How much do lab tests cost: $9 or $275 with insurance? Or, how to shop for health care

Filed Under: Costs, Health plans, Patients

When my TED talk was posted again recently on Facebook, with prominent mention of disparities in lab test costs, there were a lot of comments. This one stood out, so I’m putting it here as part of our “A friend writes” series. She’s in the Knoxville, Tenn., area.

“Yup!!!
“I had a panel of tests done at 1 place & was charged $275 (after ins), when before it only cost me $13. I called & asked why, they simply said ‘Yes, we just charge more because we can!’ I had no choice but to pay it, but they can wait!! I’m only dribbling it to them at $17/mo.

“I called around & found LabCorp charges $9 (after ins).

“It pays to call around & ASK”

“The $13 & $275 were two different places than the $9.”

I asked her for more detail, and she wrote:

“It took me about 1/2 a day & yes the independent labs acted like I had 2 heads when I called asking this question. I first called my insurance company and asked why, complained & tried to get help. Dead end. The agent felt empathy, sharing a similar story, but said all she could tell me is what they billed & what ins paid.

“She applauded me for saving THEM $ but in reality although I felt it was unfair I was mainly concerned with MY bottom line.

“I got the specific name of the blood test & code. Googled a list of all labs in the area & got started. Many were hesitant to give me the information, I had to request a Supervisor at one, but usually when I explained the difference in prices a few people (actual people not acting as representative of the organization) thought that was crazy & two even told me similar stories!

“I have a chronic condition that requires this same blood draw of 5 tests every 6 weeks so as you can imagine it was WELL worth my time to find a better deal! Saving $266 wasn’t a bad days work add that up every 6 weeks & I saved myself almost $2,300 / year!

“And this is just one instance! Similar ins issues have happened with my daughter on 2 occasions. Once she went to the ER, submitted her ins, waited, called back & was seen by Attending, he ran tests & so forth but then came in & said he was leaving & Dr. ____ was taking over. We were disturbed but didn’t think any more until we got the bill… the second doc was OUT of network & she was charged his fees (at emergency rate) IN FULL!

“Now how’s a patient to know the second doctor, which the hospital sent you, wasn’t in network with your plan??

“Again similar issue our daughter was scheduled for a minor surgery, pre-authorization was done on Monday, she was headed into hospital for 1 day surgery scheduled a few days later. When the nurse called with instructions of what not to eat, etc… she asked if we wouldn’t mind having it done at the surgery center vs hospital? We agreed as she assured us it was ‘just easier for the doctor as on that day he has several earlier surgeries there & its very safe being across the street from the hospital.’ When we got the bill…. yup, that surgery center wasn’t in network & we didn’t know to ask so we had THOUSANDS of $$ in bills.

“I could go on, I’m sure most could share similar stories because healthcare isn’t streamlined it is unethically causing an undue hardship on the patients purse strings!”