# MRI bill question

1. May 15, 2013

### humanino

Dear PFers,

The hospital gave us a $12k bill for one MRI (head with contrast). The people I talked to at the hospital tell me that they do not know whether this is a fair price, which I find suspicious. The same procedure in France costs$300. As I am unsure what to do, I would appreciate advices from people here. Is this possibly a fair price ? Is there anything I can do to have them re-evaluate this price ?

2. May 15, 2013

woah that is insane! I got a pelvic MRI with contrast for $600 a few months ago. 3. May 15, 2013 ### leroyjenkens I had a cat scan when I was a teenager because I had stomach pains. Didn't have insurance. They also sent me a bill for 12k. That was like 10 years ago. I never paid it. So yeah if a cat scan is 12k, I could easily see an MRI being 12k. 4. May 15, 2013 ### mazinse at my local ER, a head CT alone is$5k so your price tag is likely nation wide. Why is it like this, should we really have a long discussion on healthcare cost

5. May 15, 2013

### MarneMath

6. May 15, 2013

### chemisttree

Did they perform the MRI with contrast agent? That price is in the 2-3k range at the hospitals I've dealt with.

7. May 15, 2013

### humanino

Yes chemisttree, and yes that would be the price range I would consider fair in this region. Is there any third party assistance I can find apart from going to court ?

8. May 15, 2013

2-3k is not fair, they are ripping you off. Go to an independent imaging place. Smart Choice MRI did mine for $600 total. 9. May 15, 2013 ### Evo ### Staff: Mentor humanino, did you go to a hospital or to an outpatient imaging center? The difference can be thousands of dollars higher at a hospital. If you went to an ER first, tack on a couple thousand more. You didn't have any type of insurance? Many hospitals will get you in touch with charities that can help pay that bill for you. They will even help fill out and submit the paperwork. Request an itemized bill. Evo Child had hives and it was at night, so her friends took her to the ER, she had always been covered by my insurance, so didn't give it a second thought. Two hours later she was released with some cream for the rash. The bill, over$5,000.

Last edited: May 15, 2013
10. May 15, 2013

My doctor bill, for example, says "office visit: $135, negotiated cost:$65, my copay: $5 The$5 is all I pay with the option I chose. The insurance pays the remaining $60 to the doctor. 15. May 15, 2013 ### humanino The original price was$13k which was taken to $12k. So our share is$2.4k. When I read MRI price $2k to$3k am I to understand that is after the insurance share ?

16. May 15, 2013

### lisab

Staff Emeritus
That's key.

Here's a summary as I understand it, from my husband who used to work for a big hospital.

All hospitals have a "hospital billing charge", also called a "billing charge rate", for every procedure. These rates are insanely high! But large insurance companies negotiate much, much lower rates. Medicare (US government health care for people over 65) also pays a much, much lower rate.

What you saw was probably the billing charge. You need to contact your insurance company to clear this up.

The health care billing system is insane here. Hospitals purposefully obscure patients' actual cost because they don't want to empower the customers, IMO.

17. May 15, 2013

WTH?

Yes. But an insurance company could only manage to negotiate $1k? Something sounds very wrong. I've had a number of MRI's and CAT scans, and I paid from a low of$40 to a high of $150 (insurance plans changed) 18. May 15, 2013 ### humanino At the time of the procedure, it was ACE. I appreciate your feedback very much. 19. May 15, 2013 ### Evo ### Staff: Mentor You can contact the insurance commissioner for your state, also the state's Attorney General's office. 20. May 15, 2013 ### Locrian Did you go out of network for this service? 21. May 15, 2013 ### humanino No, the hospital was prescribed by the regular general practitioner. 22. May 15, 2013 ### Evo ### Staff: Mentor I'm also surprised that the doctor did not send you to an outpatient imaging center, or at least give you an option. It's possible the doctor gets a kickback from the hospital for sending them business. Oh, also, they should give you a free CD with the actual MRI on it as well as the radiologist's report. Everywhere I've gone, the first CD with report is free, each additional copy is$25. You will want this. The CD includes the software to view the MRI.

Also, did you get this insurance through your employer? If so, your employer's benefits department should be able to help you sort this out. The insurance company should have a specialist dedicated to your employer's plan.

Last edited: May 15, 2013
23. May 15, 2013

### humanino

That is one scary thought to me

Yes, we have the CD.

24. May 15, 2013

### Locrian

Whether it is in network depends on whether your insurance company has a contract with the provider; the GP may not have that information.

If the insurance company was negotiating with them after the fact, then I suspect (but can't say for sure) the provider is out of network. If it was, that would be helpful information in ensuring this doesn't happen to you again.

25. May 15, 2013

### humanino

The insurance did agree to pay 80% of the \$12k so the provider can not be out of network (unless I misunderstand).