Kaiser Ct Scan Cost Copay



Kaiser Permanente Estimated Fees. SERVICE ESTIMATED FEES Tests and Procedures (continued) Stress test $128 Surgically destroying an abnormal area of skin $43 Ultrasound test of heart $218 Vasectomy $711. X-rays, CT Scans, and Other Imaging Studies. CT scan of chest, including dye $710 CT scan of pelvis, including dye $699.

Douglas White knew high-deductible insurance is supposed to make patients feel the pain of medical prices and turn them into smart shoppers. So he shopped.

He called around for price quotes on the CT scan his doctor ordered. After all, his plan’s $2,000 deductible meant paying the full cost out of pocket. Using information from his insurer, he found a good deal — $473.53 at Coolidge Corner Imaging in Boston, a half hour from his house.

But the bill he got later was for $1,273.02 — more than twice as much — from a hospital he had no idea was connected to the imaging center.

  1. X-ray of knee $107 Full charges — $107 Copay or coinsurance — for example, $10 or 20% of estimated fee Ultrasound of pelvis $380 Full charges — $380 Copay or coinsurance — for example, $20 or 30% of estimated fee Stress test $188 Full charges — $188 Copay or coinsurance — for example, $25 or 40% of estimated fee Are you a member registered on kp.org?
  2. Kaiser Permanente Riverside Medical Center procedure pricing information for a CT Scan of Abdomen can be found listed below. Find a cost comparison to other providers in Riverside, CA and see your potential savings.

“I was shocked,” said White, a doctor of physical therapy who thought he knew his way around the medical system. “If I get tripped up, the average consumer doesn’t have the slightest chance of effectively managing their health expenses.”

A national study by Consumers Union basically comes to the same conclusion, suggesting that there are millions of Douglas Whites lost in the medical billing maze.

Nearly one in three Americans with private health insurance surveyed by the research group got a surprise medical bill in the past two years — defined as when a plan paid less than expected and doctors and hospitals tried to recover the balance from the patient.

Of those with surprise bills, nearly a fourth got bills from doctors they had no idea were involved in their care and nearly two-thirds were charged more than they expected.

“When we talk about transparent health care and the need for consumers to shop around, it’s just not possible in many situations,” said Blake Hutson, a senior associate for Consumers Union, the policy arm of Consumer Reports. “Even if you work for a big company and have what you think is a good health insurance plan, you can get a surprise medical bill.”

The deductible is what patients pay before insurance kicks in. The higher the deductible, the more you pay out of pocket. Deductibles of $3,000 or $5,000 are not unusual these days, although the health law caps out-of-pocket costs at $6,600 for individuals and $13,200 for families.

Making plan members pay more in this way is supposed to prompt them to check prices and put competitive pressure on medical providers.

The problem is that you can’t buy medical services the way you buy a phone plan. Doctors, hospitals and other providers generally don’t advertise their prices and often keep them confidential, even when asked by patients about what to expect. Providers charge different amounts for the same service depending on the insurance.

One episode of treatment can generate bills from multiple caregivers, especially in the hospital.

A new study by the Employee Benefit Research Institute shows that members of high-deductible plans have higher incomes and are more educated on average than the typical American. But a post-grad degree from MIT might not be enough to figure out some bills.

The system is so complicated that one patient in three who got a surprise bill in the Consumers Union study didn’t investigate or fight it.

“I didn’t think it would make a difference,” or “I was confused about what to do” were common reasons for inaction.

That’s the wrong response, said Karen Pollitz, a senior fellow at the Kaiser Family Foundation who studies how the health system affects consumers. (Kaiser Health News is an editorially independent project of the foundation.)

“It’s always advisable to ask questions if you receive a surprise bill or if insurance pays less than you expect,” she said. “Mistakes happen and following up can save you money. If it gets too confusing or frustrating, ask for help.”

Movavi video editor. Consumers Union offers an online tool for finding the relevant agency in your state and its contact information.

White’s billing problems were cleared up — many months and phone calls later and after a reporter started inquiring.

His plan, Harvard Pilgrim Health Care, said it had given him an incorrect quote for the CT scan last fall. The plan eventually paid the imaging center the full $1,273, saying it wasn’t White’s fault that the plan’s quote was wrong.

Copay

The bill had come from Brigham and Women’s Hospital, which owned the radiology center, even though White said there was no indication of that when he went to get the scan.

Harvard Pilgrim said it didn’t know Brigham and Women’s was affiliated with the center, either. Hospital-owned facilities are often far more expensive than independently owned doctors’ offices.

Rates

So how does he like the transparency revolution in health care, boosting competition and empowering patients?

“There is nothing transparent about most health care billing,” White said.

The average cost of a CT scan in the United States is $3,275, though prices can range from $300 to $6,750.

How Much Is A Ct Scan At Kaiser

One factor that can greatly affect the cost of your CT scan is whether you have it performed in an inpatient facility, like a hospital, or an outpatient surgery center.

Outpatient centers are just as safe as hospitals but could save you thousands on your medical bill.

Based on our data, the target fair price for a CT scan is $525, whether you have health insurance or not.

  • National Average: $3,275
  • National Range: $300 – $6,750+
  • Outpatient Facility Average: $525
  • Inpatient Facility Average: $4,750
  • Target Fair Price: $525

Your doctor may recommend a CT scan for a variety of reasons. Below, you’ll learn the costs associated with each type of CT scan, as well as what factors into the cost of a CT scan and how to find a fair price for your procedure.

