Speaking on a more generic level, I think it is outrageous how hospitals charge many, many times what a procedure actually costs when it is not covered by insurance. When it is covered by insurance, they pay a far lower pre-negotiated price, and they still make a profit. Here are a couple examples from my own experience.
- A friend went in for stomach pains he had been having for a while. He thought it was a UTI, but the doctor suggested getting a CT scan to be sure. He had a high deductible insurance policy, and the CT would not be covered. They said it would cost him $11,000 out of pocket. He refused to pay that much for something that was "just to be sure." When the pain didn't go away, he had the CT scan, which showed a perforated bowel and the need for immediate treatment to save his life. Yes, he had to pay $11,00 out of pocket, which is many, many times what a CT actually costs the hospital.
- I had a surgery that was supposed to be covered and was pre-approved. The hospital technician who did the pre-approval made a coding error, and the insurance company refused to pay for the surgery after it was done. The hospital billed me for the full $144,000 rather than what they would have gotten from the negotiated price. I fought it and quickly discovered that the hospital's billing me was a ruse, hoping I would pay--by law, they can't bill the patient when they make the error. When it finally settled, the insurance company did pay--about $15,000.
