How I Saved About $2,000 on My Kid's X-Ray … Has Anyone Else Figured This Out?

Reviews
1

I recently had a really frustrating experience with medical billing, and I think sharing what I learned might help others avoid paying too much. Some of you might already know this, but I hope it can assist someone who doesn’t.

The Situation:

My baby’s doctor said he needed a hip X-ray for hip dysplasia checks. When I asked for options, they said the only place was ‘Children’s Hospital of Atlanta’ which was disappointing. I’m in Atlanta, GA.

After calling CHOA, I found out they would charge $2,200 for the hospital fee, and they wouldn’t give me any discount. Also, I had to pay 85% beforehand.

I reached out to other hospitals despite being told there were no alternatives, and luckily I got through to Northside Hospital. They said they do offer pediatric imaging and their self-pay rate was $700. When I inquired about self-pay discounts, they said they give a 75% discount upfront, bringing my total down to $175 for the X-ray. That was amazing!!

But nobody shares that there’s a separate radiologist fee for reading the X-ray. They don’t include that in their upfront pricing which takes you by surprise later. In my case, I’ll still owe around $150 for the radiologist, making my total about $325. I’m really happy after almost giving up and thinking I’d have to pay over $2,200 to CHOA.

What They Don’t Tell You: Getting a Price is a Nightmare

You’d think asking “How much will this cost?” as a cash payer would be easy. It’s not.

  • I had to go through a special pricing department just to get an estimate.
  • They made me fill out a form and wait for it before giving me an ‘estimate’.
  • After they finally gave an estimate, they didn’t mention the radiologist fee.
  • When I asked directly, they didn’t even know if there was a radiologist fee.
  • I had to be transferred again, find a third-party radiology group, and repeat the whole process just to find out I’d owe an extra $150.

And that’s just for an X-ray. Other procedures could have even more hidden fees from doctors I wouldn’t have known were involved.

What I Learned (the Hard Way):

  1. Hospitals won’t tell you about self-pay discounts unless you ask. Accepting the price CHOA gave me would have cost me over 10 times more.
  2. They won’t tell you about separate radiologist fees. The price quote doesn’t include the doctor interpreting the X-ray, leading to an unexpected bill later.
  3. Getting a price is a huge hassle.
    • You can’t just call and ask—they put you through a whole process.
    • Even after that, it’s probably not the final price.
  4. Insurance would have been pricier than self-pay.
    • I currently don’t have insurance while waiting for my new Marketplace plan (my wife is now a stay-at-home mom, and I’m self-employed).
    • Even with insurance, I possibly would have ended up paying more than the self-pay price.
    • Insurance often bills the full contracted rate, and with high-deductible plans, you pay that full amount out of pocket.
    • The self-pay discount is often greater than any insurance discount.
  5. High-deductible plans are often not worth it unless you have significant medical expenses.
    • If you have insurance but don’t meet your deductible, you still waste money paying full price.
    • Hospitals usually won’t let insured patients access self-pay discounts because they must charge the contracted insurance rate.

What You Should Do If You Need an X-ray (or Any Imaging):

:white_check_mark: ALWAYS ask for the self-pay or cash discount. Don’t take full pricing for granted.
:white_check_mark: Call different hospitals and imaging centers. Prices can be vastly different.
:white_check_mark: Ask if the radiologist fee is included or separate (it’s usually separate).
:white_check_mark: If you have a high-deductible plan, compare the self-pay rate to your insurance rate—it’s often lower.
:white_check_mark: If they require you to fill out forms for pricing, expect that the number they give may not represent the total cost.

I can’t believe how many people must be overpaying just because the system misleads you into thinking you don’t have a choice. If I had blindly accepted my doctor’s advice, I would have paid about $2,400 for a $325 X-ray at a different reputable hospital.

Has anyone else faced something similar?

3

Thanks a lot for sharing your experience.

I noticed with my insurance (Cigna) that self-pay rates tend to be higher than insurance rates, but that’s mainly for office visits. I wonder if imaging and other procedures might differ.

4

@Tyler
Absolutely, hospitals can be more flexible with discounts when they are paid upfront. Just FYI, I also took my son for his 4-month checkup and got shots using the self-pay rate. The total for the visit and shots was $200, which I thought would be much higher. It’s a good pediatric office in a nicer part of Atlanta.

5

@Lennox
For shots, you might want to check with your local health department as they often provide them for free for those without insurance.

