TAMPA - I, like many of you, have medical insurance -- but it comes with a high deductible, more than $5,000 in my case. So that money is coming out of my pocket before insurance even kicks in.
As doctor's offices, diagnostic centers and our legislators become more and more aware of the need to price shop for low cost but quality medical care, policies are changing.
Tonight at 11pm, I am doing a story on a local mother who needed to get her daughter's abdomen scanned with a CT scan to further diagnose a suspicious spot on her liver. When she called around to different diagnostic centers and hospitals for a cost estimate, she met resistance and in some cases couldn't get a price.
Legislation is working its way through the Florida House and Senate that would make posting prices for some doctors a necessity.
I decided to do a little price shopping myself to see what I could learn about finding the best price for a medical procedure. I called five large diagnostic centers and two primary care doctors and found that indeed it does pay to shop around.
Let's start with the cost of a screening mammogram. Many insurance companies will cover that as preventative medicine but if yours doesn't or you're uninsured, would shopping around make a difference?
I called each of these centers and said either I had a high deductible and would be paying up front or would self pay in cash.
When I called the Carol and Frank Morsani Center for Advanced Health Care on the USF campus and asked for the price of a screening mammogram I was transferred around a bit but finally ended up in radiology with a woman who was helpful. She told me the cost at USF would be 376 dollars. But if I went to Tower it would be 90 dollars. When I asked her why the cost difference she said they used some of the same radiologists, but Tower is independently owned and can give the discounted rate.
So I called Tower Imaging on Habana Avenue in Tampa. I was quoted a $75 price for a screening mammogram if I paid up front. At Baycare Outpatient Imaging, formerly St. Joseph's Diagnostic Center, the person who answered the phone said a screening mammogram would be $351 – $176 with a cash up front discount. At SDI Diagnostic on Swan Avenue I was told the screening mammogram would be $140. And at Rose Radiology Centers on North Armenia I was quoted $80, but before I could hang up the person on the phone told me they'd match any other price I got locally. So, some places will negotiate if you pay up front.
I also asked about a chest X-ray and a CT scan of the liver with contrast if I paid on my own or with cash up front and here are the prices quoted to me by phone.
- Rose Radiology: $50
- Tower Imaging: $35 to 55
- BayCare Outpatient Diagnostic: $76 - $38 cash upfront
- SDI Diagnostic Imaging: $40
- USF - Center for Advanced Health Care: $91 for 2 views
CT scan of the liver with contrast
- Rose Radiology $350
- Tower Imaging $350
- BayCare Outpatient Diagnostic $1,038 – cash up front
- SDI Diagnostic Imaging $435
- USF – Center for Advanced Health Care $275
On one of my calls to Tower, I asked what it would cost to self pay cash for a CT scan of the liver with contrast and the woman told me $350. I asked her if she filed to United Health Care my insurance agency, so I'd get credit toward my deductible, what would the charge be? She told me they'd bill United $1,104. Then I called United to see what their contracted rate with Tower was because that's what I'd actually be billed eventually. I needed a procedure code for the CT scan for my insurance agent to check. Once I got that code, an employee of United plugged the numbers in and told me my responsibility would be $318.50. That's was just slightly cheaper than if I paid in cash.
Remember, every insurance plan is different and you may need to make a few calls to find out procedure codes and determine out if the diagnostic center or hospital is in network before your insurance company can quote you a cost.
Next I called two primary care offices that also offered some types of medical testing and asked for a quote on an EKG of the heart and an ultrasound of the leg for leg pain.
South Tampa Medical Group on West Kennedy Boulevard told me I'd have to see one of their doctors first. A new patient appointment was $135. An established patient fee was $40. The EKG would cost $20 and the ultrasound of the leg would be from $220 to $260.
At the LoCicero Medical Group on Swann Avenue, a self pay new patient visit is $120, but $96 if you pay up front with cash. An established patient, who self pays, is $80, but $64 if you pay up front with cash. An EKG is $50, but only $40 with that 20% cash discount. And an ultrasound will run you $275 to $325, but 20% less with a cash discount.
Bottom line -- it pays to shop around and know the questions to ask so you can make an informed decision. And cash is obviously king.
None of these offices or centers offered pricing on their web sites. But that may be changing
if some Florida legislators have their way.