Medical MRI bill question

  1. 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 ?

    Thank you in advance !
  2. jcsd
  3. Greg Bernhardt

    Staff: Admin

    woah that is insane! I got a pelvic MRI with contrast for $600 a few months ago.
  4. 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.
  5. 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
  6. chemisttree

    chemisttree 3,717
    Science Advisor
    Homework Helper
    Gold Member

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

    Staff: Admin

    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. 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. Thank you for this advice. We will investigate other local facilities for the next MRIs (which will happen regularly, as the $12k turned up unfortunately useful). I anticipate to find better offers, and I want to present them as evidence.
  11. It was not an emergency. We went to a hospital because her doctor prescribed the diagnostic. We already switched plan from 20% to fixed $250 copay for the MRI. I went yesterday to ask for itemized bill. The contrast agent was $300. There are two items for two parts of the head although she went only once in the magnet ! One is priced $5k the other $7k. They were not professional.
  12. Evo

    Staff: Mentor

    Did you have insurance at the time of the MRI? If you did and you gave them your insurance card, you only pay the copay, regardless of the amount of the bill. Some places will send you the entire bill while insurance is being processed, but you don't owe it as long as your insurance pays.
  13. Yes, and the insurance has agreed to pay 80% and claims they negotiated the price.
  14. Evo

    Staff: Mentor

    That sounds right. I would ask the insurance company and hospital to show you the negotiated price. I have serious problems believing $12k was the negotiated price, which you would pay 20% of. Something does seem wrong.

    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. 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. lisab

    lisab 3,188
    Staff Emeritus
    Science Advisor
    Gold Member

    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. Evo

    Staff: Mentor


    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. At the time of the procedure, it was ACE.

    I appreciate your feedback very much.
  19. Evo

    Staff: Mentor

    You can contact the insurance commissioner for your state, also the state's Attorney General's office.
  20. Did you go out of network for this service?
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