Cost of Breast MRI - $11,560 ?

jenlee

I'm reviewing medical bills and my insurance company was billed $11,560 for a Breast MRI.  Really?  This is why our premiums keep going up!  Does this sound like it's in line with what it should be?  

• $ 339 - Laboratory/ Pathological  (can't think of any needed for an MRI)
• $ 5389 - MRI (all I can say is "wow," that's expensive)
• $ 1560 - Medical/Surgical Supplies (WTF? maybe for the use of the gown?)
• $ 1078 - Other Imaging Services (like what?)
• $ 1022 - Pharmacy (Contrast dye?)
• $ 2172 - Radiology/Diagnostic

Mallory107

And the crazy thing is that I could have walked in and had the exact same thing after you and our costs would have been different based on our insurance and ability to pay.  Posting est costs per procedure would go a long way in making things right.

J9W

I go for my MRI next Wednesday and once I get the billing info I'll post again so we can compare costs.  A year or so ago I called my insurance company and told them I thought they were getting over charged because once I got the itemized bill, I saw things on there that were no where near me on procedure day.....and they didn't seem to care!

jenlee

J9W, that's what I was thinking, that the insurance company doesn't really care...

you hear about insurance companies deny ridiculous things (like a $10 tissue handling charge on one of my patholgy invoices) but then they pay for all this b.s., probably no questions asked.  I'm going to contact them and ask them to audit it.  I doubt that it will go anywhere.  

Also talked to the hospital billing dept. and asked how I could get detailed explanations of the charges. She said I needed to dispute the bill in writing and then a certain department would look at at it more closely. Ok, I didn't really want to dispute it, but if that's the procedure, then that's what I'll do.  Just out of principle. 

sewingnut

At least the radiologist fee for reading the MRI is included in the charge....

riverhorse

Just FYI I paid out of pocket (waiting for new insurance to kick in) $3200 for the bilateral breast MRI and $1000 for the radiologist report.    Medicine -- because so few people actually pay themselves -- is about the only field where the cost of technology does not seem to be lower over time.   People don't care unless they are paying for it themselves. 

peggy_j

Wow, that's outrageous. I had a B-MRI last year and the total bill was about $5000. 

Mallory107 wrote:
And the crazy thing is that I could have walked in and had the exact same thing after you and our costs would have been different based on our insurance and ability to pay. Posting est costs per procedure would go a long way in making things right.

 

I hear you. A Washington Post reporter wrote a book a few years ago comparing health care systems around the world. Somewhere (France?) they have a list of procedures and rates posted on the back of the door of each doctor's exam room. Everyone is billed the same thing. (I can't imagine how much time/$ is spent on overhead due to all these different plans. What a waste of $) 

DivineMrsM

I am looking up the MRI costs for the one I had last year, January 2011.

It looks like I was billed $5,279 for the MRI.  They gave my insurance company a discount of $3,491, so the insurance paid the hospital $2,237. 

It appears there was a separate bill from the radiology department for about $670, I imagine that was to read the results.

jenlee, your MRI does sound pricey. I had my MRI done at Allegheny General Hospital in Pittsburgh, PA.  I wonder if these price differences are regional.

Oh, and just to throw this info out there...the cost that was billed to my insurance for six rounds of chemo......approximately $120,000 (one hundred twenty thousand dollars).

Then when I had radiation, I went to a facility closer to my home town.  The radiologist doctor consulted the oncologist doctor over the phone about my medical records three times.....my insurance was billed about $450 for each phone consult!!! 

DivineMrsM

The cost of 33 rounds of radiation was about $20,000.

Layla2525

Yes, Peggy_I and TheDiv are right because mine was about $5000 with various other small charges being billed to me that the insurance didnt pay. I have Blue Cross which has a Provider Audit dept and they only pay a certain amt for each procedure but like TheDiv says since they negotiated with a preferred provider the patient doesnt always pay the difference; its usually waived. I think cuz you are in Cali the prices are a little higher than some areas of the USA. However,the others could be right it may be related to what the medical providers office thinks the insurance will pay. Yep,Europe is so different,my son is in France studying at P&M Curie in medicine and currently France has one of the best medical research along with Germany.

dlb823

jenlee ~ Some of those charges sound pretty outrageous, even by Newport Beach standards!  I'd absolutely call and ask for more details, especially on the three you pointed out (lab, supplies, and other imaging), since it's hard to imagine what they're including.  Unfortunately, few people bother to question outright exhorbitant bills, and when you do, there are occasionally errors. 

