I have no insurance and pay out of pocket. It is near impossible to get the medical community to provide costs prior to treatment. Recently had a chest X-Ray and noted pulmonary nodules. Went to Pulmonologist and he had to repeat the very same X-ray. Would not say why the one from two days earlier was not good enough. Then recommended a CT scan of chest. The urologist had recommended a bone scan because of high PSA this in spite of no symptoms. After the scan the Pulmonologist wanted to do a bronchoscopy with biopsy. This is where the story really gets interesting and, I think, is why we pay so darn much.
Pulmonologist fee: $460
Anesthesiologist fee: $2000 (for two hour max) $250/15 minutes thereafter.
Facility charge: $5000 to $16000. No explanation of why there is such a spread in the estimate and they noted rather ominously that this "was based on 2010" costs. I used to manage large capital projects for a major corporation and I would have been fired for providing such an estimate to my bosses.
Pathology fee: Unknown refused to provide any cost.
Worst case cost would be over $18500 for a diagnosis not treatment. I would not sit still for this even if I had insurance.
So far I have spent $1300 and have not received a definitive diagnosis. I asked the pulmonologist if we could do a needle biopsy. Much less expensive but he would be cut out of the deal. Two weeks and no reply in spite of follow up on my part with his office. I think it is time to find another pulmonologist who can move a bit faster than the current one.
I have always contended that the issue is not access to medical care but the cost of it. Without insurance it would be a lot less. We may have less choice and technology in the free market approach but I suspect that it would not be much less.
One more anecdote. I read an article when researching my initial treatment that showed that costs in a community go up when more than one provider has the same treatment capability. In my case radiation machine. Reason is the market demand for services is finite and each provider must get a return on their investment or at least return of their investment.
I am sure that the lottery litigation for medical mistakes also contributes to the cost in insurance premiums and unnecessary tests.