How prices work
A hospital doesn’t have one price. Here it is in pictures.
1
One procedure, many prices
- List priceBefore any discount. Few people pay this.$3,158
- Cash priceIf you pay yourself, without insurance.$1,775
- Commercial insurance rateWhat an employer or individual plan pays in total.$2,643
2
Each price is for one group of people
- Commercial insurancePlans through an employer or bought yourself.
- Medicare AdvantageMedicare plans run by private insurers.
- Traditional MedicareOriginal Medicare, paid by the government.
- MedicaidState programs and their managed-care plans.
- Paying yourselfNo insurance, or choosing not to use it.
Every price on CareNavIQ carries one of these labels. We never mix groups.
3
What you pay with insurance
- $500 You pay first, until your deductible is met.
- $300 Then your 20% coinsurance on the rest.
- $1,200 Your plan pays the remainder.
4
The number we show for a hospital
5
Find your best option in three steps
- SearchType a procedure, or a question like “MRI with Premera in Seattle”.
- NarrowChoose your insurance group, ZIP code, distance and CMS quality stars.
- Estimate and callSee what you might pay, then call the hospital to confirm and book.
Questions and answers
Is this what I’ll pay?
No. It’s what the hospital published. Your cost depends on your plan, deductible and the care you actually receive. Ask your insurer and the hospital for an estimate.
Why does a hospital say “Not published”?
Its own price file has no price of that kind for the service. Some list insurer rates but leave the cash or list price blank.
I don’t have insurance. What should I do?
Compare cash prices, then ask the hospital for a Good Faith Estimate. Under the No Surprises Act, providers must give one to uninsured and self-pay patients when they schedule care or ask.
How is distance measured?
In straight-line miles from the center of the ZIP code you enter, not driving distance. We don’t ask for your street address or your device’s location.
What do the quality stars mean?
The Centers for Medicare & Medicaid Services (CMS) overall hospital star rating, 1 to 5, based on measures such as safety, readmissions, mortality and patient experience. Some hospitals, often small rural ones, aren’t rated.
Can I see the earliest available appointment?
Not yet. Hospitals don’t publish appointment availability, so we show each hospital’s phone number to call and ask.
Which states do you cover?
Washington today. CareNavIQ is built for the whole U.S. and more states are on the way.
How current are the prices?
Each price shows the date the hospital gave for its file. The search page shows when we last loaded the data.
A price looks wrong. Who do I tell?
Use the “Tell us about it” link on that page, or contact us.