Our community member reported to us that an MRI of the lower extremity without dye (CPT code 73721) had cost $848 at X-Ray Associates of New Mexico (Xranm) in Albuquerque, N.M., in October. The note said: “This is for an MRI of the knee. This is the cost for self-pay and not running it through my insurance. If I ran it through my insurance the contracted cost would have been $1069. I had not reached my $3000 deductible yet so i would have had to cover the entire cost. My insurance is with PHCS Multiplan.”
We chatted by email. Here’s our conversation:
1. Can you tell us about the circumstances?
My son was in a motorbike accident and he originally went to Urgent Care/ER but needed to follow-up with an Orthopaedic doctor. The doctor ordered a knee MRI and since I knew the facility they usually send you to might not be under my insurance I got in touch with my insurance to find out who was in-network. Since I’m on a high deductible insurance plan and had not reached my deductible I knew I would basically have to pay for this MRI so I was trying to find the cheapest option.
2. How did you find out the price with and without insurance?
I asked X-ray Associates of NM. I’ve learned that you can typically tell them you want to do “self-pay” and they will tell you. I’ve done that before because it is usually cheaper than what my insurance discount cost would be. So the knee MRI cost: $848 self-pay, $1602 price to insurance, $1069 price with insurance discount, $320 once I reached my deductible (but I had not).
3. It looks to us as if you have a high deductible plan. How high is it?
$3000, once I reach that amount my insurance will pay 80% of my cost and I am responsible for the 20%.
Trying to find out an estimate was difficult and it did require many phone calls to XRANM and my insurance before I was able to get all cost. XRANM was great in helping me find the cheapest route.
I ended up doing “self-pay” and filing a claim to my insurance so it was included in my deductible BUT not running it through the insurance. From my understanding some insurance companies don’t allow you to do “self pay” and include it in your deductible.
Please let me know if you need further questions or need clarification on my response. Health insurance is frustrating and I’m learning a lot from my son’s accident.
P.S. how did you find us? I was searching the internet to find out the cost of a knee MRI and came across your site.
For further information: Our other posts about how much an MRI costs, and our post about 10 questions to ask to find out what stuff costs in health care. Also here’s our post about a New York area MRI-shopping experience.