6

@Tyler
This is spot on. Just to add, different providers can have different self-pay rates. Some are even less than the insurance negotiated rates. I learned this through a tough experience with bad insurance that wasn’t accepted by many providers. I had to negotiate between paying out of pocket and the negotiated rate for BCBS.

7

Thanks for the valuable info. One thing about high deductible plans is that they allow contributions to an HSA (Health Savings Account), which can be up to $4,300 for individual plans and $8,550 for families per year. Contributions to HSAs are tax-deductible and can even be invested.

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@Cameron
Absolutely! Keep contributing to your HSA every year and you’ll have savings for medical bills when you turn 65.

9

Kellan said:
@Cameron
Absolutely! Keep contributing to your HSA every year and you’ll have savings for medical bills when you turn 65.

You can actually use HSA funds for things other than medical expenses once you hit 65.

10

@Cameron
It’s great for the upper middle class and wealthy, but the downside is that lower-income individuals often end up opting for the lowest premium options without considering the long-term cost. They can rarely afford to save.

11

@Dorian
Could you clarify what you mean about the low premium situation affecting people’s choices? I’m not sure I understand.

12

Cameron said:
@Dorian
Could you clarify what you mean about the low premium situation affecting people’s choices? I’m not sure I understand.

Sure! When lower-income employees are given choices for health insurance deductions, many go for the lowest premium option without realizing the consequences or in a bid to keep more cash in hand. Most can’t afford to contribute to an HSA, and if they could, it would need to go towards healthcare costs instead of being saved.

13

@Dorian
Got it, thanks for explaining! It’s really tough for many people to invest in health savings.

14

Using insurance doesn’t add up if your plan type has a high deductible. I have health issues and regularly hit my out of pocket maximum, so it’s smarter for me to stick with insurance. My company also covers around 80% of the deductible, making the high deductible plan actually advantageous for me.

For others, self-pay can still be a solid choice, especially if you only need occasional healthcare.

15

@Zen
That’s fair. I should mention that I’m self-employed. If you’re on a company plan, running through insurance often makes sense since deductibles and out of pocket maximums are generally subsidized.

16

@Zen
That’s a good point—your company’s contribution is definitely a big factor in your reasoning.

17

Blake said:
@Zen
That’s a good point—your company’s contribution is definitely a big factor in your reasoning.

Not really. I would hit my out of pocket max anyway. It would end up costing me more if I didn’t use my insurance.

19

In the future, consider checking out dedicated medical imaging centers. They offer services like MRIs and X-rays at prices much lower than hospitals. Many of these facilities serve all ages and deal with insurance, but make sure to ask for self-pay prices first. Some also provide payment plans or lower costs based on income. Many independent imaging locations include the radiologist fee in their pricing, while others do not, so it’s good to confirm first.

20

I agree that high-deductible plans can be a scam unless you have significant medical costs.

I need monthly medicine to survive, and with insurance, the cost is $1,460 every month.

Thanks to a helpful CVS tech, we discovered that if I run the bill through GoodRX instead, it costs only $50.

$50. It feels like a scam.

21

@Brandy
With pricing like that, your high-deductible plan is doing what it was intended: encouraging patients to shop around for the best prices. Unfortunately, the downside is that they often don’t manage to negotiate better rates. Drug costs are particularly difficult since insurers take rebate payments outright from pharmaceutical companies instead of using them to lower patient prices.

22

@Brandy
As a pharmacy tech, I can say CVS can be pricey. I used to work for a pharmacy benefit manager and I’d encounter patients ready to pay $500 for medications they couldn’t afford.

I would suggest to them—wait, let’s see if we can find a better price—and even at worst places, I used Mark Cuban’s Cost Pharmacy for a $20 price instead of the $500 at CVS. The same medication, just a different manufacturer.

In these cases, don’t hesitate to reach out. If they tell you they can’t help, ask to talk to a supervisor. Never accept the first price unless you’re fine with it.

When using GoodRX, unfortunately, it does not contribute towards your insurance deductible. Also, always Google your medication with “manufacturer coupon”; you might be surprised. For injectables like Dupixent, they often provide free doses through proper channels. You need to be savvy or get lucky with whom you deal with.

And one last tip, always check your pharmacy’s medication labels. If your meds are suddenly high-priced, they might’ve been charged incorrectly.

Hope this helps!