9 Ways to Find the Price of a Test or Surgery Before You Say Yes

Imagine sitting down at a restaurant only to learn that the price of the meal won’t be revealed until after you’ve eaten. You’d probably skip the filet mignon, right? Or better yet, you’d get up and walk out.

But when it comes to medical care, many of us don’t think that walking out is an option. We feel helpless. We may even feel rushed to complete a surgery or test. So we agree to our doctor’s first suggestion, and we don’t see the price until the bill arrives weeks later.

We’ll let you in on a secret: You can price shop for medical services just as you would for anything else. If one provider is too expensive, you can walk out and go to another. So why don’t more people do this? They don’t know where to start — and the medical community hasn’t made it easy.

“The price of the same service at the same hospital can even vary based on who’s paying for it,” says Nicole Broadhurst, a patient advocate at Tennessee Health Advocates. “It depends on whether you pay cash or use your insurance, and it also depends on the specific plan you have inside of that insurance.”

In other words, pricing can be complicated. But if you know where to look, you’ll be able to shop for the best deal before you undergo surgery (or an x-ray). “There are some barriers to finding this information, and some of that is by design,” Broadhurst says. “But there are tools you can use to shop around.”

To that end, we’ve rounded up nine of the best websites and strategies that will help you make informed decisions about your health.

1. Healthcare Bluebook

Healthcare Bluebook uses a simple color-coded system to show you which providers in your area offer the best prices. Green signals a good deal, while yellow and red are more expensive.

The search tool is nested under the “resources” tab, and you’ll want to use your queries wisely. Once you sign up with an email address, you’ll be limited to 10 free searches per month. For more than that, you’ll need a paid membership.

2. Fair Health Consumer

Fair Health Consumer offers cost estimates for more than 10,000 medical services. It uses a database of records from 36 billion private healthcare claims and 37 billion Medicare claims dating to 2002.

This service will also estimate what an insurer might pay an in-network provider, but the actual amount depends on your specific insurance company and plan.

3. Guroo

Guroo was created by the Health Care Cost Institute. It’s an independent nonprofit research organization whose members work to help people get the best value from their medical spending.

With Guroo, you can look up data on healthcare costs at national, state and local levels to get a baseline on what a procedure should cost in your area.

4. ClearHealthCosts

ClearHealthCosts compiles real rates reported by patients. It was started by a journalist who wanted to bring transparency to the healthcare marketplace. Use the “find prices” tool at the top of its website to get a scan of prices paid within 5 to 500 miles of your ZIP code.

The results show you the total cost for your procedure, along with what the insurance provider paid, at each location.

5. Solv ClearPrice

Telemedicine platform SolvHealth worked with more than 5,000 urgent care providers to launch this price-shopping tool, Solv ClearPrice. It compiles cash prices for the 10 most common urgent care services, including x-rays of different body parts, stitches, and in-office visits.

You can view national averages and enter your ZIP code to see local rates.

6. Look on the hospital’s website

If your hospital follows the price transparency rules put in place in 2021, you should be able to go online to find the costs of at least 300 “shoppable services.”

But it’s worth noting that hospitals are still catching up to the rules. Of 1,000 hospitals reviewed, only 14.3% had made all their prices available, according to a February 2022 review by Patient Rights Advocate.

To see if your hospital’s prices are online, Google its name along with “transparency pricing.” From there, you may have to download a spreadsheet to see the prices.

7. Reach out to your local clinics

Hospital prices tend to be the highest. Freestanding, ambulatory, or same-day clinics will usually cost far less. A complicated scan that costs thousands of dollars at a hospital, for instance, might cost half that amount at a local imaging center. The average national cost of MRIs and CT scans at hospitals is $1,855, compared with $682 at freestanding facilities, according to United Healthcare data.

“Freestanding clinics are cheaper for a couple of reasons,” Broadhurst says. “One is the lack of the facility fee that hospitals charge. And since they’re an independent facility and they're not owned by the hospital, they’re competing with the hospital, so they charge competitive prices.”

A quick way to save money: Find a clinic that specializes in your procedure. Either scan its website or call the clinic.

8. Find the billing code

If you’re comparing prices across different providers, it may also help to find the billing code for your procedure.

If you’re not familiar with billing codes, they’re five-digit numbers that identify a medical procedure. They’re used to prevent confusion in reporting.

One type of billing code you’ll see is a CPT code (current procedural terminology). Another is an HCPCS code (healthcare common procedure coding system). You can plug either one into the procedure price lookup tool at Medicare.gov to see the average cost you can expect to pay at both hospitals and freestanding clinics.

You can also use CPT codes to compare costs using the online price transparency tools listed above. Instead of entering “CT scan lumbar spine with and without dye,” for instance, you can enter code 72133. And you’ll be sure the procedure you’re seeing in the tool is the same one you’re discussing with your doctor.

9. Contact your insurance provider

In addition to the total price, you may want to consider how much your insurer will pay. For that, you’ll want to contact your provider.

Alternately, you could look it up in your plan document, Broadhurst says. It might also be called your “plan contract” or “plan description” and is usually over 100 pages long, she says. “It tells you everything you need to know about what they will pay for, what that looks like, what the criteria is—everything is in there.”

If that sounds daunting, just dial the number on the back of your insurance card to speak to a rep.

If you’ve never shopped for prices, it might seem intimidating, Broadhurst says. But as with anything else, it’ll get easier as you do it.

“Use the same shopping principles that you use everywhere else when you’re vetting a healthcare provider,” she says. “Don’t just pick the first one that comes up."

Additional sources:
Public awareness of price transparency requirements: Peterson-KFF
Why it’s difficult to estimate the cost of care: Peterson-KFF
Hospital price transparency rules: Centers for Medicare and Medicaid Services
Report on hospital compliance with price transparency: Patient Rights Advocate
Penalty for hospital noncompliance with price transparency: Federal Register
Freestanding clinic vs. hospital prices: United Healthcare
Billing codes overview: American Medical Association