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What Would A Medical Procedure Cost Without Insurance?

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I've not had medical insurance for about four years.  I often try to determine what a procedure might cost and I find it's not easy to get a straight answer from a medical practice or even an urgent care center.  When I showed up a hospital-owned urgent care center last September with flu symptoms I was told that I needed to pay $140 before I could see the doctor.  There could be other charges depending on what the doctor did.  I had to leave a credit or debit card in the office manager's possession to ensure that they got paid.  If I had insurance it would have been a copay of probably between $20 and $40.  Without insurance, that visit came out to around $200 for which I earned a prescription for an antibiotic and cough medicine.  I've been lucky to not to have need of a more serious (and expensive) procedure.  However, I was curious about the prices, so I did some research and came up with some national averages.  These prices came from a variety of sources but local prices could vary wildly.

Colonoscopy:  $2,400

Mammogram: $300

CT Scan: $650 to $6,500 depending on what is being scanned.

EKG:  $1,500 to $3,700 depending on type.

MRI: $3,700

Knee Replacement: $11,000 Physician and Hospital

Hernia Repair: $7,100

Stress Test: $3,800

Appendectomy:  $15,850

Hip Replacement: $20,000 to $40,000 depending on how it's done. Includes physician and hospital.

Vasectomy: $750

Hysterectomy: $8,550 includes physician and hospital charges.

Gall Bladder Removal: $6,500 includes physician and hospital charges.

C-Section: $8,000 includes physician and hospital charges.

Cataract Removal:  $3,200 per eye includes physician and hospital charges.

Bypass Heart Surgery: $56,000 includes physician and hospital charges.

Angioplasty: $19,900 for a single vessel. includes physician and hospital charges.

Thyroidectomy: $7,200 includes physician and hospital charges.

Prostatectomy: $12,200 includes physician and hospital charges.

If you have health insurance these numbers might make you feel better about your co-pay.  If you don't have health insurance these numbers might make you a bit anxious.

It would be interesting to hear from the DP community about what a particular procedure cost you or what you saw your insurance company billed.  I have a friend who's total hip replacement reached $90,000 in insurance billings but I doubt the insurance company paid more than 1/3 of that figure.

erick99 posted May 04, 2012

The no-insurance cost of the delivery and hospital stay total for my first pregnancy was a bit past $3,500, which is much lower than I expected it to be. But then, that doesn't include all the prenatal visits, non stress tests, ultrasounds, etc.
With our insurance, that happened to include maternity coverage, we left the hospital after writing a $12 check for the birth certificate filing.

jpanddanielle (rep: 96) posted May 04, 2012


I had an Appendectomy 4 years ago, and the insurance billing was a lot higher due to a longer hospital stay. I think I paid $100 out of pocket + cost of medication and follow up visits.

lilywow (rep: 8.7k) posted May 04, 2012


Two knee replacements, six months apart, about $24,000 all together.

MaryRolle (rep: 23) posted May 04, 2012


It makes absolutely no sense to me that the same doctors and hospitals which charge an uninsured individual an arm and a leg readily accept a pittance for the exact same service for an insured patient. The insurer does not even remotely make up the difference between the patient's co-pay and the provider's "regular" fee.

A few years ago I had to see a specialist for a few visits after a hospitalization. I started talking with him about health care costs, and he surprised me by letting me see my account records in his computer. His regular office visit fee: $300, my co-pay: $40, the insurer pays: $9. I couldn't believe that the insurance that me and my employer pay more for every year shells out a paltry $9 for each visit!

So if a specialist is willing to accept $49 in total payment per visit from an insured patient, why can't he charge $49 for an uninsured one? I'd really like to know. It would make sense if the majority of patients had no insurance, but that is definitely not the case.

Insurers pay hospitals less than half of what they bill uninsured patients. Why should the price be more than double just because someone has no insurance?

When a car needs body work that isn't covered by insurance, it's quite common to be given a discounted quote by the body shop. But when a patient has no insurance, they're expected to pay 3 to 6 times what the insured plus the insurer pay combined! WHY?

fluffy (rep: 2.2k) posted May 04, 2012


my son was in the hospital about 3 years ago with pneumonia spent 5 days and the bill was 22 thousand something cant remember exactly the insurance negotiate the bill and ended up paying only 5 thousand and we only paid 100 co-pay

rd995 (rep: 151k) posted May 04, 2012


I just don't go unless I have been very sick for a long period of time such as last fall (I had flu symptoms for two weeks) or I think I might die. When I broke four toes I did go to the emergency room. That bill was about $1,000 though they didn't set the toes, they taped them together and gave me a mind-boggling painful shot for pain. That was about four years ago. I was finally able to wind my way through a lot of paperwork that eventually go the hospital bill forgiven. The E.R. physicians group reminded me of longshoreman in their attempt to collect their $500 (for about 15 minutes of attention). I still owe that.

erick99 (rep: 432k) posted May 04, 2012


Still I cannot see the dental here, OMG its like $3000+ for 2 teeth.

Dexterous (rep: 102k) posted May 04, 2012


I work with Texas Medicid that worka very differently than a private insurance does but i still see so much shit going arounf in that world too that its unbelievable. There is so many times that i have encoundered that we have paid a ospital more than what they billed us for!! I am still to understand why health care is so expensive in this country when every year theree are tons and tons of complications causing readmissions due to provider negligence!! This is such a sensitive topic for me cause i deal with this mess at work every day so i should just stop! Lol

Florida2Texas (rep: 15.1k) posted May 04, 2012


My friend doesn't have insurance and was in over $10,000 debt for her son's spinal tap. When my son was in the hospital, we racked over a million dollars of debt. We were able to get Social Security and Medicaid help because of his condition but organizing and keeping track of the bills was a nightmare!!

VirginiaPeanuts (rep: 12.4k) posted May 05, 2012


Florida that's why I have my job today. :) you are right. It's a mess in the healthcare industry.. That's why we have the RAC to come and fix this overpayment/underpayment mess!

gangstabarbie (rep: 21k) posted May 05, 2012