Discounted Cash Price

The discounted cash price is the amount a hospital will accept from a patient who pays directly, without running the service through insurance. Federal rule requires every hospital to publish it for every service, next to the gross charge and the negotiated rates. It is not the same thing as a charity discount or a hardship write-off; it is a standing price available to anyone who asks and pays.

The reason this line matters is that it is frequently lower than what an insured patient pays. A hospital in the Dallas area lists a CT of the abdomen at a $3,200 gross charge, a $1,100 discounted cash price, and negotiated rates between $1,300 and $2,600 depending on the carrier. A patient on a high-deductible plan who has not met the deductible would pay the full negotiated rate, say $1,900, out of pocket. The cash patient pays $1,100. Same scanner, same technologist, same radiologist's read. Hospitals set the cash price low because they get paid the same day with no claim to process, no denial to fight and no collection risk. Texas, Tennessee, Arizona and a handful of other states now require insurers on state-regulated plans to count that cash payment toward the deductible if the patient sends in the receipt, which removes the last reason not to do it.

The takeaway: if you are inside your deductible, ask the hospital for its discounted cash price before the service and compare it to your plan's negotiated rate. When cash is lower, pay cash, keep the itemized receipt, and file it with your insurer for deductible credit where your state allows.