Healthcare: Deceptive Pricing

I recently had an outpatient medical ultrasound procedure. It took all of 30 minutes and was performed by a skilled technician. The bill came to something like $3900.

I don’t know how to value such a procedure but apparently my insurer does.

Below is the accounting of payments and “adjustments” to the price.:

Medicynical Note: Pricing of healthcare in the U.S. is more opaque and difficult to understand than the pricing at a new or used car lot. My sincere apology to car salesmen for the comparison.

Actually, hospital pricing makes the car dealers look good. But, unlike a car purchase, healthcare is not a discretionary expense and when needed, shopping for the best “price” is impossible because of time constraints and because the bottom line price is obscured.

In this case my insurer paid a total of around $900. The rest of the balance, something like $3,000 was an adjustment/discount. My total co-pay was $50.

A person without insurance, however, would have been billed the full $3,900 and would have had to pay that total or enter into some type of bargaining. I may be wrong but I doubt that the hospital would offer the same magnitude of discount even if a patient was savvy enough to ask for it.

In this case the medical facility used was one of the Catholic “non-profit” PeaceHealth facilities in the Northwest.

I’ve noted similar huge adjustments to bills ($25,000 bill discounted to $12,000 for example) in the past. These “adjustments” appear to be the standard operating procedure in hospitals in America.

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