luke’s University Health Network, in the Lehigh Valley, which says it’s listing prices to take the surprise out of hospital costs. Others are jumping in as well, in Pennsylvania and elsewhere.
“St. Luke’s has launched an online tool that enables health care consumers to see bundled prices in advance of specific procedures or surgeries,” Jim Deegan writes in LeHigh Valley Live. “Hospital officials say it’s a move toward greater transparency as a growing number of patients are paying more out of pocket because of high-deductible health plans and coinsurance. As a result, they’re more attuned to hospital bills. … The St. Luke’s PriceChecker at pricechecker.slhn.org provides complete costs to the patient for common procedures such as a hysterectomy, lumpectomy, colonoscopy or arthroscopic surgeries. It also covers common diagnostic imaging studies.
“For example, the cost to the patient for a laparoscopic hysterectomy is $7,400; for a screening colonoscopy is $1,500; and for an arthroscopic rotator cuff repair is $8,000. The prices are all-inclusive, covering the procedure, the cost for the doctor to perform it, anesthesia and operating room expenses, hospital officials said. Anybody can access the information, but it doesn’t apply to those on Medicare or Medicaid because of limitations the government puts on health care providers, Botek said. … For now, it is available in Pennsylvania but not to New Jersey patients — St. Luke’s has a hospital in Phillipsburg — though it may be down the road, officials said.”
These providers join an increasing number of others publicizing prices. For a look at many others, displayed in our hospitals database, click here and use the tool to share or search prices.
At Lakes Surgicare Center, in Commerce Township, Mich., a number of podiatric surgical procedures are available with prices posted here. The site says “What our prices include: If you have a high deductible or are part of a self-insured plan at a large company, you owe it to yourself or your business to consider Lakes SurgiCare Center and the transparent pricing we offer. If you have no insurance at all, our facility will provide to you the highest quality care with the lowest prices we can offer. Remember, high prices DO NOT mean high quality!”
Asking for a price quote in advance
The Surgery Center of Allentown in the Lehigh Valley also has a cash pricing program, but you have to ask up front. Here’s the form: they are a hand surgery center, and as near as we can tell they do not post prices online, but they suggest that you can get an estimate up front.
The site says: “In an effort to better serve our non-insured patients, Surgery Center of Allentown now offers a cash for service pricing structure. Please fill out the form on the right to schedule one of the below procedures at the cash price.
The prices listed below are not negotiable and must be paid prior to the date of service by either cash or credit card. If you are scheduled at our facility and we will be submitting your claim through insurance and/or Medicare, the following pricing DO NOT apply to you.”
Low-price GI tract tests, cash only
This business says it does not accept credit cards or checks, but if you have cash: these are reported to be all-in prices, from beginning to end. Separate charge if biopsy is necessary.
So if you find a cash price you want to pay, instead of the insurance price, is that legal and acceptable under contract? You might inquire of your insurer or your provider; some providers are telling us that they cannot accept cash prices from insured people under their contracts with insurers, as this hospital told us about a mammogram.
Anecdotally, we hear others saying they do so all the time, or often, as do some of the providers in this blog post. This means that the patient pays cash and does not ask the insurer to pay; this payment, then, would not fall against your deductible.