Blue Cross and Blue
Shield of North Carolina Sheds Light on Medical Costs
Insurer publishes typical costs for hundreds of visits, procedures
Chapel Hill, NC (CompNewsNetwork) - Blue Cross and Blue Shield of North
Carolina (BCBSNC) is taking some of the mystery out of health care costs.
BCBSNC, the state's largest health insurer, is publishing online the average
prices it pays statewide for physician office visits, diagnostic procedures and screenings,
prescription drugs, and disease treatments. The Health Cost Estimator, now available to
members at bcbsnc.com, includes one of the most comprehensive listings of total average
costs related to diseases and conditions of any health insurance plan. Along with its
effort to promote health cost clarity for its members, BCBSNC supports initiatives to
increase the quality, safety and effectiveness of health care.
"Our Health Cost Estimator will give our customers a much clearer idea of
where their health care dollar goes because the prices we pay translate to the premiums
that customers pay," said BCBSNC President and CEO Bob Greczyn. "Consumers are paying an
increasing share of health care costs, but until now they've had little way of knowing
what medical services actually cost."
The Health Cost Estimator includes:
Physician office visits, with separate categories of average costs for a
variety of services for men, women and children. For example, the average cost BCBSNC pays
statewide for an annual physical examination for a 35-year-old man is $279, including
recommended lab work and immunizations. A child's doctor visit for a cold typically costs
the company $75.
Diagnostic screenings and surgical procedures, with average costs broken
out by place of service. For example, an MRI provided in an outpatient hospital setting
costs BCBSNC $1,975 on average, while the same scan in a freestanding facility costs $933.
Anterior cruciate ligament (ACL) surgery costs the company an average of $10,337 if done in
an outpatient hospital setting, and $6,859 if done in an ambulatory surgical center. The
average cost for an outpatient colonoscopy is $2,040 at a hospital, $1,203 at an ambulatory
surgical center and $889 in a physician's office.
Total average costs for treatment of diseases and conditions. For example,
the average total that BCBSNC would expect to pay for a member who requires heart bypass
surgery is $57,280, including office visits, hospital costs, drugs, tests and other
services. A typical course of breast cancer treatment, including surgery, costs $26,749.
The Health Cost Estimator includes prices BCBSNC pays for the most commonly
used prescription medications. Members can learn, for example, that a brand name
cholesterol-lowering drug can cost as much as $150 or more for a month's supply, while a
generic drug can cost as low as $20 per month.
Members can customize the tool, adding services they expect to receive during
a medical visit, such as lab tests and x-rays, or removing those services they do not
expect to receive.
"With this information, members will be better able to make informed choices
about quality, cost-effective health care options," Greczyn said. "That could help
moderate health care costs."
Having reliable information on the cost of care is particularly important for
consumers with the latest health plan designs that couple a high-deductible plan with a
Health Savings Account. HSA plans are becoming increasingly popular because they typically
have lower premiums than traditional health insurance plans. Participants are responsible
for paying a greater proportion of their medical costs upfront, which they can manage
through tax-free, interest-bearing health savings accounts.
Actual costs of medical services provided to members depend on a number of
factors, including the severity of their case, the actual treatment they receive, BCBSNC's
contracted prices with the particular physicians and facilities members visit and other
BCBSNC has also enhanced the health information on its Web site to provide
members with quick access to information about health care provider quality, linking
customers to details about doctors and facilities that have been named BCBSNC Centers of
Excellence for obesity surgery and heart surgery. It also provides information about
physicians who participate in other quality recognition programs.
The Health Cost Estimator is available to customers who sign up for online
member services, a secure, password-protected site that allows them to check claims and
benefits, request member cards, sign up for care management programs and participate in the
Blue Points physical activity and wellness incentive program.
About BCBSNC: Blue Cross and Blue Shield of North Carolina is a leader in
delivering innovative health care products, services and information to nearly 3.6 million
members, including approximately 825,000 served on behalf of other Blue Plans. For 75
years, the company has served its customers by offering health insurance at a competitive
price and has served the people of North Carolina through support of community
organizations, programs and events that promote good health. Blue Cross and Blue Shield of
North Carolina is an independent licensee of the Blue Cross and Blue Shield Association.
Access BCBSNC online at www.bcbsnc.com.
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