Paying for HSG out-of-pocket--Suggestions for Where to Go?

[Anonymous]

My insurance has already told me they won't cover it, so I'll be paying up front for the entire cost of the HSG. Washington Radiology told me it would be about $1200 (have not tried to negotiate with them yet) and I plan to call around to other providers to find out what they would charge. Any suggestions from others who have paid OOP? Thanks.

[Anonymous]

I forget what they charged, but GW hospital was cheaper than the fertility clinic I was using at the time (Dominion). The downside is that the procedure will most likely be done by a resident (in my case a guy who did not look a day over 21).

[Anonymous]

I go to Columbia Fertility and was told that if my doctor performed the test it would be around $1000. However, she was on vacation when I needed to have it done, so I was directed to go to radiology at Laurel Regional Hospital where the doctor there did it and it cost me about $250!! I think the higher price quoted to me was to pay for my doctor's fees, so I really lucked out.

[Anonymous]

Even if your insurance company won't pay for it, there's a possibility you'll still get their negotiated rate. I don't know if it would be lower than $1200 for WRA, but you could ask either your insurance co or WRA itself. ("If its covered by insurance, what's the cost?")

Basically, most medical facilities charge individuals much higher rates for things than they charge insurance companies like Aetna because Aetna has negotiated down the rates for their members. You're still a member of your insurance plan -- it's just that this procedure is not covered. So maybe you can have Washington Radiology (or whoever) bill your insurance company, and then have the insurance company bill you because it's not covered. We always try to route things through the insurance co first, even if we wind up payingfor it ourselves in the end. Good luck!

[Anonymous]

I've never heard of a provider accepting the negotiated rate if your insurance company does not cover the procedure. That said, you can always try to negotiate on your own. It's just that you have a much weaker bargaining position than your insurance company. Good luck!!!

[Anonymous]

To the 9:40 poster - There are instances where the negotiated rate is accepted even if the procedure is not covered. If you have Aetna for insurance and your IF coverage runs out at Shady Grove, then you still get the negotiated rate for your IVF cycles. My benefits ran out after my first cycle. I have done a couple of cycles since and I pay the same rate that was billed to my insurance - and it is definitely lower than the global or rack rate. Other procedures, like AH and ICSI, are not part of that deal and you pay the rack rate for them. I guess my point is that you can't assume that you don't get the insurance rate just because your insurance co doesn't cover the procedure. You have to ask!

[Anonymous]

I'm the original poster and just wanted to report back that I negotiated with Washington Radiology and ended up paying $325 for the HSG. It may not have been the least expensive provider out there, but the location was very convenient and I was happy with the price and the service.

[Anonymous]

Anonymous wrote:I'm the original poster and just wanted to report back that I negotiated with Washington Radiology and ended up paying $325 for the HSG. It may not have been the least expensive provider out there, but the location was very convenient and I was happy with the price and the service.

Fantastic!!! Thanks so much for reporting back -- very helpful!