Cost of MRI - HDHP before deductible

[jeromedawg]

Hey all

I just went in for an appointment for a MRI and didnt realize they collect before the scan. The woman told me it would cost $478.xx or somewhere around there as I'm on an HDHP and haven't hit the deductible. Definitely got sticker shock so decided to opt out and process/research this a little more.

Are there lower cost alternatives out there? At this point I'm not sure I care to try hitting our deductible. This is for pain in my left wrist which my doctor thinks might be tendonitis. He was mentioning potentially a ganglion cyst but seemed doubtful about that and was suggesting an MRI just to see what might be going on. I had an two MRIs (one without contrast and then one with) done several years ago for my left finger (osteoarthritis) and nothing substantial was found. So this also adds to my hesitation of going through this. It didnt hurt as much (financially) back them because I'm pretty sure we hit our deductible from our daughter being born that year.

[Ramparts]

I'm also on an HDHP and had an MRI last year (also in SoCal). Unfortunately I can't answer your questions on lower cost alternatives and whether or not it would be worth it, but here's what mine cost for reference:

Billed by provider: $1,397.00
Plan discount: $1,029.82
Allowed by plan: $367.18
Plan paid: $293.74
What you pay: $73.44

(We had hit our deductible earlier in the year, so I had a 20% copay). So your cost seems a little higher based on the "Allowed by plan" line. Hope that helps, and good luck with your wrist!

[affordablehousing]

It's probably fine to jsut let your wrist be and wait til you get a new job or better insurance. You could try asking the doctor if it's really worth $500, or he'd only suggest it if it's free.

[Abe]

I can’t give specific advice as a doctor but in general:

Try a wrist splint at night (and during day if possible) for a few weeks and see if it helps.

If you fell on it or something, an x-ray is useful for seeing if you have a fracture. If it’s a chronic problem, even that isn’t needed usually.

For chronic wrist pain, people rarely require any treatment other than rest/splint. Only after trying a splint for a few weeks should anything else be considered.

 If your job involves a lot of computer work, consider an ergonomic keyboard and mouse (mine doesn’t, but even that helped for the 1-2 hours a day I use the computer). That can prevent future injury if your pain is specifically caused by typing/using a mouse, and may help with your current one.

An MRI isn’t that useful, and I would only get it if an orthopedic surgeon suggested to get one for surgery planning. However I’m not your doctor so probably should listen to their advice, and maybe discuss the above suggestions with them too

[jeromedawg]

Thanks all. It has been bothering me for over a year now - what's confusing is that the Dr and PA have told me not to wear a splint but the OT has told me to wear one...! When I would wear one, my wrist would be stiff - the Dr and PA didn't like this so were saying not to do that. The OT just told me I should and it's normal for it to be stiff and that I should just use heat to loosen it up.

I did have an X-ray done and nothing was determined from this, which is what led to the MRI as the next step. The Dr mentioned an ultrasound but said an MRI would probably be more useful. He also was talking about a cortisone shot but seemed apprehensive suggesting it then mentioned that a risk (which happened with one of his patients) is that you could potentially rupture the FCR(?) tendon during the injection.

I probably should look for an ergonomic keyboard for sure. The pain isn't necessarily associated with that but it could very well be a factor.

Forgot to mention something funny but as soon as the admin told me what the cost would be, my wrist immediately started feeling 100% better LOL - ironically, my wrist actually feels a lot better right now. So not exactly sure what's going on. I have been using the hand thearpy putty/hand squeeze tool kit as well as a Powerball (not aggressively and for no longer than a minute or two at a time) over the course of the week. So it could be that the wrist being used and strengthened in that way is helping with recovery in some way? Another thing to note is that, upon the Dr first thinking it was STT arthritis, I started taking a glucosamine/chondroitin/MSM supplement - I stopped doing this however a couple weeks back because I noticed my wrist actually felt worse throughout AND the costochondritis in my chest area was flaring up. After I stopped the supplement the costochondritis (and even the wrist pain to some extent) subsided.

[IOPsycho]

For most insurance (BCBS, United, Aetna) you should be able to log onto the website and get cost estimates for MRI or other imaging in your area. I'd say $400-$600 is not out of line for an MRI. Always try to go with a freestanding clinic rather than a hospital system (more overhead = higher cost).

Also most of the time they want you to "pay up front" its a ploy - they will even offer up to 10% discounts if you pay now. It typically not a good idea because despite what they say it hasn't gone through your insurance and they air on the side of over charging. It can be very difficult to get your money back - its typically better to wait on the EOB even with an HDHP.

[jeromedawg]

For most insurance (BCBS, United, Aetna) you should be able to log onto the website and get cost estimates for MRI or other imaging in your area. I'd say $400-$600 is not out of line for an MRI. Always try to go with a freestanding clinic rather than a hospital system (more overhead = higher cost).

