Same medical test, double the base price at URMC

April 30, 2019 06:14 PM

ROCHESTER, N.Y. (WHEC) -- The price of the same exact medical test ordered by the same doctor doubled in price for an Irondequoit woman in a matter of one year.  

"Back in October of 2017, I actually had a heart attack," recalls Bernadette Taylor.


She was rushed to the hospital where she ended up having angioplasty and stents put in.

Now, she's diligent about checking in with both her cardiologist and primary care doctor who have also discovered a build-up of plaque in her carotid arteries. The doctors want to keep a close eye on it, so Taylor has to get annual ultrasounds.

"It's like an ultrasound they do when you're pregnant except they do it on the arteries that run alongside your neck," she tells News10NBC.

Taylor got a bill from UR Medicine for the ultrasound she had earlier this month and was shocked.

"It went from $393 to $715 and I went 'that's quite a jump' so I called customer service. She couldn't really explain the price difference but said 'there is an office down at the hospital where you can go, they don't take appointments but you can go from 9 a.m. to 3 p.m. and wait and see somebody', well... I work full time," she says.  

The bill from 2018 and the bill from 2019 show the same exact service was performed in both instances. Taylor was almost sure she went to the same imaging office for both but it turns out, she didn't.  

The two offices are about a half mile away from one another and while URMC does the billing for both, but they only own one.  

The imaging center Taylor went to in 2018 is privately owned and sets its own base rates, in this case much cheaper.  A spokesman for URMC says its base rate is higher because there's far more overhead associated with running a medical center.  While insurance companies pay both providers relatively the same amount for the service, those who have deductibles that have not been reached, will be on the hook for the difference.  

Taylor says she didn't realize there was a difference between the two offices and now that she does, she'll choose the private option in hopes of saving on her bill.  

In a statement, URMC Spokesman Chip Partner told News10NBC:

"We can confirm the charges and payment amounts Ms. Taylor provided to you in her invoices. Her out-of-pocket expenses are higher in 2019 than they were for the same service in 2018 primarily because of the status of her insurance deductible – the amounts paid to the UR Medicine providers are virtually identical in each year.

  • In 2018, the payment for her scan at University Medical Imaging (UMI) was $322.49 – $258.00 paid by her insurance company after her deductible was met, plus $64.49 out of pocket.
  • In 2019, the payment for her scan at UR Vascular Surgery Imaging is $338.29 – all being charged to her out of pocket because she has not met her plan's deductible for the year.

UMI is a private practice affiliated with URMC, and UR Vascular Surgery Imaging is part of the medical center, which is why the charges shown on each bill are different. However, the actual payment amounts are only about $16 apart between 2018 and 2019 at the two locations.

UR Medicine has a health cost estimator service to help consumers understand their deductible status and likely payments. We encourage people to call (585) 758-7801 or email to get a customized price estimate in advance of a medical procedure or office visit.  We also encourage consumers to apply for financial assistance if they have difficulty paying their portion of a UR Medicine bill."


Jennifer Lewke

Copyright 2019 - WHEC-TV, LLC A Hubbard Broadcasting Company


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