A few years ago my wife felt a pain in her shoulder/bicep while moving the Christmas Tree. At the time, we didn’t think much of it. However, the pain didn’t improve and months later she saw a specialist. The suspicion was a torn biceps tendon but to determine for sure would require an MRI (with dye I believe).
The group plan we were on at that time (actually COBRA) was a high deductible plan but the company funded an FSA, Flexible Spending Account, for the first $2000. Due to our daughter slipping on the ice and severely spraining her ankle, these fund had been depleted. So we found ourselves in a donut hole. We had about $900 until the insurance kicked in at 100%. We determined that an MRI at Boulder Community was approximately $1400. A different facility in Denver could do the requested procedure for about $900.
So my wife and I contemplated our two options. Either way, we were out $900, but one way would require at least a couple hour total drive time and the other solution was just a typical trip into Boulder. Obviously we selected Boulder Community. However, if it was all coming out of our pocket, yessirree, we would have driven down to Denver.
In this instance, we were able to do price discovery and made a conscious decision. From out pocketbook the decision made perfect sense. From a big picture point of view, did it make sense? In this case, it was easier to spend someone else’s money for our convenience. Somehow, I suspect if more people were willing to select a different facility, the difference in pricing for the MRI between the two facilities wouldn’t have been $500.
The diagnosis, sure enough a torn biceps tendon due to a bone spur on her rotator cuff. A relatively short surgery at the cost of about $12,000 repaired the issue. No, we didn’t price shop the surgery, we liked our specialist who had advised her since we had started the search for the problem. It’s different price shopping for a relatively well documented procedure such as an MRI, vs. surgery.