Please let us know what you find out.    Deanna 

PhunkyM

I Am left with my jaw hanging open every time my insurance company sends me a message that another bill has been finalized...$10,000 for each chemo treatment...$100,000 for the mastectomy surgery...$500 just to talk to the oncologist...I've met my deductible so I don't have to pay these amounts, but it's just crazy.

jenlee

Update on outrageous $11,560 Breast MRI charges:

Now that I've received the explanation of benefits on this one, I see that as a network provider, the hospital gave United Healthcare PPO a discount of $8340 on this one.  So I owe a co-pay of $278.67, plus a bit more because I hadn't quite reached my deductible.  Maybe the hospital overcharges for items that it doesn't really use because of the huge discounts that they end up giving.  I still think it's crazy, but I guess that's what keeps us in network.

Hortense

My MRI cost last month was $4757. I paid a co-pay of $20 and the insurance paid the hospital $1,582 because of some contract between them. That's some difference = over $3100. Seems to me that hospitals are wildly overcharging for services if they are willing to settle for roughly a third of what they bill.

leaf

I don't know if this is what happens in your case, but I do know at hospitals that accept some federal programs that they are required to pay for some care of people who can't pay.  I work at a hospital, and there have been patients there who clearly have no means to pay for their care (such as mentally ill people with extensive medical problems, IV drug abusers,  people with multiple handicaps, etc.)  I know some have stayed in the hospital for at least 6-10 months.

I'm not trying to justify these charges; many people feel that our medical system/costs are messed up.

msippiqueen

I worked at two academic teaching hospitals, one in the TMC, and most of the population couldn't pay. You did. So did I. It wasn't free.



The charges for ANYTHING related to medical care over a short period would bankrupt most Americans, unless the taxpayer or insurance covers the cost.



I often wonder why the horrendous charges aren't addressed as the number one cause of bankruptcy in America is medical cost.



Many, many Americans are underserved by the inability to access health care, especially those above the medicaid threshold or uninsured.

msippiqueen

Oh, and if you try to bargain for paying cash, a discount, if offered is no where near the discount offered insurance companies.



I have found my cash price discount is usually 20%. Who can afford "discounted" care?

DivineMrsM

My younger brother was a week away from getting health insurance at his new job when he had to have emergency triple bypass open heart surgery.....then had to go in for a second surgery later the same day to stop bleeding to the chest wall.  His was an unusual case as he could not be weaned off the ventilator he was on and he ended up being in the hospital for seven weeks.  He had a heart surgeon, cardiologist, lung doctor, infectious disease doctor, anesthesiologist, and a few other medical professionals that came in and checked on him every day.  He had numerous breathing treatments on a daily basis, a gazillion drugs pumped into him, daily blood work, chest xrays, scans to the brain to see if he'd had a stroke, and nutritional IVs.

About week 5, he finally had a tracheotomy and the ventilator was able to be removed.  He went on to skilled care, was eventually released and went back to work about a month later.

He filled out some papers at the hospital, and ended up not paying one cent for his hospital care.  Yes, I'm thrilled that my brother got all this care for free. It was one of the most stressful times of my life.  

But it just amazes me that my husband and I have been paying our deductibles and out of pocket max--thousands of dollars, plus our insurance paid $120,000 for the chemo, plus more for two surgeries & radiation, ect., ect., ect.

BUT we were reported to collections for a $200 bill that was the result of insurance filing errors!!!!!  The mess got sorted out, but that is so much injustice~!!!!!!!!  To say the least!!!!!!

dunesleeper

Man! I don't even know what all these tests are. I was just looking at some EOBs and there were 2 where the insurance wouldn't pay anything for those tests because they were done out of network. I don't even know who sent what to this place. I think the place is in Arizona. I'm in Maryland. The lab is called MOLECULAR PROFILING INST. This bill is going to be over $2000.00. Has anyone else had a similar experience?

She

Wow this is truly jaw-dropping.  I had a breast MRI in Africa, paid cash and it cost me US$600. The machine was newer than any I've seen in Canada and I don't think the breast form had ever been used.   I'm going to have to pay for one in Canada now as our system isn't understanding that post DIEP I can't have mammos and because my last tumor was on the chest wall ultrsound won't work.  I think the Canadian breast MRI will cost me about C$1,200.