Meanwhile, Grand Strand Medical Center spokesperson Caroline Preusser blamed "a glitch" involving the hospital's online calculator for the inaccurate information Yuengling received and said the correct estimate for the cash price for a breast biopsy at the hospital is between $8,000 and $11,500 "depending on the exact procedure and equipment used." Patients in Conway with private health insurance who are treated at other hospitals also typically are charged less than what Yuengling paid for the same procedure - on average about $3,500, according to Fair Health Consumer, an organization that analyzes health insurance claims.Īnd uninsured patients who pay cash prices and need an ultrasound-guided breast biopsy at the nearby Conway Medical Center are likely to owe even less - about $2,100, according to Allyson Floyd, a spokesperson for the hospital. The hospital expected more than five times the Medicare price from Yuengling and her insurer. Medicare would pay the hospital the remainder of the bill, about $1,200. ![]() By comparison, according to the federal government's website, Medicare patients who need an ultrasound-guided biopsy similar to the one Yuengling received would pay only about $300 - their required 20% coinsurance for outpatient care. Grand Strand charged Yuengling's insurance an extraordinarily high price for her procedure. "We can very confidently say this is very common," said Bai, who advised that all patients, regardless of their insurance status, inquire about the cash price before undergoing a procedure. often set their cash prices lower than the prices they charge to treat commercially insured patients. Ge Bai, an associate professor at Johns Hopkins Bloomberg School of Public Health, recently published research on this topic and said hospitals in the U.S. For the nearly 30% of American workers with high-deductible plans, like Yuengling, that means using insurance can lead to a far bigger expense than if they had been uninsured or just pulled out a credit card to pay in advance. What gives: It's not uncommon for uninsured patients - or any patient willing to pay a cash price - to be charged far less for a procedure than patients with health insurance. Yuengling was billed $5,169.67, the balance of her deductible. ![]() Cigna's in-network negotiated rate was $8,424.14, of which the insurance company paid the hospital $3,254.47. Total bill: $17,979 for the procedure, including lab work, pharmacy charges, and sterile supplies. It is one of 182 hospitals owned by Nashville-based HCA Healthcare, which generated $58.7 billion in revenue last year. Service provider: Grand Strand Medical Center, a 403-bed, for-profit hospital in Myrtle Beach, South Carolina. Medical service: An ultrasound-guided breast biopsy. The patient: Dani Yuengling, now 36, who is covered by Cigna through her employer, a human resources contractor for the Mayo Clinic. ![]() She was told her providers wouldn't know what type of biopsy needle they needed until the procedure was underway and that would impact the price. ![]() Whatever the procedure cost, Yuengling knew she'd be on the hook for most of it.īut the hospital wouldn't give her a price. She has a $6,000 annual deductible - the amount her health plan requires she pay before its contribution kicks in - and she wasn't close to hitting that. "It was the hardest experience, seeing her suffer," said Yuengling, who lives in Conway, South Carolina.Īfter a mammogram confirmed the lump needed further investigation, Yuengling scheduled a breast biopsy for Valentine's Day this year at Grand Strand Medical Center in Myrtle Beach.Īmong many concerns she had ahead of that appointment - the first being a potential cancer diagnosis - Yuengling needed to know how much the biopsy would cost. The disease eventually killed Yuengling's mom in 2017. She was 35, the same age her mother had been when she received a breast cancer diagnosis in 1997. When Dani Yuengling felt a lump in her right breast last summer, she tried to ignore it. But she had no idea how expensive the biopsy would be. Dani Yuengling of Conway, South Carolina, knew she had to follow up after a mammogram found a lump.
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