Using the FH Medical Cost Lookup
The FH Medical Cost Lookup offers information on estimated costs for healthcare
professionals’ services for medical procedures, including a limited number of anesthesia
services available on FH Estimate Assist®. At this time the website does not include
charges for durable medical equipment or separate facility fees, which may be billed
in addition to healthcare professional fees, when services are performed in a hospital,
freestanding clinic, or other treatment center. Over time, the FH Medical Cost Lookup
will be expanded to include this information.
Learn more about
office visits.
Estimating Your Costs
The medical cost lookup uses data from the FAIR Health Database to estimate costs
for specific medical procedures. You can use the site to estimate your out-of-pocket
costs with and without insurance coverage.
If you are insured, please note that some plans set out-of-network reimbursement
rates based on a percentage of “usual, customary, and reasonable” (UCR) charges,
while others use a formula based on a fee schedule established for Medicare.
Insured out-of-pocket costs will be estimated using the UCR-based reimbursement
method. If your plan bases reimbursement on a percentage of Medicare, you can easily
recalculate your results by selecting the “Medicare-Based” button on the results
page.
As you use this site to estimate the cost of medical services, keep in mind that
visits with your provider for consultation, evaluation, and management are typically
billed separately from the other services you receive. For example, if you visit
your provider for certain blood tests, your provider will likely charge you for
an office visit as well as the actual tests performed.
To help you determine the estimated cost for an office visit, we recommend that
you browse the "Office and Hospital Visits" category in the directory to the left.
The specific procedure billing code for each type of office visit - such as "Consultation
Visits" or "Established Patient Visits" – often includes a distinct length of time.
For example, the billing code for a 15 minute “established patient” visit is different
than a 30 minute “established patient” visit. The procedure you will see listed
in our directory corresponds to the most commonly billed procedure in that category.
Your visit may in fact be longer or shorter than the procedure we show you.
For your estimate to be as accurate as possible, you should obtain the CPT code
associated with your office visit and use the search tool above to find that specific
procedure.