A CT scan provides detailed pictures of your internal organs, muscles, and bones. Doctors use CT scans to diagnose diseases and to monitor the effectiveness of treatments. CT images can be used to examine any part of the body. CT scans are performed in hospitals, outpatient imaging centers, or medical offices. The price of a CT scan can vary by thousands of dollars, so it’s important to know if your insurance will cover the cost of a CT scan.
Most imaging centers and hospitals will accept health insurance for CT scans, especially if they’re an in-network facility. However, there are other insurance policies that may influence whether or not your health insurance will approve the scan at all.
Insurance companies reserve the right to decide whether or not any procedure is medically necessary. Most companies require imaging services such as CT and MRI to be subject to a “medical necessity review”. The purpose of this review is to determine whether a particular diagnostic test or treatment is appropriate and essential. Decisions are made based on the standard of care and the individual health plan’s policies and clinical guidelines. For example, if your primary care practitioner prescribes a breast MRI for cosmetic surgery, or an abdominal CT to strengthen a worker’s compensation case, it isn’t always deemed medically necessary and might not be covered. The safest (but not always the easiest) way to see if your test will be covered, is to call your insurance company and ask.
If your insurance doesn’t cover your test or if you don’t have coverage in general, getting the best out-of-pocket price for a CT scan isn’t always easy.
In general, imaging costs are very high, with or without insurance. According to Healthcare Bluebook, a CT scan can cost between $225 and $3,000. Most CT scans are typically covered by health insurance when deemed medically necessary but patients often have to meet their deductible before insurance kicks in (which means you might cover the cost of your test and at a higher insurance negotiated price).
Most medical imaging procedures, including CTs, are quite expensive, which leads to increased frustration for many patients as they are already undergoing an uncomfortable procedure. Doing your research beforehand in order to find the best facility, radiologist, and price for you can significantly lessen the aggravation these procedures bring.
A study found that patients who know how much a medical procedure will cost will save money on healthcare overall—presumably because they choose the lower-priced practitioner. The National Bureau of Economic Research found: “patients often received care in high-priced locations when lower-priced options were available. Fewer than 1 percent of individuals used a price transparency tool to search for the price of their services in advance of care.”
With Medmo, it’s even easier to compare prices. Instead of guessing the bill (and praying there isn’t a huge surprise), or spending time cross-checking centers with insurance and availability, patients can just tell us the price you can afford. We will even tell you whether there are cheaper payment options outside of your insurance such as with cash pay discounts.To book a scan, visit us at Medmo.com. Medmo helps people schedule radiology imaging tests – such as MRI, CT scans, PET, and more – at nearby accredited centers and identify the payment solution that works best for them.