venty, vent Why is our Children's hospital lab work so expensive?

[cintinative]

Every year my oldest has to get a bunch of lab work done because he has Celiac disease. Last year the labs alone (no doctor fee) were over $1600. We have an HSA so we had that full amount to pay.

Recently my son had an issue and we thought it was wise to re-run his TTG and some other things to see if he had been glutened.  Because we are absolutely drowning in medical bills this year, we could not afford Children's so my husband called LabCorp.

Frankly, I am totally shocked at the difference in prices. And I am a bit angry at myself for not checking sooner. I just never in a million years thought the differences could be this huge.  We could have been using that money toward this year's crazy medical stuff.  I have had to pull $6K out of savings this year just to pay medical bills.

I can't totally compare everything until we get the results back because I don't know that they ran all the same tests but here are some things I can compare.

General Health Panel Children's (2020)--$292.               LabCorp (2021) $24.83.  

T4 Free Children's (2020) $418                                       LabCorp (2021) $6.38.

Immunoassay nonantibody Children's (2020)  $164,      LabCorp (2021) $8.17

[pinball]

I’m sorry. That is terrible.

Could it be considered price gouging? 

[kbutton]

4 minutes ago, cintinative said:

Every year my oldest has to get a bunch of lab work done because he has Celiac disease. Last year the labs alone (no doctor fee) were over $1600. We have an HSA so we had that full amount to pay.

Recently my son had an issue and we thought it was wise to re-run his TTG and some other things to see if he had been glutened.  Because we are absolutely drowning in medical bills this year, we could not afford Children's so my husband called LabCorp.

Frankly, I am totally shocked at the difference in prices. And I am a bit angry at myself for not checking sooner. I just never in a million years thought the differences could be this huge.  We could have been using that money toward this year's crazy medical stuff.  I have had to pull $6K out of savings this year just to pay medical bills.

I can't totally compare everything until we get the results back because I don't know that they ran all the same tests but here are some things I can compare.

General Health Panel Children's (2020)--$292.               LabCorp (2021) $24.83.  

T4 Free Children's (2020) $418                                       LabCorp (2021) $6.38.

Immunoassay nonantibody Children's (2020)  $164,      LabCorp (2021) $8.17

You might check Compunet as well. I am so sorry!

 

[Tap]

Have you asked the children’s hospital about it. Sometimes they discount costs for cash pay pt’s. The fees are higher because the insurance co would have negotiated the rates for you. They would paid a fraction of that.  Since you are essentially cash pay you have to shop around and get the best cash prices yourself. It sucks but it is the system we have.😢

[cintinative]

1 minute ago, Tap said:

Have you asked the children’s hospital about it. Sometimes they discount costs for cash pay pt’s. The fees are higher because the insurance co would have negotiated the rates for you. They would paid a fraction of that.  Since you are essentially cash pay you have to shop around and get the best cash prices yourself. It sucks but it is the system we have.😢

They do run the billing through insurance, even though we have to pay the full balance because of the HSA.  The rates I listed are from our Explanation of Benefits from the insurance company. Sigh.

[kbutton]

2 minutes ago, Tap said:

Have you asked the children’s hospital about it. Sometimes they discount costs for cash pay pt’s. The fees are higher because the insurance co would have negotiated the rates for you. They would paid a fraction of that.  Since you are essentially cash pay you have to shop around and get the best cash prices yourself. It sucks but it is the system we have.😢

I wonder if they make their money on labs.

DS has a yearly workup (echo, etc.), and some of the cost is almost always discounted. We have an HSA as well. 

I will note that some insurance plans get better rates than others, HSA or not. 

[cintinative]

3 minutes ago, pinball said:

I’m sorry. That is terrible.

Could it be considered price gouging? 

I don't know how to evaluate that. I did google and saw something about a study of various ER rates and how they varied so much by location, and even within the same city there were huge differences.  The article mentioned bringing it to the attention of the state representatives. In this case though, it is not emergency services. I guess they could say that we should have called around sooner to check rates?

[kbutton]

We have the best insurance we've had since the ACA went into place, and we have paid an astonishing amount this year. It's nuts. We fully fund our HSA, but we don't necessarily have it in there to spend yet when the bills come in since the deposits are spread out all year.

[cintinative]

3 minutes ago, kbutton said:

We have the best insurance we've had since the ACA went into place, and we have paid an astonishing amount this year. It's nuts. We fully fund our HSA, but we don't necessarily have it in there to spend yet when the bills come in since the deposits are spread out all year.

