Outpatient Labs/Tests – Rural IL
I recently moved to a VERY rural area and am still wrapping my head around some of the differences in service options. There are two main "systems" that support my area (both are an hour away) and are hospitals with little offices inside for various PCPs/specialists. The farther out I go, the more options I have, but they all seem to have this same setup. As in, none are classic "family medicine" offices, they're all rural "one-stop" hospitals.
My plan covers OP labs, x-ray, imaging at 100% after deductible, but those same services in an office are at my $25 copay (it's a hybrid plan).
I recently got my regular labs done at the local rural hospital. It's an OP lab, and I knew that. Last time I got these exact same labs done (run of the mill stuff – CBC, A1C, etc), they were done in office. If I'd had to pay the full cost it would have been $70 total, but I paid the copay instead. So I mentally accepted that I'd have to pay more like $100, no big deal.
Turned out, my bill was $1,000. I also went to this same hospital for ortho and received an X-ray for a whopping $800. Insurance says the hospital just "charges more." Luckily, I have a surgery this year and pulled out enough FSA to cover my OOP.
However, I need to figure this out for my future plan years where I only plan on receiving PCP care and my regular testing. If I can't find an office that does labs in-house, are those amounts run of the mill for hospital outpatient labs/tests? Like, my instinct is to ditch this hospital system and drive a bit farther to the next one out, but it's not like anyone is upfront about those costs and PCP waiting times make it difficult to shop around.
TL;DR: My main question is whether OP labs/tests are usually this markedly different, or if I just found a shitty local place and should look elsewhere.
submitted by /u/MorbidAgenda
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