Using the Health Care Blue Book


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I should probably create a separate static page for this information, but for now I’ll just do a blog post. Are you aware of the It’s a great site for figuring out fair pricing for medical procedures. I had no idea something like this even existed before I become a Samaritan Ministries member. You can search out various procedures in your area, by zip code, and it will spit out a price based on what providers in your area are accepting as full payment from insurance companies for those services. This is useful because if you call for a quote of a non-emergency procedure and it varies a lot from what is listed at you can begin the conversion about the discrepancy. ¬†Why should you pay more than what insurance is paying? The hospital agreed that the insurance price was acceptable payment, so you should at least get that rate, if not better (for saving them the hassle of dealing with insurance paperwork and paying them faster).

I spot checked a few procedures that I had already asked the hospital billing department about just because I was curious. For most of them the pricing was pretty close to what I was quoted (because our hospital gives self-pay patients the same discount that insurance gets if you ask for it), with the exception of the colonoscopy quote. That one is off by $2000. HCBB says it should be just over $1500 for everything (outpatient, no complications, no biopsy) including facility fee, doctor, and anesthesia. However the hospital quoted me a typical price of $3500. That’s crazy different and $3500 is pretty high from what I’m hearing about other quotes around the country. I haven’t revisited this with our hospital yet, but I plan to before scheduling that procedure. I may have to travel elsewhere.

Pointing the billing staff toward HCBB is something that may help explain why we ask for certain pricing on procedures which is often much lower than their chargemaster rate. Being an empowered patient means we have choices about how we spend our money (non emergency) and we should not be taken advantage of. We also want to pay a fair price for the services received as these doctors, nurses and other staff work very hard and should be paid fairly for it. Getting off scott free should not be the goal. Fair pricing is the goal, and we should handle ourselves accordingly. Gentle, but firm.

So shop around, ask questions, don’t be afraid to push for a fair price. This will take some getting used to if you are used to just accepting whatever bill you get. Whether you have insurance or not you should get in the habit of asking what it costs. Because even with insurance you can be stuck with a very high bill and being aware of the charges makes you that much more prepared.

Before finding I wouldn’t have had a clue what a fair price is for any given procedure. (Since I like to think in 1980’s pricing I’m sure everything would sound high to me.) By having that website as a resource I have a good knowledge base and won’t have to feel like an idiot or a pushover when speaking with the billing department.

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