Thursday, July 23, 2009

How Much Does It Cost?

What does your health care cost? Your office copay may be $15 or $20, but that’s just a sliver of what it actually costs to provide the care. Here’s a sample of common medical treatments and the average charge from hospitals or clinics. These are the charges prior to any discounts negotiated by a health plan or insurer and are calculated using 2003 charges.

Medical Treatment



A common cold, office visit

You feel rotten, go to the doctor and are told to go home, get plenty of rest and drink fluids.


A common cold, ER visit

You feel rotten, and instead of going to your clinic during the day, you wait until midnight and go to the ER.


Sore throat, office visit

Your throat hurts, you go to the doctor. Price includes visit with physician and Strep test. Test was negative.


Sore throat, ER visit

It’s the middle of the night and your throat really hurts. You decide to go the emergency room. Includes ER charges and test for Strep. The test was negative.


Ear ache, office visit

Your 2-year-old daughter is pulling on her ear. You go to the clinic. Office visit and exam. No infection is diagnosed.


Ear ache, Urgent Care visit

Your 2-year-old daughter is pulling on her ear. You go to Urgent Care. Visit and exam. No infection is diagnosed.


Ear ache, ER visit

Your 2-year-old daughter is pulling on her ear. You go to the emergency room. ER visit and exam. No infection is diagnosed.


Tubes in ears

Your child has had chronic ear infections. The decision is made to insert tubes his ears. Price includes office visit 30 days before procedure and 30 days after, day surgery charges, antibiotics, drops and decongestants.


Diabetes check-up

You have been diabetic for six years and your diabetes treatment has been going well. This is your annual trip to the clinic to see the doctor for a diabetes checkup, including cholesterol and blood sugars (HbA1c) checks.


Chest X-ray

You go to the clinic with a bad cough. Your physician thinks it may be pneumonia and orders a set of X-rays to help make the diagnosis. Price includes clinic visit, X-ray and reading of the results.


Diagnosis and treatment of Gonorrhea

The prevalence of sexually transmitted diseases is a public health concern. This price includes an office visit, test and treatment of Gonorrhea with an antibiotic injection or oral antibiotic.


Allergy shots

You have been diagnosed with allergies and go to the clinic each week for a shot. The visit does not include seeing a doctor.



Full, flexible colon scope test conducted by specialist on an outpatient basis. Includes test and reading of the results.


GI Endoscopy

Conducted by a specialist. Scope exam of the gastro-intestinal track on an outpatient basis. Includes conducting the test and reading the results.


Skin cancer diagnosis

A black, purple odd shaped mark on your arm requires a consultation with a specialist, biopsy and removal of skin lesion.


Stress test

Your primary care doctor orders a stress test. This price includes a trip to the specialist, administering test, reading results.


Eye exam

Exam by ophthalmologist.


Allergic reaction to a bee sting

Price includes the ER visit and diagnosis, in addition to drugs to treat allergic reaction. Treatment could also include a hospital stay for a severe reaction.


Broken ankle

You broke your ankle playing soccer. Includes trip to the ER, X-ray of ankle and applying short leg cast.


Step on a rusty nail

You step on a nail while taking a walk. Price includes laceration on foot, ER fee, repair, tetanus shot or antibiotics if needed.


Broken arm

Your child jumped off the swing set. Price includes ER visit, X-ray, simple cast.



Your child (under 12) needs her tonsils removed. This price includes a pre-surgical office visit, surgery at a one-day surgery and any related post surgical visits with in 30 days.


Frostbite treatment for a hand

Your child loses her mitten on one of the coldest days of the year. You make an urgent care office or ER visit. The price includes diagnosis and treatment and excludes critical cases.


Diagnose mono

Your teenager is run down, extremely tired. A trip to the clinic and Heterophile antibodies test shows mono.


Therapy session

You see a licensed therapist. Does not include prescriptions drugs or psychiatrist evaluation.


Outpatient chemical dependency treatment

You attend 21 to 30 days of alcohol- or drug-related chemical dependency counseling through a hospital’s outpatient program.


Cut on the hand

You’re using that new knife and you slice into the tendon in your hand. Price includes an ER visit, complicated stitches, tetanus shot if needed.


PAP test

Woman of childbearing age, includes exam by gynecologist, test and reading of results.


Routine mammogram

Women 35 and older, includes the test and reading of results.


Prostate cancer screening test (PSA)

Includes office visit for man age 50 or older, blood draw and PSA test.


Having a baby

Price is based on “perfect” pregnancy, including routine prenatal costs, no risk factors to mother, uncomplicated vaginal birth.



Simple hysterectomy, not caused by trauma, cancer, etc. Includes physician charges, hospital surgical and room and board charges and follow-up visit.


General physical, charges vary by age:

Exam of a person in good health. Simply a physical, not a problem-focused clinic visit.

Well-baby check


Age 5 to16


Age 18 to 39


Age 40 to 64


Age 65 and older


Prescription Drugs

2005 Average Wholesale Price. Prices show difference between a prescription drug co-pay of $25, for example, and the retail price of the drugs received. Prices are based on common dosages for co-pay arrangements.





84, 1/35 tablet birth control pill, (standard three-month prescription with one co-pay).



30, 20 mg capsules, used to treat depression.


Generic for Prozac – fluoxetine

30, 20 mg capsules



30, 10 mg tablets used to treat allergies.



30, 20 mg tablets used to treat high cholesterol



60, 20 mg tablets. Used to treat ADD/ADHD.


Generic for Adderall, D-amphetamine

60, 20 mg. tablets.



100, 10 mg tablets used to treat ADD/ADHD.


Generic for Ritalin, Methylphendidate

100, 10 mg. tablets.



60, 18 mg tablets used to treat ADD/ADHD.


Source: Minnesota Council of Health Plans, 2005.

This document reflects Minnesota health plan commercial and government programs data, analyzed by Data Intelligence, LLC.

For information, contact: Eileen Smith

In a democracy, silence is not golden; it is condonance in the face of injustices; it is fear, where the thought of reprisal fosters control. – Rodney A. Davis

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