Patient MRI Savings with Typical Insurance Policy
Example: Ryan has a 70/30 policy for imaging, and his family has met their deductible for the year. He’s got it made, right? No so fast.
Typical 70/30 Insurance Northwest MRI
$725 $400 (cash) $550(insurance billed)
Payment with Typical Insurance: $725 Net out of Pocket
Let’s say Ryan schedules an MRI from XYZ imaging center or hospital. They are an “in-network” provider and their charge to you for an MRI is $2500 plus a $250 charge for a Radiology report.
$2500 List Price for a Scan PLUS $250 for the Radiology Report
His insurance company has negotiated a discounted price with XYZ imaging center of $1800 for the MRI and $150 for the report.
$1800 Negotiated Scan Price PLUS $150 for the Radiology Report
Let’s assume his insurance coverage after he pays his deductible of $200 has been met is 70/30 for medical imaging. This means his insurance coverage is 70%, and he has to come up with the 30%.
Ryan Pays $725!
30% of $1800-$200 = $480
30% of $150 = $45 $200+ $480+$45 = $725
Payment to Northwest MRI If We Bill Insurance $550 Net out of pocket
Out of Network at 50% $200 deductible
Ryan schedules the same MRI Scan at Northwest MRI – an “out of network” provider. Our everyday “out-of-pocket” charge for a standard MRI billed to insurance is $900.00 (which includes the radiology report- NO hidden fees).
Insurance Billed Rate $900
Most insurance companies will cover “out of network” providers at 50% after the deductible is met. $900- $200 deductible paid at 50% +$350 reimbursement. $900-$350 = $550
Northwest MRI Insurance Billed: John Pays $550 Saves $175
If we manage the work with your insurance company, your total out of pocket would be $450.00 compared to $725, saving you $175.
Northwest MRI – CashPayment $400 Net out of pocket
Out of Network at 50%
If Ryan pays cash, and bills his insurance himself, with the paperwork we provide, he pays even less. John schedules the same MRI Scan at Northwest MRI – an “out of network” provider. Our everyday “out-of-pocket” charge for a standard flat rate MRI is $599 (which includes the radiology report- NO hidden fees).
Flat Rate $599
Most insurance companies will cover “out of network” providers at 50% after the deductible is met.
Northwest MRI Cash Payment: John Pays $400 after insurance
Ryan Pays Northwest MRI $599, and sends the bill to his insurance company. They reimburse him at the 50% “out of network” rate, after removing the deductible sending him a check for $299 after they process his paperwork.
$599 cash price – $200 deductible = $399 reimbursed rate. $399 x 50% = $199.50 reimbursement
Total cost $599 cash price minus $199 reimbursement = $400
This is a “typical scenario” each situation is different. We will gladly create a personal cost savings estimate for you by talking with your insurance company, and you can make the best decision for yourself.
Flat Rate, No Hidden Fees – Check your saving at our Pricing Page.