I can never get them to tell me what it would cost if insurance were to cover it. Either pay a definitive amount of cash today, or insurance will cover some unknown arbitrary portion of a similarly arbitray and unknown amount tomorrow, and pay the difference.

Yes, it works for routine stuff, but don't try to pay cash for abdominal surgery. You will get a very terrible, high price. After all, it's agree to our low price or die of appendicitis.

Not really. Its a matter of knowing where to find the place that can treat you.

For example, this surgery clinic will treat your appendicitis for less than the average patient's deductible + coinsurance. I'm including the flight + hotel stay in that estimate.

https://surgerycenterok.com/pricing/appendectomy-laparoscopi...

The problem is how you go about finding this information. Most ASC's and even independent doctors are extremely obtuse precisely to hide this huge liability from you. Hospitals will treat you like you are joking. Most hospital billing staff will prefer to do a cartwheel for you, instead of quoting you a price (insured or not). Or they will give you the super helpful range of 1,000 to...100k. Yes,I'm exaggerating to make the point. Heck, even if 1 out of 3 facilities do give you the estimate you seek, that's still 1 hour of time wasted for every 3 calls (avg call hold+time = 30mins) made.

For this reason, I recommend you go with a facility that is part of https://fmma.org/

Disclaimer: I don't have any relationship with OK Surgery or FMMA. Only a big fan, and also working with my startup to take out insurance out of regular healthcare choices.

1000 to 100k? How about zero to infinity? Hospital refuses to give any price range for a colonoscopy, wouldn't quote a cash price because I had insurance. Insurance can't say if it is covered. Won't know until the claim is submitted. Says it might be fully covered as preventative care, or partially covered, or not covered at all. Might not even go against the out of pocket max. Spent a week on the phone trying to get a straight answer. Final bill 3k.

"Its a matter of knowing where to find the place that can treat you." This is fine if you can plan in advance and have the funds to travel, but what if you can't? What if you're in a car accident, or have a heart attack? You can't shop around when your guts are spilling out on the asphalt.

> this surgery clinic will treat your appendicitis for less than the average patient's deductible + coinsurance. I'm including the flight + hotel stay in that estimate.

Are there really people flying to avoid overpaying for an appendectomy?

Boy, I had to have an appendectomy and I could barely stand. I can’t imagine flying for one, or holding off to get everything arranged. I suppose I may have had less time to plan than is implied here: went to bed fine, woke up in agony.

“OK Surgery” is not a name that inspires confidence!

That has not been my experience in both Nevada and Arizona. I have paid cash for two child births, one was an emergency C-section, the other was planned. I was told costs up front and paid cash. I paid cash for a septoplasty and two tonsillectomies, all well under what I would have paid if I had self pay insurance..

Not all abdominal surgeries have opaque pricing. An appendectomy at Surgery Center of Oklahoma is $7,368, paid in advance. https://surgerycenterok.com/pricing-disclaimer/

This is provider-specific. Medical tourism exists, both internationally and within the USA. Some providers are happy to accept immediate cash and forego the pain of dealing with insurance company bureaucracy and delayed reimbursement.

Any country where it is different? For example, they play the exact same games in Thailand and would never give an estimate.

Some US providers, one referenced in a comment above, https://aapsonline.org/surgery-centers-with-cash-friendly-pr...

Web search for Thailand returned this 2020 price list, https://www.bumrungrad.com/en/blog-news/fixed-prices

Sorry, low effort post on my part: This is silly, so now we are expected to negotiate and haggle medical costs like we do at a car dealership? No thank you. Rather we all pay the same price, and if we have insurance, charge the insurance more.