Like many Americans, Janet Winston suffered from a persistent rash and she was frustrated by not knowing exactly what allergens affected her.
So despite her doctor’s hint that it might be expensive to run a battery of tests, she set up the procedure.
After all, as a state employee in California, her health coverage benefits were among the best, and the Stanford Health Care center, where the work was done, was in her network.
Even so, discovering that she’s sensitive to a compound of lavender and other plants, a ketoconazole cream, neomycin, a clothing dye, a preservative and gold, nickel and cobalt, generated a bill of more than $48,000.
NPR reported the English professor from Eureka, California, went to the Stanford clinic because her local dermatologist was booked.
“Winston, who had avoided lipstick and other skin products for years, said that 119 tiny plastic containers of allergens were taped to her back over three days of testing,” NPR reported.
As a cost of $48,329.
That included $848 for the time she spent with her doctor.
NPR found that Anthem Blue Cross paid Stanford a negotiated $11,276.47 on the bill, and she was billed $3,103.73 for her 20 percent share.
“I was grateful I had such wonderful care at Stanford, but I was pretty outraged they could charge that,” Winston told NPR. “No one cut into me. No one gave me anesthesia. I had partly open plastic containers filled with fluid taped to my back.”
It seems Stanford charged $399 per allergen tested, even though the typical cost is about $35.
NPR said the average charge physicians submitted to Medicare was only $16 per allergen.
Experts said the charges did appear to be out of line.
“That charge is astronomical and nuts,” Margaret Skurka, a retired professor of health informatics at Indiana University and a medical coding and billing consultant, told NPR.
NPR said Winston’s case “highlights how some health providers set exorbitant rates, knowing they’ll ultimately be paid a lesser amount.”
“Patients rarely pay these rates – known as ‘chargemaster’ or list prices – and they can generate headlines for the $100 aspirin. But such list prices, as the starting point for negotiations and discounts, do influence the amounts insurers pay, and ultimately what patients pay as their share of cost,” NPR reported.
Stanford spokesman Patrick Bartosch told the broadcaster that Winston’s treatment cost more because it was customized.
The report said: “After some bargaining with Stanford’s billing department, Winston ultimately paid $1,561.86 out of pocket. She made the argument that her doctor had told her the cost per allergen would be about $100, not nearly the $400 Stanford ultimately charged her insurer.”
Stanford still received more than $12,000.