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Understanding the Cost of Your Care

Things to keep in mind:

Your total healthcare costs might be different from these charts because of how much a service costs or how many resources you or a family member used. You may also find different costs for the same service if you compare different doctors, clinics, communities, or insurance companies.
Price is not the same as quality. The most expensive treatments do not always produce the best results. Ask your care provider about high-value care choices that might save you money while giving high-quality results.
More care is not always better care. Better, more efficient care may improve your health while reducing costs and helping you avoid unnecessary tests or visits.
The amount you pay for care is only a small amount of the total cost of your care — even if you add up your premiums, co-pays, co-insurance and deductibles. Understanding your total cost of care can help you do your part to make healthcare in MN better and less expensive.
The member services staff of your health insurance company can explain your coverage, possibly saving you time and money. Contact them before you schedule a visit or procedure. Ask if the provider is in your network, if the procedure is covered, and what out-of-pocket costs to expect. The contact information for member services (or customer service) is on your insurance card.

New developments in health care mean that you will need to take a more active, informed role. If you understand the cost of a service and how many resources you will use, you can make better choices about value. 

The MN HealthScores cost of care ratings organize information into different categories:

  • Average cost by procedure – Provides information about the average cost of 88 common procedures performed in Minnesota clinics. Use these ratings to find where you can get the highest value for the service you need.
  • Cost by health insurance plan – Includes links to  several major health insurance plans. This gives you more specific information about your health plan.

How much you pay (also called your out-of-pocket cost) depends on if you have health insurance, what your health insurance plan covers, and how much you have to pay before insurance will contribute. 

Another cost you may see is called a “facility fee.” A facility fee is a charge from a hospital when it does a procedure or service. A clinic that is located in a hospital or connected with a hospital network may also charge a facility fee. Even with insurance coverage, a facility fee can increase the amount you would have to pay out-of-pocket for a procedure or service.

Cost is one factor in choosing health care. Other considerations that might affect your health care decisions include:

  • The quality of care
  • Your experiences as a patient
  • Your relationships with providers (such as doctors or nurses)
  • The convenience of the care (such as location or hours)

How to use our information about the cost of care
We want to help you make better health care choices. Our information for 88 common services can help you shop for medical care and possibly lower the amount you need to pay out-of-pocket. MN HealthScores ratings can also help you decide if your current or future health care is a good value.

You can use the cost of care information on MN HealthScores to see what MN health insurance plans paid on average for specific services or procedures. Then you can check with your own plan to see what you might pay for the same service and compare it on MN HealthScores.

How we develop the cost information
We develop our cost information using information from employer-based health insurance plans in Minnesota. These charts show payments for physician services in offices – not hospitals. The charts use data on amounts paid in 2011-2012, so your current costs may be different from what you see here. The charts on cost of care do not include information from government programs, such as Medicare or MinnesotaCare.

Four major health plans provided cost of care information to MN HealthScores: Blue Cross and Blue Shield of Minnesota, HealthPartners, Medica, and Preferred One.

Where you can learn more about healthcare costs and quality