[quote=Pete D]The billing amounts are effectively the undiscounted cash price for the procedure, followed by the much lower discounted price negotiated by Medicare and other ins providers. Just let the dust settle, esp if you have Medicare plus a supplementary insurance, because it takes time to process individual cases through two ins cos. [/quote]

Medicare and different insurance companies negotiate their own maximum allowable charges which can vary tremendously. Here is a great example of what Craig and I were each charged for a simple two-film chest X-ray.

We have FEPBlue Insurance since Craig is retired from civil service. Last year Craig signed up for Medicare and that is now his primary carrier and FEPBlue is now medigap (i.e. picks up all the charges Medicare does not cover). I still have FEPBlue as my primary carrier, and they pay 100% once a year for a chest X-Ray as a part of their preventive care program. Therefore, the chest X-rays we had at the same institution on the same day cost each of us $0.00.

Here are the numbers reflected on our BC/BS statements:

Submitted charges by the hospital: $705

Craig's statement:
Plan allowance-Medicare: $705
Medicare PAID: $696.55
FEPBlue paid: $8.45
Total insurance payment: $705

My statement:
Plan allowance-FEPBlue: $68.78
FEPBlue paid: $68.78
Total insurance payment: $68.78

I realize that the negotiations between medical providers and insurance companies are give and take (i.e. we will pay more for this test if you will take less for that test, etc.).

BUT.... Is a two-film chest X-ray (not including the charge for reading the X-ray) worth $705?

And look who is putting out $696.55?

We are, fellow taxpayers!