I have insurance that only covers $7,500 of surgery....so I have to find the cheapest place, but is that the same as self-pay if it's the rate they charge my insurance?

You often times get what you pay for. I would think that the ethical way for a doctor's office to bill for a procedure is the same for self-pay and insurance. At least you have some insurance to help you out. I had none and paid $16,000 out of pocket. Ask around at your support meetings. There's lots of information there. SS

Edited May 26, 200818 yr by ssdown

Usually they charge your insurance more because they know that they won't get all the money they charge. However, if they have a contract with your insurance company, that means they have agreed to except what your insurance company says is a usual and customary charge. So they shouldn't charge more than that. If they try to get you to pay the difference, find some place else!

I am wondering the same thing because my insurance pays 90% with a lifetime max of $8000. I am pretty sure that you pay more if you self-pay. When insurance is paying, they usually negotiate stiff discounts that fall under the "usual and customary" clause. For example, my statement from Cigna about a toe surgery I had listed the Dr billed $590, then showed the discount and that the insurance paid $136. I owe nothing.

I hope this is the case with this surgery too.