4 steps to get medical cost estimates before you get care

Imagine sitting down at a restaurant only to learn that the price of the meal won’t be revealed until after you’ve eaten. You’d probably skip the filet mignon, right? Or better yet, you might choose to go elsewhere.

But when it comes to medical care, many of us don’t think making a choice or shopping around is an option. You may even feel rushed to schedule a surgery or test. Some of us might just agree to our doctor’s first suggestion, not even knowing the price — until the bill arrives weeks later.

“The price of the same service can vary depending on where you get the service or even within the same facility,” says Rebecca Madsen, chief executive officer of advocacy at UnitedHealthcare. “It can depend on whether you pay cash or use your insurance, and it can also depend on the specific plan you have with your insurance provider.” 

In other words, health care pricing can be complicated. But these 4 steps may put you in more control, helping you price the cost of a surgery, test or medical procedure before you agree to it.

“Doctors and facilities in the UnitedHealthcare network agree to provide services at a discount,” says Madsen. “That means, when you choose those providers, your costs will be lower — you’ll save money.” Providers who are out of the network can charge more, which means their services could cost you more or may not be covered at all.

Your insurer may provide cost estimates from in-network providers. For instance, UnitedHealthcare members can sign in to myuhc.com, then choose Find Care & Costs at the top of the page. (If you use the UnitedHealthcare app, choose “Find Care” at the bottom of your screen.) You’ll see a search bar labeled “Search for providers and services” that lets you search for the treatment you need near your ZIP code.

You can enter phrases like hip replacement, back surgery, carpal tunnel, etc. to see a list of in-network providers near you. You’ll be able to view each provider’s estimated total cost, what your policy covers and your estimated out-of-pocket cost. Where appropriate, you may also see the option to choose an ambulatory (freestanding) surgery center.

Tip: The UnitedHealth Premium® Program helps UnitedHealthcare members identify providers ranked for providing quality and cost efficiency. When you see two blue hearts next to a provider’s name, it means they’ve met the program’s quality and cost-efficient care criteria.

Hospital prices tend to be the highest. Freestanding, ambulatory, or same-day clinics will usually cost far less. A complicated scan that costs thousands of dollars at a hospital, for instance, might cost half that amount at a local imaging center. The average national cost of MRIs and CT scans at hospitals is $1,855, compared with $682 at freestanding facilities, according to UnitedHealthcare data.¹

“Freestanding clinics can cost you less for a couple of reasons,” Madsen says. “One is you can avoid the facility fee that hospitals charge. And since they’re an independent facility and not owned by a hospital, they’re competing with hospitals, so they tend to charge competitive prices.”

A quick way you may also save money: Find an in-network clinic that specializes in your procedure. Either scan its website or call the clinic.

Another simple route to finding a quality care provider or estimating costs is to contact your insurer. For UnitedHealthcare, the phone number on your member ID card connects you to help sorting through your options. “If you need a surgery, test or other procedure and you’re not sure where to go, or if you need some help identifying a quality care provider and determining what your costs might be, we’re always here to help,” Madsen says. “Just call the number on your card, or in the UnitedHealthcare app, choose the ‘Get Support’ button at the bottom of the screen. Our customer care advocates can then help you find a quality care provider close by and give you cost information, including any out-of-pocket costs.”