I Got the Bill

Note: This is the third entry in my experiment with price transparency in the US health care system. See the first entry here, the second entry here, the fourth entry here, and the fifth entry here.

doctor bill - Boulder Valley DermatologyI finally got the bill for the surgery (pdf). It was quite high compared to the estimate I received. I recorded the calls I made to each of the doctors offices when I was trying to find the cheapest one. Here you can listen to a person at the Boulder Valley Center for Dermatology (they gave the cheapest estimate) give me a quote of ~$110 (on average) for the initial doctors visit and “between $200 and $300 to remove the lipoma, but the doctor would be able to tell me better.” Well, when I asked the doctor and the doctors assistant how much it would be at each of my visits, all they could tell me is that “it depends” and “it’s hard to tell.”So, what was the damage? The initial visit was billed at $165. The surgery came to $1,639, ouch! I expected it to be a little higher than what I was quoted, maybe even $600, $700? But it was over 5x higher than the ballpark estimate I was given on the phone. “It’s hard to tell?” I guess so!

No wonder consumer directed health plans aren’t getting any traction. What was the point of calling around to get the best price? Was she just making it up off the top of her head? We have a long way to go before healthcare is an actual “free market” system. In order for this whole “free market” idea to take hold, I really think it would take government intervention like John Goodman, the “father of health savings accounts” used in his example. Hmm… free market requires government intervention? There’s no way in hell people are going to just voluntarily switch to high deductible health plans in this kind of environment.

Also, one common thread I noticed when calling around to the doctors offices to get estimates: they were surprised that I even cared about the price. “Don’t you have insurance?” I don’t think they get too many people price shopping for their healthcare quite yet.

Any ideas on how I can get my bill more in line with the original estimate? Even if I get a 50% discount like Michael Cannon, I’m still overpaying by about $500.

About Jay Norris

Jay operates a health insurance brokerage in Colorado, where he helps individuals and small groups obtain and maintain health insurance coverage.
Complimenting his work as a health insurance broker, Jay also provides data analysis and creates visualizations that are easily understood by consumers and other stakeholders in Colorado’s health insurance market.


  1. this whole situation is ridiculous. would you have gone through with the surgery if all the places you called gave you a quote of $1,800? after listening to the recording, I think this doctors office has a moral obligation to bring the invoice more in-line with the price you were given over the phone. good work thinking ahead and recording your calls.

  2. Tim Gerry says

    I had a lipoma of about the same size removed from my shoulder blade in November. Mine was covered by insurance, but the cost billed to them was $800. That was for everything, included the initial diagnosis visit, biopsy, and follow up visit. Yours is probably just so much more expensive because your insurance didn’t cover it. If you just ask them to give you the insurance rate you’ll probably only end up paying less than half.

  3. I’m in the wrong business if removing a lipoma nets you 1,800 bucks. An initial estimate of $200-$300? I heart our health care non-system!

  4. …Colorado Health Insurance Insider’s approach to taping conversations with office staff when shopping for surgical procedure prices… I wonder what my office staff would say to these questions? Would their answers have been different if they knew they were recorded?

    Empowerment of the health care consumer takes on new meaning, eh?

  5. Looks like they billed you for two complex repairs on the same day. A few thoughts:

    1) Most likely you should have only been billed for 1 complex repair.
    2) Your insurance company would have reduced the complex repair allowable by 50% due to same procedure / same day.
    3) The ins co would probably request the op notes since a complex repair usually shouldn’t be charged the same day / same site as a benign removal

  6. Maybe it’s hard for them to give reliable estimates over the phone, but this was waaaaaaay off! She might as well have just quoted you $5. Free market my a**!!!

  7. Even though you are paying out of pocket, aren’t you entitled to Humana’s negotiated rates?

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