How would you shop for a shoulder MRI?

shoulder-MRI Now that Robbie and I have switched our Blue Cross Blue Shield health insurance policy to a High Deductible Health Plan (HDHP) & Health Savings Accounts (HSA) called Options Blue, it’s in my interest to start thinking like an informed consumer.

I hurt my shoulder (landed on it while snowboarding a few months ago) and all the usual remedies have not worked. Next step, sayeth Dr. Bob Shepley, is a shoulder MRI.

It seems to me that a shoulder MRI is a commodity, like getting a throat culture. Price and convenience are primary factors.

I started shopping earlier this week, but rather than describing what I’ve been learning ahead of time, I thought I’d post it for discussion first.

As a Northfielder, how would you shop for a MRI?

27 comments to How would you shop for a shoulder MRI?

  • 1
    Anthony Pierre says:

    We have talked about this before. The hospitals can charge whatever they want, because the insurance will pay anything.

    There needs to be some reform

  • 2
    Anthony Pierre says:

    Oh ya, I would shop for an mri by talking to John Goth, cause he has the MRI hook ups.

  • 3

    Have you checked out carol.com?

  • 4
    John Thomas says:

    Have you thought about Off-shore? One of those medical vacations? 8-)

  • 5
    Griff Wigley says:

    I first called the Northfield Hospital. The woman I talked to said a shoulder MRI was $1963, and that there was a radiologist fee on top of that but she didn’t know how much.

    I then called a place in the cities called Stand-up MRI. Their fee for a shoulder MRI was $1632, plus $408 for radiologist.

    At that point, I was still inclined to use the Northfield Hospital as it was only $300 more (assuming their radiologist fee was similar). I was willing to pay more for convenience, plus I like to ‘buy local.’

    I then called Rich Falck, local financial advisor and BCBS insurance broker who’d helped us change over to the Options Blue plan. He suggested I look at the new web site (mentioned by Penny above) called Carol, “the Care Marketplace.”

    Carol.com listed 3 different providers for a shoulder MRI, with estimated fees ranging from $875 to $1000. I say ‘estimated’ because you’re prompted to enter your insurance info before they can give you an exact quote/place the order. “This diagnostic imaging test requires a written order from a referring physician. In addition, this test may require us to go through a pre-notification process with your insurance company.”

    Instead of placing an order with Carol.com, I decided to phone one of the providers, CDI. They said their fee for a shoulder MRI was $840 and that INCLUDED the radiologist fee.

    Wow. $800 vs. $2400. Big difference (assuming that low price would hold up and the Northfield Hospital price couldn’t be lowered) when paying for it oneself.

    I then told Robbie what I was doing and she reminded me of her unpleasant experience with CDI’s Burnsville location. They lost her brain MRI and after two months of hassle, she had to have another one done. And they evidently weren’t apologetic. She suggested I call CRL Imaging in Edina where she’s gone lately for her MRIs. I called and they were about $100 more CDI.

    I then called Scott Richardson at Northfield Hospital to ask him who I should talk to there about the fee. He suggested I call Roger Stapek, chief financial officer.

    Stay tuned.

  • 6
    Christine Bernier says:

    Griff -- You can go to http://www.mainstreetmedica.com and find your procedure and it lists the Minnesota care providers by price of the procedure. It’s a great website. It appears as though the MRI you would need could be as low as $700.

    Check it out & take care!

  • 7
    Griff Wigley says:

    Thx, Christine. Interesting that the low cost grouping on the page comparing costs for a knee MRI includes some hospitals.

  • 8
    Christine Bernier says:

    That is interesting, Griff. Even though the costs on the mainstreetmedica.com site are based on those covered under Medica’s Choice network, it’s still a useful to find the different care providers available near us and gives a glimpse at what costs you may be facing. Good luck!

  • 9
    Griff Wigley says:

    A reader alerted me that the Northfield Allina Clinic provides MRIs. I called and they said it was $1500, including the radiologist fee.

  • 10

    accupuncture anyone? I did the MRI thing last year and I didn’t want to do it, cuz I had heard bad things about it causing cancer, and then, I said, well
    I am not that young anyway, so what the heck. Then, when I got home I heard on network news that MRIs cause cancer in children,who had gotten a full body scan, 20 years after they got the MRI. That was not good to hear after all.

    For years I kept saying I wouldn’t get an MRI cuz IRme, and didn’t want my atoms scrambled, but alas there are things you can’t see any other way.

    But for me, they were checking for cancer, and none was found.

    Accupuncture, or even accupressure is a good alternative if it’s all about a tissue injury and not something more more.

  • 11
    Dawn Lunde says:

    I’d suggest you consider using MedCare Compare.com as a resource to determine health care costs. Consumer members can search for common services as well as request estimates from a multitude of health care providers simultaneously. The cost information on MedCare Compare is insurance network specific.

    MedCare Compare.com is new, so not all health care providers have yet joined (they pay nothing to post their information, so there should be no barrier). However, there is a mechanism that allows consumers to request their provider join.

  • 12
    kiffi summa says:

    Where did your Dr., Dr Shepley ,direct you? I have never had an MRI recommended without also having the Dr set it up, to facilitate with ease all the referrals that may need to see it.
    Medicare paid a lower percentage of the MRI fee than they do on some other procedures. If it’s the most efficient diagnostic tool , then I don’t see why they should pay a lesser percentage; might pave the way to quicker more efficient (less costs) correction.
    I agree with Bright; use acupuncture whenever possible … way less invasive, way less $$, way more History !

