How to ask for the cash price

Before you call

Get two facts from the ordering clinician's office: the CPT code that was ordered and whether anything is expected to be added on the day (contrast, tomosynthesis, biopsy, additional views). A price for the wrong code is not a price for your procedure. The procedure pages on this site list the common code variants for each of the 10 launch procedures.

The exact ask

Use the same sentence at every facility so the answers are comparable:

"What is the all-in cash price for CPT [code] performed in [setting], including the professional fee, the facility fee, anesthesia, and pathology if they apply? Please list what is included and what would bill separately."

Then ask the follow-ups:

1. "Is that a global price, or will the radiologist, cardiologist, or endoscopist bill separately?"
2. "If the plan changes on the day - for example a diagnostic colonoscopy becomes a biopsy colonoscopy - what code will be billed and what will the price be?"
3. "Do you offer a self-pay or prompt-pay price that is different from the standard cash price?"
4. "Can you send that in writing with the CPT code, setting, and inclusions?"

What a complete quote includes

Element	What to write down
CPT code and descriptor	The exact 5-character code and whether modifiers apply
Setting	Hospital outpatient, ASC, imaging center, or office, with the facility name and address
Professional fee	Included, amount, or billed separately by whom
Facility fee	Included, amount, or not applicable
Anesthesia / pathology	Included, likely, or billed separately, with the group name if known
Day-of-change rule	What code and price apply if the procedure changes
Validity	How long the quote is valid and who provided it, with date

How to compare two quotes

Compare all-in to all-in for the same CPT code. A hospital facility-only quote will look lower than an imaging-center global quote until the professional fee arrives. Add the layers before you decide the hospital is cheaper or the center is more expensive. The Price Anchor Explorer shows the Medicare version of the same split.

If the facility will not quote a cash price

Ask for the billing office or patient financial services and repeat the CPT-specific ask. If you are uninsured or choosing self-pay, ask for a Good Faith Estimate (see Guide 2). If the service is shoppable and scheduled in advance, you are allowed to ask another facility for the same code. Get every competing quote in writing.

What not to rely on

Do not rely on a hospital chargemaster list price as your price. List prices in machine-readable files are not what most patients pay and are not presented on this site as patient prices. Do not rely on a quote for a different code, a different setting, or a quote that leaves anesthesia and pathology unstated for an endoscopy. When in doubt, ask again and get it in writing.

A worked comparison using anchors already on this site

Take brain MRI without contrast, CPT 70551. On this site the verified Physician Fee Schedule global anchor is $193.67 - $68.81 professional plus $124.86 technical - when one entity bills both parts, as an imaging center usually does. In a hospital outpatient department the verified OPPS facility anchor for the MRI without contrast composite is $540.27, and the professional fee bills on top of it. Those are Medicare anchors, not cash prices, and they come from the sources printed on the MRI without contrast procedure page.

The lesson is in the structure, not the exact dollars. At the imaging center there is one number to ask for: the global cash price. At the hospital there are at least two layers, and a facility-only answer will understate the total. Ask each setting the same sentence from this guide, write down each layer, and only then compare. The facility-type pages explain why the payment system, not the scanner, creates most of that gap.

Common mistakes that make quotes incomparable

• Comparing a hospital facility-only quote with an imaging-center global quote and calling the hospital cheaper.
• Accepting a quote for a nearby code - with contrast instead of without, or a diagnostic code when a biopsy code is likely - and discovering the change on the bill.
• Forgetting anesthesia and pathology on an endoscopy quote, where both commonly bill as separate layers.
• Keeping no written record of who quoted the price, on what date, and how long it stays valid.

Each mistake is fixed by the same habit: exact code, exact setting, every layer named, price in writing. Our methodology explains why we publish the Medicare anchor and facility education instead of inventing a self-pay range to fill the gap.

Frequently asked questions

Next: Good Faith Estimates and the No Surprises Act - Questions to ask billing (checklist).