Also most of the time they want you to "pay up front" its a ploy - they will even offer up to 10% discounts if you pay now. It typically not a good idea because despite what they say it hasn't gone through your insurance and they air on the side of over charging. It can be very difficult to get your money back - its typically better to wait on the EOB even with an HDHP.

Thanks - I'll have to double-check on it. I think since it's HDHP, we do expect to pay out of pocket the higher prices - it has just been a while since I've had to do this much. The clinic I went to is part of a network but I don't think it's officially part of a hospital. That said, I believe they have freestanding clinics as well as 'rented' space from hospitals or auxiliary buildings around certain hospitals. They made no mention of the 10% discount when I went but I never got a good vibe at that particular location - last time I went (for an Xray) people were crowded and there was a long line. It was going to be a 2+ hour wait to do an Xray! So I just left and ended up getting it done at the doctor's office - I'm not sure why they didn't just offer to do this when I got a referral for an Xray - maybe they felt like they don't have the resources but it was a short 5 minute process and they got the result immediately. In any case, when I went back to the imaging clinic (this time at night), there were still people waiting and while I was having the clerk input my info, another patient in the waiting area came up and asked when she would be seen - she said her appointment was at 7:50pm and it was already 8:15pm and wanted to know when she would have her scan done... not sure if this was an Xray or MRI but if the latter I probably would have been there for at least another hour or more WITH an appointment! I'm not sure if this location is understaffed or what but their process and scheduling seems really messed up. I'm going to avoid going to these locations (or at least this particular location) in the future given these past two experiences. All that to say, I am very much used to being billed for the service(s) after the fact. With the exception of the OT, which I somewhat understand.

[RetirementDreaming]

I don't know of any alternatives. But the price seems to be spot on. My daughter had one within the last month and it was $500.

[Abe]

I’d recommend a rheumatologist referral (unless the doctor you mention is one).

[jeromedawg]

I’d recommend a rheumatologist referral (unless the doctor you mention is one).

The orthopedic doctor mentioned a rheumatologist. I actually saw two different rheumatologists back in 2017-2018 to look at my finger and they couldn't figure out what was wrong and concluded it's either osteoarthritis or pre-psoriatic arthritis (I've seen a dermatologist and a couple of PCPs who I've asked about this and they have all said I don't seem to have psoriasis...I do have some patches of eczema though). Anyway, I went through a battery of blood tests ordered by the rheumatologists and they came back negative on the rheumatoid factors. One actually had me checked for hemochromatosis (which was negative). So not sure if a different rheumatologist is going to find anything particularly significant in this case.

[Abe]

I’d recommend a rheumatologist referral (unless the doctor you mention is one).

The orthopedic doctor mentioned a rheumatologist. I actually saw two different rheumatologists back in 2017-2018 to look at my finger and they couldn't figure out what was wrong and concluded it's either osteoarthritis or pre-psoriatic arthritis (I've seen a dermatologist and a couple of PCPs who I've asked about this and they have all said I don't seem to have psoriasis...I do have some patches of eczema though). Anyway, I went through a battery of blood tests ordered by the rheumatologists and they came back negative on the rheumatoid factors. One actually had me checked for hemochromatosis (which was negative). So not sure if a different rheumatologist is going to find anything particularly significant in this case.

Ah you’re in my boat! Yeah unlikely anything will figure it out. Unless the pain is very specifically reproducible with pressure at certain spots, mri won’t be helpful in that it won’t lead to any new therapy to help you. Even if something was found, there’s unlikely anything to do about it other than ibuprofen and rest. Repetitive stress injuries are by far the most common cause in younger adults. Based on my experience, I’d try the splint again and see if it helps with the pain. Unless you fully immobilized it for days on end, the joints will be fine.

[jeromedawg]

I’d recommend a rheumatologist referral (unless the doctor you mention is one).

The orthopedic doctor mentioned a rheumatologist. I actually saw two different rheumatologists back in 2017-2018 to look at my finger and they couldn't figure out what was wrong and concluded it's either osteoarthritis or pre-psoriatic arthritis (I've seen a dermatologist and a couple of PCPs who I've asked about this and they have all said I don't seem to have psoriasis...I do have some patches of eczema though). Anyway, I went through a battery of blood tests ordered by the rheumatologists and they came back negative on the rheumatoid factors. One actually had me checked for hemochromatosis (which was negative). So not sure if a different rheumatologist is going to find anything particularly significant in this case.

Ah you’re in my boat! Yeah unlikely anything will figure it out. Unless the pain is very specifically reproducible with pressure at certain spots, mri won’t be helpful in that it won’t lead to any new therapy to help you. Even if something was found, there’s unlikely anything to do about it other than ibuprofen and rest. Repetitive stress injuries are by far the most common cause in younger adults. Based on my experience, I’d try the splint again and see if it helps with the pain. Unless you fully immobilized it for days on end, the joints will be fine.

The other issue besides pain is that my FCR tendon area is swollen :( I'm trying to do light exercises but nothing that causes pain. I'll try wearing the spica again