  • 13
    Griff Wigley says:

    Kiffi,

    Shepley’s office automatically set me up to have the MRI done at the Northfield Hospital… understandable, since his Orthopedic clinic is owned by the Hospital.

    All MRI providers require a doctor’s order before it can be performed.

  • 14
    kiffi summa says:

    I am curious if other venues for having the MRI were offered to you?
    Do you think they should have been?

  • 15
    Anne Bretts says:

    You should always get a list of all providers — and in a perfect world, their rates — when you get a referral. Of course, if your insurance provider requires you stay within a network for care, it eliminates choice. Certainly when your clinic is owned by the company that offers the MRI, you should have that information disclosed to you immediately. The range of rates you found is dramatic, but not surprising when most people don’t ask because they don’t think they have a choice — or because their insurance is paying and they don’t care. Good for your for sharing your experience. Maybe you can set up a permanent resource page with permanent links to the best sites for checking prices.

  • 16
    Griff Wigley says:

    Kiffi, no, no other suggestions were made re: other MRI providers. And I don’t think they should have unless I asked. It’s not unlike a car repair shop that discovers I need a brake job after replacing my tires. They’re not required to tell me that the shop down the street is cheaper. It’s my job as a consumer to shop around if I’m not sure I’m getting a fair price.

  • 17
    Griff Wigley says:

    I spoke by phone last week with Roger Stapek, CFO at the Northfield Hospital. He said the Hospital’s contract with Blue Cross pays them $1562 for a shoulder MRI. So since I’m on a high deductible plan, BCBS would likely charge me that amount instead of the $1963 that the Hospital would normally charge. If I was completely uninsured, the fee would reduced an additional 31% to about $1350. He didn’t know what the radiologist fee would be since they don’t control that.

    He said he thought they were competitively priced with other area hospitals for this but that it was hard to know for sure since BCBS doesn’t publicize their contracts, making it difficult to compare.

    So I decided to get the MRI done at the same place my wife Robbie gets her brain MRI done every year: CRL Imaging in Edina. With a 24 hr turnaround, I was able to get Dr. Shepley’s diagnosis on Friday. My rotator cuff has a 1 cm tear. Surgery scheduled for late next week… at the Northfield Hospital, of course!

    Because I’m still so young, I should be ripping up the racquetball courts and leaping tall boulders with a single bound on my motorcycle by Sept 1 if not sooner. Pray for me. ;-)

  • 18
    John Thomas says:

    Great… a heavily medicated, semi-immobile Griff blogging… This should be interesting.

    I highly recommend the electric scooter rental for getting around downtown. 8-)

    You are going to be really surprised how inaccessible a lot of places downtown are, as well as the need for wide sidewalk access for the dining ordinance…

    God Speed Griff. I hope all goes well for you, and I wish you a speedy recovery.

  • 19
    Barb Kuhlman says:

    A very useful discussion, Griff. I had a knee MRI last fall and it never occurred to me to “shop around.” I did have insurance, and as Nfld hospital was a “participating” BCBS provider, I got a substantial reduction on the fee. Just because I have insurance doesn’t mean I “don’t care” what it costs--I still had to pay 20%, of that and all the other costs related to my knee surgery. Contrary to comment #1, insurance companies will not “pay anything.” They are often quite particular about what they will pay.

  • 20

    The people that bill me tell me that they negotiate the charges with the insurance companies every time. That means we pay for the negotiation process as well.

  • 21
    Paul Fried says:

    I had a rotator cuff injury a few years ago, which was not serious enough for surgery, but which restricted movement. I had physical therapy, but it was expensive (always using up my BCBS deductable). This later led to frozen shoulder. I had an expensive shoulder MRI, and they explained that for another few grand, they could put me out while a doctor manupulated (forced) my arm to move where it otherwise didn’t want to go. Crack it, basically.

    Meanwhile, more physical therapy and stretching.

    I eventually opted to hang from a chin-up bar 2-3 times a day to regain mobility in the shoulder. It was painful at first, but less painful than paying to have someone put me out, and another to straighten my shoulder.

    I wish I’d tried that from the start instead of paying for the MRI, which told me a lot I didn’t need to know about the shoulder, much of which simply confirmed what the doctors and physical therapist already knew.

  • 22
    Griff Wigley says:

    I’ll be a patient at the Northfield Hospital early tomorrow morning. After a snip here and a stitch there, I’ll be home later in the day and hopefully back online after the cobwebs clear. I’m not sure what they’ll let me do with a camera but not to worry, no hospital gown photos will be forthcoming.

  • 23

    Hoping for every success and a speedy recovery!

  • 24
    Griff Wigley says:

    thx Bright. I’m back home. All’s good, but one-handed typing and lots of napping will slow me down till tomorrow at least.

  • 25

    I have to say the neighborhood was a lot quieter this morning…I guess it was all that two handed typing. :))

  • 26
    Patrick Enders says:

    Griff,
    I know this suggestion is nearly two years late, but did you consider bartering with the Northfield Hospital as a way to save money on your MRI?

    Republican Senate candidate Sue Lowden -- running against (and currently polling ahead of) Sen. Majority Leader Harry Reid in Nevada -- has the following alternative plan to reform our health care system: “bring a chicken to your doctor.”

    http://www.youtube.com/watch?v=qZezfjWox5s

    I don’t know about you, but I’m feeling a little bit peckish.

  • 27
    Griff Wigley says:

    I had not considered bartering, Patrick, but I like the idea. Let’s see, what do I have to offer the hospital that they might be interested in?

    I know! Consulting advice on how to increase cigarette revenue from the Gift Shop:
    http://locallygrownnorthfield.org/post/278/

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