• New Edge Solutions

Are You Getting the Best Price for Your Test?


Many health care procedures are shoppable for employees. Common diagnostic tests such as ultrasounds, MRIs, and arthroscopic surgeries are generally easy to price shop given they are often scheduled in advance.


How does the employee best shop these types of health care procedures?

  1. Employees can start by speaking with their doctor about the service being ordered and ask for the CPT code (or codes) utilized for billing. This will ensure they’re getting the most accurate estimate for the services needed.

  2. They should ensure an understanding of the doctor’s “why” for ordering the test or procedure.

  3. Whether the service is considered “diagnostic” or a routine “screening” can often impact the overall cost.

  4. Where the service will be rendered and whether the institution/facility is in or out of network.

  5. Some employee groups are benefitting from online tools within their health plans that allow them to gauge their out-of-pocket expenses, and shop for the best price. Yet, some shopping tools are hit/miss on the accuracy of listed estimates, so employees should check to ensure a provider remains in their network.

  6. If the employee group plan does not provide pricing tools, there are some states that are providing price comparison tools.

  7. Find out the price paid for that procedure by Medicare in an employee’s area. The Medicare price is a great benchmark to gauge health care procedure costs.

  8. Call the facility and ask for a price estimate prior to scheduling.

  9. Keep a log. Document the who/what/when of the information gathered from the steps above. Many times, people asking questions will get differing information from the same insurer or provider clinic.






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