Freestanding Clinic vs. Hospitals: Understanding the Cost Savings for Imaging Services

Your doctor just told you that you need an MR or CT scan. Your initial thoughts may be, how much does that cost or where should I go? You may think to head to the hospital but there are other options available that may save you both time and money in the process.

Whether it’s a broken bone or a bonked head, MR or CT scans can be a challenge to navigate – especially when it comes to the bill. But by having a scan at an independent facility you could save hundreds of dollars. For example, a member in a fully insured plan may save an average of $384 and a member in an ASO plan may save an average of $1991. The average national cost of hospital-based imaging services is almost three times the cost of receiving those same services at freestanding imaging centers or physician’s offices. 

Health insurance companies, like UnitedHealthcare, are always looking for ways to lower consumer out-of-pocket costs and promote price transparency. So, beginning on March 1, UnitedHealthcare members will be referred to convenient, reasonably priced non-hospital locations to receive their MR and CT scans. Exceptions will be granted for a variety of situations, such as if a patient has a chronic condition, or if using a freestanding imaging center could delay care.

Here’s what you need to know: 

Where are they located? 

You may find imaging centers in a medical office building, a shopping center or a doctor’s office. Physicians will be referring their patients to freestanding imaging centers within a close proximity (approximately 10 mile radius) of the patient’s zip code (unless otherwise specified by a mandate/guideline set by the member’s state of residence).

How much does it cost?

There is a dramatic difference in cost. UnitedHealthcare’s internal data shows the average national cost of MR and CT scans at hospitals is $1,855 compared to $682 at freestanding facilities. Receiving care at lower-cost facilities may save you hundreds of dollars.

Won’t it be an inconvenience for me? 

According to UnitedHealthcare data, most members (85-90 percent) do not receive their MR or CT the same day as their referral, so this service provides the opportunity for a convenient, safe and lower cost alternative without a delay in getting a scan. Hospital care will be authorized if the use of a freestanding imaging site could result in delay of care.

 For more information on this implementation, call the number on your ID card.

1 Based on a UHC analysis of 147 types of MR and CT procedures during the 12 months ending June 30, 2018.  The potential savings are hypothetical and will change based on the type of plan the member is in and the status of the member’s annual deductible.