Clearcharge

Hospital prices, out in the open.

Occupational therapy evaluation, high complexity in Atlanta, GA97167

HC OT EVAL HIGH COMPLEX 60 MIN

Across 25 hospitals within 35 miles of Atlanta that publish a negotiated price for this code. Each hospital's figure is the middle of the rates it publishes across its own insurance plans, so the spread within one hospital is often wider than the gap between two. “Cheapest tenth” and “dearest tenth” are the hospitals a tenth of the way in from each end, not the single cheapest and dearest — one hospital publishing a placeholder rate should not set the headline for a whole state. Every hospital, including both extremes, is in the table below. A hospital whose published address is a PO box is placed at its city centre, so a distance shown for it is approximate.

That is a 5-fold difference for the same billing code, between hospitals within 35 miles of each other — a gap between hospitals, not between treatments. It is worth ringing more than one.

Self-pay is what the hospital charges someone paying themselves rather than through insurance — the number to use if you have no coverage, or if this hospital is out of network. Paying self-pay usually doesn’t count toward your deductible, so it can cost less for this one service and more across a full year, if you’d have met your deductible anyway. Every other figure here is what an insurer pays, not what you would.

At 6 of the 25 hospitals here that publish a self-pay price, it is lower than what that same hospital typically accepts from an insurer — so it is worth asking for, in writing, at those. At the other 19 it is higher. Either way it is worth asking whether you qualify for financial assistance, which is a different thing and often a much larger discount.

Narrow this by your insurance plan or distance →

These are prices the hospitals published themselves, as required by the federal Hospital Price Transparency Rule (45 CFR 180.50). They are the hospital's share only — the surgeon, anesthesiologist and radiologist usually bill separately and do not appear in any hospital file, so treat every figure here as part of a total rather than the total. What you actually pay also depends on your plan's deductible and coinsurance.