[sol8]

The entire pricing scheme is an elaborate sham if you ask me. My wife had to have surgery. A outpatient laparoscopic procedure that required cutting a tendon. The time she spent at the facility (from the when they took her back and discharged her) was about 3 hours. A month later we got a statement showing they tried to charge $67k and were denied… followed by a separate bill for $7.5k We ignored the bill and contacted Anthem who said the hospital didn’t code it correctly. Anthem said they would resolve it. A month later… another attempt to charge $67k another separate bill for $7.5k. Again we repeated the same process. This time it appears it went through. Final total when they “coded it correctly” was $74k.

I have a friend who had to have an emergency appendectomy this year. She paid $1500 for it after insurance. My father had knee surgery he says they tried to charge the insurance company $64k for it.

At this point I think the pricing is all arbitrary. It’s about them trying to charge what they think they can get away with and sticking you for the rest. Kind of like raising the price so you can offer a deep discount later on. I think the real price of the surgery (without insurance) was probably the $7.5k.

I can think of no other business where you agree to have work done without an agreed upon price. The insurance company will tell you it’s covered but the hospital you go to may decide to play games with you. At the very least I suppose they are just hopping you pay so they can collect interest on your money on it before sending it back.

[21]

> I can think of no other business where you agree to have work done without an agreed upon price.

You can't really compare this with other businesses. Unless you want the doctors to stop the moment they hit your negotiated price (like lets say a building constructor would).

However you should be able to get a rough quote for the procedure (assuming no unexpected complications).

And I agree with you in general, US health care is a total scam (very high-quality to be fair).

[sol8]

That's good point. I wouldn't expect pricing to function like that, especially in life or death situations. In our case, this was a surgery that was planned and scheduled a month in advance and at no time was a price ever mentioned. Just a letter from Anthem saying it was covered. We didn't start to see anything on the monetary side until after it was all said and done with. In advance of the procedure I tried to find some pricing data on the surgery but struck out. Apart from some articles about hospitals in California publishing prices for procedures, I could find nothing for the east cost.