Knopf: Cost-conscious health consumer (column)
March 2, 2017
I've been recovering from an illness that's been going on for more than three weeks. Without getting into the gory details, I've been dealing with the icky gucky of a sinus infection that just won't go away. If you've ever had this illness, you know it's not fun and frankly I'm sick and tired of being sick after three runs of antibiotics and two runs of steroids.
My ear, nose and throat doctor told me he wants to see a CT scan of my sinuses. I've been through all the insurance authorization and now it's time to go get my scan. You will be amazed to know how important it is to be a cost-conscious consumer of your health. I received a call from St. Anthony Summit Medical Center in Frisco wanting to set up the scan. Wait a minute, I remembered when I needed an MRI last year, I checked St. Anthony and they wanted to charge more than $1,000 for the privilege of getting the job done in Summit County. I didn't go with St. Anthony last year. I scheduled my MRI with an imaging clinic in Denver for half the price.
I had continuous health insurance coverage, so these prices are the "negotiated rates" with my insurance provider. So why such a dramatic difference in the cost of the identical procedure? This doesn't make sense. You would think the price of a procedure would be the same, imaging center to imaging center. Au contraire mon ami! So let's get back to my sinuses. When St. Anthony called me to schedule my CT Scan, my MRI experience from last year popped out of my memory bank. I told the very nice lady from St. Anthony, "Thanks so much. Let me get back to you on that."
Then I hit Google. I searched for "CT Sinus Scans, Denver Colorado." The first thing that popped up was "Denver, CO Ct Scan Cost Comparison." I was amazed! What a find! The site detailed a series of procedures. And there it was, a category for CT Maxillofacial (Sinus) Cost Average. I clicked the link and it took me to a page with 40 different imaging facilities and the price ranges they charge for the procedure. You'll love this. Fifteen of the facilities charge in the $230-$550 range, nine in the $400-$700 range, four in the $440-$1,050 range and the rest up from $675 and as high as $2,100. And all for the very same procedure. What is going on? This site gives you the option of clicking for a free quote. I chose instead to look at a couple of convenient locations estimating between $250 and $550, in-network with my insurance and call them on the phone. I had both the procedure code and diagnosis code from my doctor.
My next call was to my insurance provider letting them know I wanted them to authorize my procedure to be done at Integrated Imaging in Denver. They said no problem and thanked me for being so cost-conscious. Of course I am, considering I’ll pay the full amount, because I haven’t met my deductible for the year yet.
My first call went to Integrated Diagnostic Center in Denver. I was quoted $250 for the CT Scan of my sinuses without contrast. Fantastic. I thanked the pleasant woman on the phone and told her I'd get back to her. Then I called Lakewood Imaging Center. They quoted me $480 for the very same CT Scan without contrast. Just for grins, I called Outpatient Radiology and Imaging at St. Anthony in Frisco to get a quote from them. They told me the negotiated rate with my insurance company was $765.07.
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My next call was to my insurance provider letting them know I wanted them to authorize my procedure to be done at Integrated Imaging in Denver. They said no problem and thanked me for being so cost-conscious. Of course I am, considering I'll pay the full amount, because I haven't met my deductible for the year yet. So it's all coming out of my pocket.
There's been a lot of heated talk about health care, insurance companies, pharmaceutical companies and how downright complicated our health care system is in our country. So why the disparity in the cost of a standard procedure like a CT Scan of my sinuses? Is it because each medical imaging facility has invested different amounts to equip its operation? Sure, that might be possible. Is it because each facility can negotiate whatever rate it wants to with the insurance companies? That could be possible too. Where does that leave you and me? It means you can't settle on the obvious. You might think you're getting the best deal locally, but hopefully you now understand, that's not necessarily the case.
Most people shop around for the best prices on goods and services, especially since we have the convenience of information available online to comparison shop. The same thing is true for our health care procedures, especially the non-emergency ones. So take the time to do your due diligence! It could save you hundreds of dollars. Excuse me for sneezing!
Jonathan Knopf is a permanent resident of Summit County and a contributor to The Summit Daily. Jonathan is currently a television news consultant with more than 40 years of experience in the broadcast news industry, covering 9-11 and a wide range of local and national news stories.