Here's the financial damage from my PET/CT scans, for which I just got the bill. BTW, it was a combined PET and CT scan (skull base to mid-thigh per my request for a full-body scan), also called a "Fusion" because of the software linking the two scans. I don't know what the cost would have been for a shorter set of scans.

Billed price for scans: $3050.00
Billed price for Doc report: 500.00

less network discount for scans: -363.65
less network discount for Doc: -250.00

Total 2936.35

My share, under 80%/20% plan $587.27

In this case, my cost is actually somewhat higher because I have not met my annual deductible, but I chose to exclude that because it is really a timing event and dependent on other services I may or may not have paid year to date.

For those who may not know what a 'network discount', that's an agreed price reduction from the 'list' price of the service between the insco and a 'preferred provider'.

I am sure glad that I have Kaiser. I pay 50 bucks for any type of scan except chest x-rays which are 10 bucks. The reading/report is free.
Doctors visits are 5 bucks as are generic meds (name brand 15bucks). ER, as I found out last Sunday, is 100 bucks. It does almost $1500/mo for my wife and I...

Boy, we must have it lucky 'Down Under'. My PET/CT was covered by the government as it was done in a hospital. Not one cent did I pay!

If procedures are done outside a hospital, say a private clinic, yes I have to pay. A CT costs around AUD$400, and Medicare gives some rebate, though not as much as I'd like

Cheers!

Tizz (who does not know how long this system will be so kind)

If I'd been on a HMO plan and IF I could have talked my Doc into getting the full-body scan, likely the plan would have paid for the whole thing.

I have chosen the plan I have because it gives ME the choice to go outside the PPO (preferred provider organization) if I choose and still have coverage, albeit without the in-network discounts and still having to pay the 20% (up to $2,000 out-of-pocket per year, BTW, after which the insco pays it all -- That happened in the calendar year in which I started surgery/rad -- I paid $2K and the insco paid more than $30K). I have the insurance to cover the really big stuf -- $600 isn't a trivial amount until one compares it to $30K!!

For example, if going to a CCC was NOT on the insco's list of providers or within the guidelines of local HMOs, I still had the choice to go anyway and be covered after $2K out-of-pocket -- In fact, I could exercise choice to choose among ALL the US CCCs to use the best!

Things are not always what they seem to be at first!

Even in an HMO they can sometimes refer you out. Kaiser picked up the entire cost of my RO and treatment at UCSF CCC. I also had one of the best RO's in the US. I didn't even have a copay - not even for CT's done at the CCC