4 Reasons Your Medical Bills Are Unpredictable

Unlike the shelves of a supermarket, there’s no upfront price tag attached to medical procedures. Your actual health is one of many factors that figure into how much you pay for healthcare services. While more obvious factors include doctors’ fees or the costs of lab tests and surgical procedures, factors that have nothing to do with your personal health can also influence your healthcare bill.



One of the biggest cost-driving variables when it comes to healthcare is location. These researchers found that the cost of childbirth can vary by as much as twenty-thousand dollars when comparing city-by city. Price variances can be seen within the same city, but when looking at state-by-state comparisons, the spending variations are substantial and persistent over time.



Hospitals often try to cross-subsidize facility or technology upgrades by building in facility fees to their bills. Private practices that have been purchased by hospital systems often include those facility fees for doctor’s visits, even if they occur outside of hospitals.

Where you seek time-sensitive medical advice—whether it be an emergency room (ER) or an urgent care facility—also determines how much your treatment costs. Of course, some circumstances demand a trip to the ER, but many would be aptly treated at a lower-cost facility such as a walk-in clinic or urgent care center. US hospitals are legally required to treat all patients who arrive in the emergency room, whether or not the high-cost emergency treatment is necessary, and regardless of the patient’s ability to pay.

Urgent care centers are a more cost-effective alternative to emergency room visits. Because they are open late 7-days a week and don’t require an appointment, they are often more convenient than scheduling a visit with a primary care physician. Walk-in clinics, which are similar to Urgent Care centers but staffed by nurse practitioners rather than physicians, are also a good option for patients whose health concerns are not so severe that they need to be seen rapidly.

Where you recover from a procedure can also play a role in your final bill. Patients who are moved to recovery rooms post-surgery, rather than left in intensive care units, are charged thousands of dollars less. Hospital operating rooms typically charge by the minute, not the hour. If you’re looking to keep costs down, check your hospital bill to ensure that it reflects the exact time you are moved to a recovery room.


Who’s Paying

For the uninsured, healthcare costs often feel insurmountable. Deductibles, copays and additional out of pocket expenses can add up even for those who have insurance. You can ask for a good faith estimate about the cost of treatment, but with so many variables, what’s quoted may or may not match your bill once everything is fully processed.

Although each hospital has a master list of what different procedures cost, these costs vary drastically based on negotiations between insurers and hospitals. The price you pay also varies depending on which plan you have. Government programs such as Medicare and Medicaid also negotiate on behalf of their millions of members.



Physicians may offer you the option of name-brand or generic medication, but sometimes they make the decision for you. Generic drugs can cost up to 80% less than their name-brand counterparts, and regulation requires that they are chemically-equivalent and equally as effective as the name-brand option. Consult your insurance plan to figure out what portion of your medication costs your insurance will cover.


Because there seems to be no association between higher cost and better quality treatment, variations in medical costs can seem arbitrary. Now that you’re more aware of the various factors that can influence your medical bill, there are steps you can take to keep your medical expenses down.

Be proactive about asking your provider whether each test and procedure is necessary and what they estimate the cost to be.  Research procedures and their associated costs ahead of time. Avoid seeking treatment at emergency rooms unless you are experiencing a true health emergency that requires immediate attention. When you do receive a bill, insist that it is itemized so that you can double-check each cost. With these strategies, you may be able to save yourself thousands of dollars without compromising the quality of your care.

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This information is not designed to replace advice from a mental health professional or physician on the appropriateness or risks of a procedure or treatment for a given patient. Always consult your doctor with medical or mental health concerns. Revivallhealth.com does not provide medical or mental health advice, diagnosis or treatment.

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