How to price a scan or test when you pay cash

Name the exact service first

Prices only line up when the service lines up. “An MRI” is not one thing. A knee MRI without contrast is priced differently from one with contrast, and both are priced differently from a lower back MRI. Before you call anyone, get the precise name of what your doctor ordered. The order or referral usually says it. If it lists a procedure code, write that down too, because it is the fastest way to make sure two offices are quoting the same thing.

The same goes for tests. A basic blood panel might mean a complete blood count, a metabolic panel, or both. Ask your doctor’s office which tests are on the order so you can price exactly those.

Compare posted self-pay prices

Many providers publish a self-pay price, sometimes called a cash price, for common services. Those posted prices are where a comparison starts. Put them side by side for your area and the spread is usually wide.

Here is what that looks like, using example data for a knee MRI without contrast near 89052: two imaging centers at $410 and $525, an outpatient clinic at $780, two hospital outpatient departments at $1,240 and $1,610, and a hospital at $1,900. Same scan, same ZIP code, and the highest posted price is more than four times the lowest.

Write down where each price came from and the date you saw it. Posted prices change, and a number with no source or date is hard to hold anyone to.

Ask what the price includes

A posted price for a scan may cover the scan and nothing else. The doctor who reads the images often bills separately. So can an anesthesia provider, a lab, or the facility itself. When you call, ask these questions and write down the answers:

• Does this price include the reading or interpretation?
• Will any other provider or facility send me a separate bill?
• Is this the price for paying up front, or for paying later?
• How long is this price good for?

Get it in writing before you book

A price on a website or a number on the phone is a starting point. A written estimate is what you can plan around. If you are uninsured or paying for yourself, you can ask the provider for a written Good Faith Estimate. When you schedule at least three business days ahead, the provider must give you one (45 CFR 149.610).

Ask for the estimate by name. Say you are paying for yourself and you would like a Good Faith Estimate for the service, in writing. Keep it with the date you received it. If the final bill comes in well above it, that piece of paper matters.

Choose, then keep the paper trail

Price is not the only thing that counts. Distance, how soon you can be seen, and what your doctor recommends all matter, and only you can weigh them. What a comparison gives you is a clear view of the range, so you are choosing on purpose instead of finding out later.

Once you book, keep three things together: the posted price you saw, the written Good Faith Estimate, and the final bill when it arrives. Those three documents answer most questions that come up afterward.