I've asked a similar question before, but looking at the EOBs for my LO's last two well visits has me 
. For a basic well check (baby) plus immunizations, my insurance company was billed just over $1,000. I'm not responsible for it, so I'm not really complaining, but it just seems outrageously high. How much does your ped charge for well visits/immunizations?
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$0 out of pocket for well visits. No clue what's billed to insurance. Never looked.
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Wow - that's a lot!
DD just had a 6yr well visit - no shots and the bill before insurance was $156
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0$ for well visits, but I'm not sure about the immunizations
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Probably in the range of 600-800 I'd guess
It has been a really good exercise moving to a hdhp. I really like having a better grasp of what is being charged to the insurance and subsequently, to us. I think it's made me a more aware health care consumer. It forces me to ask more questions and advocate...i.e.. what is the test, why are you doing it, is it necessary etc etc.I know what the docs and facilities charge is out of control. But their hands are sort of tied by the insurance companies. If they actually charged what it "cost", their reimbursement would be paltry, especially in higher cost markets. I know that they charge some insurances more than others for the same code, because the reimbursements differ. They might charge Cigna $600 but oxford $800. Its crazy.
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It's over $1k. So crazy! I never pay a dime because well visits are covered, but I can't believe how much it costs!
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Well checks are covered so it's always 0$. Sick visits are $55 if we haven't met our deductible.
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@Mrs. Lemon-Lime: @Mamaof2: @arosebyany: @Littlebit7: @avivoca: Right, I don't pay anything for well visits but I'm an obsessive EOB stalker because it fills me with righteous anger over the broken system, ha. The worst is the lack of transparency--I've called so many local offices and no one will give you any pricing information. Like, why on earth is each shot $200 and then they charge another $200 "administrative" fee for giving each shot??? Come on.
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Sorry, now I see that I look like a crazed ranting person.
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@babypugs: you don't at all. This is a topic that causes rage eyes in most people once you really start to take a close look at how ridiculous our system is
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@Littlebit7: Yes, I really only started paying attention to the doctor/insurer/patient bizarre and symbiotic relationship a few years ago when I was pregnant with LO1. It's totally wild.
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@babypugs: I'm right there with you with the rage over all the separate, large charges.... I recently spent 7 hrs (sleeping) in the ER getting 2 bags of IV fluids and a dose of Zofran. There were 10-15 claim codes listed on my ER bill, with 5 of them being IV bag, IV bag, initial IV insertion/first hour, addition IV hour, additional IV hour. The total for just the IV stuff was $1500! And that's not including the charges for the actual ER care, zofran, bloodwork, etc.
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@babypugs: I'm obsessed with looking at EOBs too and seeing the spread differential between what doctors bill and what insurance pays. I just looked it up and my DD's ped charged $1336 for her 4 month well visit which included vaccinations. Administering each vaccine had a charge of $55! I know it's all done as sort of a game to maximize what they get paid by insurance. I just wish there was more transparency in the medical industry so there was just a set market price for services! The EOBs for my DDs NICU bills were completely mind boggling. I couldn't imagine what one would do if they didn't have insurance and faced those.
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Same I also like looking at the EOB's and seeing the real cost they charge / insurance pays, because we had tons of troubles with our insurance when DS was a baby and they wanted us to keep paying stuff we shouldn't have been paying for. Ever since then I pay much closer attention! I just checked for his 2 year well visit and they charged $436, insurance paid $242 and the rest was a "discount" so we paid nothing.
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I looked up my son's last well visit bc I've never looked at the EOB before and I was curious. For his 2-year well visit (which included a flu shot, lead screening test, and subsequent labwork), it looks like they charged $258 total. We have a $20 co-pay.
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I just checked and the visit with the doctor was $122 for our last checkup (nine months). The lab work testing for lead and iron (which is done in the office) was another $80.
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Just looked at my EOB for the 4 month visit, the total billed was $1,495. Insurance paid $645 and I have to pay $19.
$1,200 of the total bill was just for vaccines! I also had to fill out a mental health risk assessment for me and it was billed at $50! The discount is $31 and I owe $19 since it technically isn't covered under the well visit.
For my 5 year old insurance was billed $390 and they paid $213.
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No idea! Well baby visits are covered 100% for us, so we don't even get EOB's for them in the mail.
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There's no co-pay for me, but my insurance is being charged between $350 and $400 for these visits.
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So I'm fairly certain its the same in all areas...but I'm a mental health therapist and so I bill insurance companies all the time. It doesn't matter what I charge, they have a "negotiated rate" as part of the contract I enter into with them, and so I can charge whatever I want- it won't change what they pay. And certain companies cover somethings (like 60 minute sessions, which is my preference), while others won't do that without a lot of extra paperwork/referral from an MD and will only cover 45 minute sessions. If I do an assessment and bill it as such, some companies pay more while others pay less.
Its stupid and very frustrating.
My husband is a pediatrician and what can be frustrating for primary care doctors is that a "consult"- so answering your questions/chatting is one bill code regardless of whether they talk to you for two minutes or if they are with you for an hour. Our medical system reimburses based on procedures- which is why doctors who do a lot of short "procedures" make way more money than primary care doctors.
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