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About how much should a pelvic MRI cost?
My gyno ordered a pelvic MRI for suspected fibroids, and today I went in for the procedure. I was in the MRI machine for 20-30 minutes without contrast, then the tech injected contrast and rolled me back in for another 10 minutes of scans. I did not receive sedatives or any other service of any kind. Upon my arrival, I was informed that without insurance it would have cost $9,400, but they will only charge my insurance $6,800 (of which I owe 10% out of pocket). Does this sound right? It seems high to me, but I don’t know.
The exam will be billed out as one exam, and can only be billed as dictated by the radiologist. $6,800 is a lot, but it all depends on the setting. Hospitals will charge far more than IDTFs (Independent diagnostic testing facility). Insurance contracted rates will ALWAYS be higher than an uninsured rate. If you pay the uninsured rate though you have to sign a waiver that you do not have insurance and the money you spend does not go towards your deductible. A cash price for MRI Pelvis W/WO contrast in the Dallas/Fort Worth area would be around $550 which would include the radiologists read. Facilities do not advertise uninsured pricing because it violates their contracts with insurance companies, and the reimbursement rate is far less. Healthcare is a business, and many diagnostic imaging facilities are joint ventures with hospitals which will increase their contracted rates. If I can answer any other questions about imaging going forward, and where to find a quality exam at a lower price, let me know. These are the healthcare secrets that need to be made public. I hope you get some answers from your MRI and feel better soon.
I do have insurance. The insurance will be billed $6,800, and I owe 10% of that. But that’s the insurance’s “discounted” rate, without insurance it would have cost $9,400! Even $6,800 seems really high to me. I thought there must be some mistake, but I was too embarrassed to call and ask. I had 2 ultrasounds (regular and trans vag) at the same imaging center a month ago, and the total bill was only $670, of which I paid $67. I expected the MRI to be more expensive, but not 10 times more!
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$9,400 sounds like a U&C (usual and customary rate). No one ever really charges that amount. I have tried answering some questions about MRI pricing and the business side of radiology in the radiology forum. If you have any specific questions, I can try to help.
Thank you!
My pleasure.
COMMUNITY LEADER
Ya, that sounds high to me! When I put it into a couple cost shoppers, it was listed as 1,000 to 5,000. Can you check some other places and see if you can find this cheaper?
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So I looked online and saw that the price for a pelvic MRI in my area runs anywhere from around 2,000-4,500. Since they took scans with and without contrast, I wonder if they’re charging me for 2 separate procedures at the highest rate for each? But it was one appointment, lasting less than an hour; the tech simply added contrast for about the last 10 minutes. Can these things be disputed or renegotiated?
Yes, you should be able to 'appeal'. Do you have insurance? That is the place to start. What you should do though in the mean time is make minimal payments to the facility that says you owe money. I had a discrepancy when I had my first child and had to go through appeal and during that time, I mailed them 15 dollars a month. That way I wasn't ignoring a bill. I won my appeal so then just made my copay (my issue was I was at an in network hospital and the anesthesiologists were out of network but who gets to choose those when you are at a hospital having a baby? Right? So I had a full anesthesia bill of 3000 due to out of network, I appealed and got the in network copay instead and just had to pay 15 percent but it did take a year to resolve! Insurance denied appeal twice and I eventually when through my employer's HR who got it resolved).
Anyway, you have rights! You can appeal to your insurance company. IF this was self pay, ask for all documents. Then please know that there are services in which you do pay a fee but they negotiate your medical bills for you. Typically the fee plus when you end up paying is far less than what you are being told you owe now.
Anyway, you have rights! You can appeal to your insurance company. IF this was self pay, ask for all documents. Then please know that there are services in which you do pay a fee but they negotiate your medical bills for you. Typically the fee plus when you end up paying is far less than what you are being told you owe now.
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