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Wide Open Access to Healthcare Prices

      Ever tried to get a firm price tag before going to the doctor or the hospital?  Good luck.  Historically, the search for healthcare prices has been an exercise in futility.
Lisa Zamosky, Los Angeles Times
      Sometimes the cash price is lower than the insurance negotiated discount.
Devon Herrick,
Senior Fellow, National Center for Policy Analysis
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A medical code identifies a specific healthcare service.

Codes (sometimes labeled as a CPT or HCPCS code) will usually appear on:

  • a medical facility's itemized bill (though not typically on a summary statement)
  • an insurance company's Explanation of Benefits (EOB) statement

If you don't find medical codes on your statement, you may request a new statement that includes them. Healthcare institutions are legally required to provide this to you.

Find medical codes on your statements:
  1. Find the itemized listing of services on your statement (some facilities send itemized statements and summary statements separately).
  2. The medical code is often labeled as a CPT, HCPCS, or just "Code".
  3. The code is typically 5 digits. If no label is present, search for the code in the descriptive text or in a column for the same line item.
  4. Ignore service charge numbers, which may also appear for each item. Charge numbers are typically longer and often have a dash. These are usually different for each facility and can't be used reliably to compare medical service prices.