KCBD Investigates Consumer Awareness: Dare to Compare

Updated: Jan. 12, 2021 at 10:27 PM CST
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LUBBOCK, Texas (KCBD) - The KCBD Investigates team is looking into a major price disparity for local breast cancer screenings.

In fact, you may be surprised to know, when compared to cities outside of Lubbock, the cost for a Breast MRI can vary by more than 1,500%.

Our team’s investigation began when one Lubbock mother brought us the results of her own investigation. After discovering a lump, her doctor referred her for an advanced breast cancer screening. But, after being given what she called an outrageous price for the procedure, she decided to shop around.

“Um, I recently had my son and my breasts had changed quite a bit, and I just noticed through that that I had a mass,” It’s a discovery no woman wants to make. But, for Lauren Jackson, the combination of the mass, along with her family history of breast cancer, made her fear come alive, “So, I went and got a mammogram.”

Which was followed up by an ultrasound. However, due to the density of her breast, cancer was not ruled out. So, a Breast MRI was her doctor’s next prescription.

“They scheduled me for an MRI and I had asked her, I said ‘I’d really like to go to LRA’, and they said ‘Well, they’re not in your network’, and I said ‘Ok. Well, I guess we’ll go to the person in my network. I didn’t think one way or the other. I just thought, ‘Ok, it’s probably going to be less expensive with my in-network provider’,” added Jackson.

But, that wasn’t the case.

“They called me the day before my scheduled appointment and they said, ‘We want to take care of your co-pay. We want to let you know ahead of time what that is’, and I said ‘Ok’ and so, I remember them saying it was somewhere around $1,600 and I was like ‘Whoa, I have to come up with this tomorrow and I’m supposed to come up with all this money last minute’,” asked Jackson.

With her co-pay at 20%, and the price of that co-pay being about $1,600, that meant the procedure was priced at about $8,000.

After calling around to out-of-network providers and being quoted at about $500 instead, she decided to take a step back and reach out to her insurance provider for help.

“Come to find out, I had very limited options here in Lubbock, so I went out further,” said Lauren, who was quoted between $510-$550 in Amarillo, $489 in Ft. Worth and between $518-$550 in Dallas. “And so that triggered me, I’m like, If I hadn’t been cognizant enough to take a step back and I was just scared out of my mind that I had breast cancer and you know, like I just need to get this done and I was hasty about it, then I would have been just, you know, taken to the cleaners basically.”

Luckily, for Lauren, the solution was staring her in the face. A pre-planned trip to Florida.

“So, I called back Cigna again and said ‘Hey, by chance, can you look up in the city where we’re going? Sure enough, $500. I think I ended up paying $89 or somewhere about there, total, after my deductible.”

We asked Lauren what her advice is to other women who have faced a similar situation.

“Call your insurance provider. Find out if they can give you your most cost-effective options. Just because your doctor schedules you with someone they work with does not necessarily mean that you have to go to that person. You have a choice and you can make that choice for yourself,” said Jackson.

This story does have a happy ending and that is that Lauren does not have cancer.

The takeaway our Investigates team got from this is that prices vary from facility to facility and from market to market. So, this next time you’re facing a procedure costing hundreds of dollars, or more, make some phone calls, because you may find a better price elsewhere with money left over to spend.

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