Healthcare Prices Explained

Paying out of pocket for healthcare services is on the rise. We’ve compiled the most common price factors to help you decipher your medical billing statement and explain how we calculate our estimated national average price.

Healthcare price factors

Cost of living, population health trends, availability of doctors, and the number of insurers in region can affect costs between states, cities, or even ZIP code.

Doctors and hospitals outside of an insurer’s network don’t offer the same negotiated discounts to patients on different managed care plans.

Operating costs typically make hospital care more expensive than ambulatory surgical centers, which are usually more expensive than urgent care or physician’s offices.

Insurance companies negotiate with hospitals to set pricing for their members, so uninsured patients can end up paying more.

Specialists tend to be more expensive than primary care providers because of their highly specialized fields. Higher price does not mean better quality care.

The medical bill is a starting point. Patients willing to pay but unwilling or unable to pay full price can try to negotiate for a lower price.

Region
Cost of living, population health trends, availability of doctors, and the number of insurers in region can affect costs between states, cities, or even ZIP code.

Insurance
Insurance companies negotiate with hospitals to set pricing for their members, so uninsured patients can end up paying more.

Network
Doctors and hospitals outside of an insurer’s network don’t offer the same negotiated discounts to patients on different managed care plans.

Provider
Specialists tend to be more expensive than primary care providers because of their highly specialized fields. Higher price does not mean better quality care.

Facility
Operating costs typically make hospital care more expensive than ambulatory surgical centers, which are usually more expensive than urgent care or physician’s offices.

Negotiation
The medical bill is a starting point. Patients willing to pay but unwilling or unable to pay full price can try to negotiate for a lower price.

One procedure,
multiple bills

Your treatment is a group effort, consisting of multiple services performed by different providers. Every contributing party will send a separate bill.

After a surgery, for example, you could receive separate bills for the surgeon’s fee, the anesthesiologist’s fee, the hospital stay, diagnostic imaging, lab tests, follow-up visits and more.

When you shop with MDsave, our prices include the most common services for a procedure, which means no more multiple bills!

FREQUENTLY BILLED SERVICES

Same procedure. Different prices?

How much you pay depends on how you pay and who’s negotiating on your behalf.

*Some hospitals have established self-pay rates for some procedures, like predetermined pricing for a birth with a two-day hospital stay. Established cash rates typically aren’t established for all procedures, if they exist at all.

Our price uses the data below to negotiate an affordable price for upfront payment.

Our cost comparison algorithm uses these 6 prices to estimate the national average bundled price.

How does MDsave estimate prices?

Estimated National Average

We use a proprietary algorithm to provide self-pay patients with a fair point of comparison for bundled prices, which includes a weighted average of chargemaster prices, discounts and insurance-negotiated prices.

MDsave Negotiated Price

Unlike many healthcare cost comparison sites, our listed price is the actual price you pay, not an estimate. Our pre-negotiated, discounted prices include hospital, physician, anesthesia, and pathology fees unless otherwise noted in the procedure details.

MDsave: the better way to buy

Convenience

We’ve done the negotiating for you. Compare costs and prepay one packaged price for your service.

Confidence

Know what you owe upfront. Prices include the most common fees. No surprise bills.

Choice

MDsave has partnered with CareCredit, a health, wellness and personal care credit card that provides promotional financing with convenient monthly payments.*

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*Subject to credit approval. Minimum monthly payments required.