The Upside Down Hospital

Description Associated Codes Gross Charge Payer Allowed Amount Cash Discount Price Deidentified Min Allowed DeIdentified Max Allowed 
Description Associated Codes Gross Charge Payer Allowed Amount Cash Discount Price Deidentified Min Allowed DeIdentified Max Allowed 
Bypass Graft Of Blocked Heart Artery231-236$122,450.30$47,573.58$85,715.21$21,431.63$62,562.13
Bypass Graft Of Blocked Heart Artery231-236$122,450.30$32,572.65$85,715.21$21,431.63$62,562.13

You would think a hospital would give a better price for cash than they would for insurance companies. No claims to file, no chasing patient share, immediate cash payment, no precertification bullshit, no concurrent care review protocols to mess with, no prolonged verification of benefits phone calls, etc.

Not so for this hospital.

The illustration above shows two commercial payers. One gets a better deal than the other. Both get discounts between 60-75%. Self-pay patients get a 30% discount off billed charges.

In this example a cash pay patient pays more than $30,000 for the same procedure. So we checked the cash price at another hospital for the same procedure. It beat the Upside Down Hospital in spades.