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Using the Healthcare Bluebook to Find a Fair Price

Why should you be an informed healthcare consumer?

It is a simple fact -- healthcare is expensive. But did you know that the cost for the same healthcare service can vary by 200%-500% depending on where you receive care?

Even if you have health insurance, you are most likely paying more “out- of- pocket” or have higher co-payments, deductibles and co-insurance. If you do not have health insurance, you have probably experienced sticker shock after receiving a bill from your provider.

It is critical that we understand what we will be responsible for paying BEFORE we receive care. Unfortunately for consumers, it is very difficult to find and compare prices on healthcare services. [Top]

How much should I expect to pay for my healthcare service?

Regardless of whether you have health insurance or are uninsured, you should pay a Fair Price for healthcare services.

The Healthcare Bluebook will help you identify the Fair Price for most services where you have the time to become educated and make knowledgeable choices (i.e. non-emergency types of services or services that are not for complex care such as cancer treatments or transplants. [Top]

How much should I pay for my service?

Regardless of whether you have health insurance or are uninsured, you should pay a Fair Price for healthcare services.

Uninsured patients should never have to pay the full billed amount for healthcare services. The good news is that if you are uninsured and are paying cash for your healthcare services, many providers will accept a price that is lower than the standard billed amount. But, in order to receive the lower price you have to ask your provider for the discount.

The Healthcare Bluebook will help you identify the Fair Price for services. [Top]

How do I use the Healthcare Bluebook to find a Fair Price?

Once you are aware of your required treatment, there are two ways to find a Fair Price for healthcare services:

  1. Type the medical terms related to your service or treatment into the search box and then click on the "Search Prices" button. You don’t need to know the full treatment name. For example, if you type “Hip” for a hip surgery, you will see several choices related to hip treatment. Click your desired treatment and the Bluebook gives you a recommended Fair Price for the service.
  2. You can also select services from the care categories listed at the top of the page. If you know that you need a laboratory test for your diabetes condition, select the Labs tab, scroll down and click Diabetes. The Healthcare Bluebook will give you a list of all major lab tests related to Diabetes. Click your test and the Bluebook will present a recommended Fair Price for the service.

For pricing in your local area enter your zip code into the box provided.

What is the Healthcare Bluebook Fair Price, and how is it determined

The Healthcare Bluebook Fair Price is the reasonable price you should pay for a service.

The Fair Price is calculated from a nationwide database of medical payment data, sorted by your geographic area (zip code). [Top]

Why do some prices* have several components?

Many surgical procedures, such as a hip replacement or knee surgery, have multiple components. The components represent the three major cost categories for most surgical procedures:

Physician Services: The Fair Price for the services of the physician performing the procedure
Hospital Services: The Fair Price for the hospital services, including overnight stay, nursing, supplies and most medications
Anesthesia Services: The Fair Price for the services of the anesthesiologist

*The Fair Price assumes a standard procedure without complications

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