CT Scan Cost Averages Around the Country

LocationPrice Range
New York, NY CT Scan Cost Average$550 – $1,400
Los Angeles, CA CT Scan Cost Average$460 – $1,200
Chicago, IL CT Scan Cost Average$550 – $1,450
Miami, FL CT Scan Cost Average$500 – $1,300
Dallas, TX CT Scan Cost Average$460 – $1,200
Houston, TX CT Scan Cost Average$525 – $1,350
Philadelphia, PA CT Scan Cost Average$525 – $1,350
Philadelphia, PA MRI Cost Average$600 – $1,550
Atlanta, GA CT Scan Cost Average$550 – $1,400
Washington, DC CT Scan Cost Average$525 – $1,350

Specific CT Scan Procedures and National Cost Averages

ProcedurePrice Range
CT Bone Density Scan Cost Average$300 – $3,800
Brain CT Scan Cost Average$825 – $4,800
CT Ear Cost Average$350 – $7,700
CT Maxillofacial (Sinus) Cost Average$600 – $6,000
CT Neck Cost Average$1,000 – $7,600
CT Spine and Neck Cost Average$1,000 – $9,300
Thoracic CT Scan – Thorax Cost Average$1,050 – $7,800
Chest CT Scan Cost Average$675 – $8,600
CT Scan of Abdomen Cost Average$1,750 – $9,500
Lumbar Spine CT Cost Average$750 – $10,200
CT Pelvis Scan Cost Average$1,700 – $10,200
CT Shoulder, Arm, Wrist, Hand (CT Upper Extremity) Cost Average$625 – $8,400
CT Foot, Ankle, Leg, Hip (CT Lower Extremity) Cost Average$650 – $11,200
Heart CT Scan Cost Average$625 – $12,700
CT Angiography – Head Cost Average$1,500 – $10,700
CT Angiography – Neck Cost Average$1,700 – $10,400
CT Angiography – Chest Cost Average$1,650 – $18,500
CT Angiography – Abdomen Cost Average$1,750 – $19,400
CT Angiography – Pelvis Cost Average$1,500 – $10,500
CT Angiography – Shoulder, Arm, Wrist, Hand Cost Average$650 – $10,100
CT Angiography – Foot, Ankle, Leg, Hip Cost Average$1,500 – $20,400
CT Angiography – Aorta Cost Average$1,750 – $13,600

Which factors affect the cost of a CT scan?

Many things can affect the cost of health care, regardless of which type of procedure you’re getting. Generally, there are three factors that cause healthcare costs to vary:

  • Facility setting — Where you have your medical procedure done affects the cost. Having your scan done in a hospital as an inpatient costs far more than having the same procedure done in an outpatient center. Since inpatient facilities tend to cost more to run, patients end up paying more for care.
  • Insured or uninsured — The price of medical procedures can vary between insurance providers. The change in price largely depends on how much of the procedure your insurance plan covers, if any at all. If you don’t have health insurance, you can expect to pay for the full cost of the procedure out-of-pocket.
  • Location — The region, state, and even city you live in can affect the cost of your medical procedure. If you live in a rural area with fewer facilities to choose from, you can expect to pay more than you would if you lived in a city with many providers. Traveling for a medical procedure can be a great money-saving option.

Inpatient vs. outpatient facility cost differences

The cost of a CT scan will vary greatly between inpatient and outpatient facilities. The national average cost for the procedure at inpatient facilities is $4,750, while the same procedure at outpatient facilities averaged $525.

Insured vs. uninsured cost differences

Insured patients have historically paid less than uninsured patients for a CT scan, especially when they stay in-network. When a patient has insurance, they share payment responsibility with their insurance company. For patients who don’t have health insurance, the cost of a CT scan falls on them and, ultimately, costs more.

In-network vs. out-of-network cost differences

How Much Is Copay For Ct Scan

In-network refers to a health care provider or facility that has a contracted rate with a health insurance company. This rate is usually much lower than what someone would pay out-of-pocket; in-network providers are almost always cheaper than out-of-network providers. This does not apply to patients who are uninsured—without insurance, you shoulder the full cost of your medical procedure.

Payment responsibility

Nearly everyone who has a CT scan will have to pay some of the cost out-of-pocket. Uninsured patients will be responsible for the total cost of their procedure.

Patients who do have health insurance will be responsible for paying their deductible, copay, and coinsurance amounts. The amount of each of these costs depends on your health plan.

More factors that affect the cost of a CT scan

  • Contrast materials — Your physician might request a CT scan with contrast, especially if the scan is focused on soft tissues such as blood vessels and organs. You will need a special dye, called a contrast material, before this type of scan. Side effects from contrast dyes are rare. Ask if this contrast material is included in the total cost of your procedure.
  • Additional office visits — In some cases, you may be charged a separate fee for an initial consultation with the physician before the procedure. You will have a follow-up appointment soon after the scan to discuss your results. Ask if this follow up visit is included in the total cost of your procedure.

Your CT scan checklist

1. Review the total cost of your procedure with your physician. Ask them to explain what each cost is for and keep a record. If you get a medical bill that’s higher than you expected, this information will come in handy.
2. Ask your physician if they can perform the procedure in an outpatient setting.
3. Check that all providers are in-network. Sometimes a provider who treats you will be out-of-network (this often happens with anesthesiologists). You can avoid this by asking your physician whether all of the providers who will treat you are in-network for your insurance.
4. Ask what the typical cost is if the physician finds other areas that need to be examined during your procedure.

Finding a fair price for your CT scan

How Much Does A Ct Scan Cost At Kaiser

No matter which imaging test your physician recommends, searching for the best value can be confusing. The national average cost for a CT scan is $5,750, but it’s not always easy to figure out what different healthcare facilities charge for the procedure. New Choice Health cuts through the conflicting information for you, so you can find out the price you should pay. Use New Choice Health’s comparison tool to find the best price for your CT scan today.