Yes, our individual deductible is more than the allowed HSA account amount and our family deductible is 11.5K. So it stinks big time. 

[kbutton]

Just now, cintinative said:

Yes, our individual deductible is more than the allowed HSA account amount and our family deductible is 11.5K. So it stinks big time. 

Pre-ACA, that wasn't allowed, IIRC. I might be wrong about that, or it could be that we didn't happen to see any plans that had deductibles higher than the contribution limit. We had our own HSA insurance for several years when they were still relatively new, and it was such a HUGE cost savings. Huge. 

That's just so, so wrong.

I get that the ACA added a lot of people to the healthcare pool, but there was no reason to gut the good parts of HSAs--if people are basically paying for their own healthcare, such as with HSAs, they should be favored, not made more complicated. It's unconscionable, to me, that people cannot fund their HSA with their deductible amount. And barring that, why did they jack up the percentage of healthcare costs you have to foot before you can itemize so that it's rarely possible for people to itemize on their taxes? For some people, that would be better than using the HSA. Sigh. 

My parents have really inexpensive insurance in retirement, and they had good benefits even after the ACA went into effect. When they complain about their co-pays, I just toss up my hands and start listing off what our meds cost per month. And then I remind them that I've only had the kind of healthcare expenses that they are used to for maybe 2-3 years out of the 22 I've been working FT or married.

[Soror]

Wow, that really stinks! 

When we had labs done at the children's hospital it was way cheaper than our local place (they are known for price gouging). 

In the future I'd ask for the lab order ahead of time and get it done locally. I've done that many times with different providers. I'd explain to them that I get better prices at LabCorp and have limited funds. 

[Tap]

Can you pay cash and then submit yourself to the HSA?

 

[cintinative]

5 minutes ago, Tap said:

Can you pay cash and then submit yourself to the HSA?

 

I think we will look into doing the future labs through LabCorp or possibly do the pay cash route as you mentioned.  My guess is that cash pay would still be way more than LabCorp.  

I am thinking I need to look elsewhere for the upcoming x-rays my son needs also.  

[City Mouse]

Wow, that is a big difference. 
I would guess that some increase (but not that much) would be expected since a children’s hospital is a specialty service. When I used to take my kids to a special pediatric dentist, cleanings and x-rays were more expensive than at my “regular” dentist, and the specialist was not covered by our dental insurance, so I had to pay it all. 

[klmama]

When you child needs hospitalization, children's hospitals are great.  For labs?  Meh.  The worse experience my dc ever had with a blood draw was from the supposed "experts" at the children's hospital lab.  Seriously, it was traumatizing for both of us, and we never went back.

[itsheresomewhere]

37 minutes ago, klmama said:

When you child needs hospitalization, children's hospitals are great.  For labs?  Meh.  The worse experience my dc ever had with a blood draw was from the supposed "experts" at the children's hospital lab.  Seriously, it was traumatizing for both of us, and we never went back.

I agree.  I am very unimpressed with the children’s hospital lab department when we had to go there.  We always use lab corps for planned labs and have much better service. 

[ScoutTN]

Sorry for the crazy high bills! 
 

Our children’s hospital (Vanderbilt) was outrageously high priced the three times we were there. 

 

 

[Murphy101]

Because it’s legal for them to jack prices around like that in the states. That’s literally the only reason.

[prairiewindmomma]

We have had the same experience. Generally labs in hospitals charge at outpatient rates. It’s totally worth it to call around and price. 

[Murphy101]

32 minutes ago, Ordinary Shoes said:

Since the OP has insurance and accesses a network, there isn't really a "price" in the sense that we usually think of prices. The allowed amount is the amount that was contractually agreed to by the hospital and the network or payor. (I'm assuming that the hospital is in network.) 

None of which changes that what I said is true. They do it because they are legally allowed to do it.  

[lovinmyboys]

My son had his tonsils removed at children’s and it was so expensive for everything. I was telling a dr friend about it and he said he would never take his kids to children’s unless they NEEDED children’s because of that. It is a great hospital but way more expensive than others in the area.

My pediatrician there was a big fan of children’s though. When my 3yr old broke his arm he wanted us to go there since he still had so much growing to do. They really are the “best” but as my friend put it you get Mercedes treatment and prices when most of the time a Ford would do.