Outpatient Imaging: What Does It Cost?
About one in every 5 visits to the doctor’s office, results in an imaging test. X-rays are still the most popular. Other common imaging tests are ultrasound, CT (computed tomography) scans, mammograms, MRI (magnetic resonance imaging), echocardiograms and bone mineral density tests. Consumers are often concerned about the costs of these tests, especially considering their high deductible health plans. Imaging charges may include both a facility charge for the scan itself, and a second charge from the doctor who reads and interprets the test result. Price transparency – the ability to know the charges clearly ahead of time – for medical tests is often hard to come by. If consumers want to price-shop, it can be difficult to know where to start. Here are a few helpful tips.
- Check Prices in Other States. Even if your local hospitals and imaging centers don’t readily make prices available, checking another state or two will sensitize you to the wide variation in prices. It also might provide you with an average price, in the event you have an opportunity to negotiate. Maine and Vermont are two excellent choices to get an idea of imaging prices. Both states provide a side-by-side comparison of prices by name of hospital or clinic. Prices will show both facility charge and professional fee (if known) for physician services. For example, in Maine, a consumer could get a digital screening mammogram for $349. In Vermont the average cost was $611 (slightly newer numbers).
- Call Your Local Hospital or Imaging Center. Consumers will have some success in calling about prices if they can provide the exact CPT code of the procedure they are interested in. It is a quick look-up in the charge master (a master price list) if the CPT code is known. The price will be current, rather than a number from last year. If you want to price-shop, your doctor’s office can help immensely by informing you of the exact name and, ideally, the CPT code for the test ordered. CPT codes apply to office visits, imaging scans, lab tests and more. It’s usually a 5-digit number and it’s standardized across the United States.In Maine, a less expensive mammogram is analog instead of digital. Some hospitals may offer this (average $25 less for a screening mammogram, or $61 less for the more sophisticated diagnostic mammogram.) Consumers will want to check with their doctors as to whether an analog test is a prudent option or not.
- Check Certification and Accreditation. The list price will never be the only factor to check, since the quality of the test is integral to your health, and potentially to your life. Consumers will want to check the certification status of the exact location where the test is given. When an organization offers services at more than one site, it’s best not to assume that every location meets current standards. In the case of mammography, the FDA maintains a database of certified facilities.
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