News: Insurance rates on hospital services may be higher than cash price

CDI Strategies - Volume 15, Issue 46

Insurance companies are negotiating rates for hospital services that are higher than the cash price and the same service can also have a wide price range even within the same hospital, according to an investigation from the New York Times (NYT).

The investigation looked at 60 major hospitals that are following CMS’ price transparency rule to publish their rates for services. When observing the prices for certain services posted to the hospitals’ websites, NYT found that services covered by insurance providers were often more expensive than for patients to pay out of pocket.

For example, the cost of an emergency rabies vaccine without insurance at Wake Forest Baptist in North Carolina costs $7,593. The same service through Humana ChoiceCare, however, costs $8,549. The same emergency rabies vaccine without insurance at Intermountain Medical Center in Utah costs $3,704. At the Utah facility, costs for the same emergency rabies vaccine cost between $4,000 and $6,000 across a variety of insurers.

At Beaumont Hospital in Michigan, a knee MRI with no insurance costs $888, meanwhile the same service with a Cigna plan or Aetna HMO will cost $1,799 and $1,437, respectively. Additionally, a pregnancy test at the Hospital of the University of Pennsylvania costs $10 without insurance, and upwards of $93 with Blue Cross Blue Shield PPO New Jersey.

Editor’s note: The New York Times investigation can be found here.

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