How to Use the Price Comparison tool
Our new cost estimator tools lets you see cost estimates for common medical procedures or costs by billing code based on their own benefits. With these estimates, you can make choices that are right for you.
These tools give you an idea of what their out-of-pocket costs may be. We base example costs on negotiated rates with network providers or on claims costs we paid for care provided in our most common network. Actual out-of-pocket costs depend on care and benefits at the time of service.
How do I search for a procedure:
- Log in to your online account at bcbsla.com.
- Click the Cost Estimator link on the left side of the screen.
- Please read the important notes before you click the Search for Costs link on the middle of the screen.
- Type what care you want to search in the search bar.
- Choose a service under Procedure Costs that drops down automatically as you search.
- You should see a list of providers who have cost estimates for this service.
- Click on the provider to get further details on what you might pay for that service at that provider.
How do I search by billing code?
- Log in to your online account at bcbsla.com.
- Click the Cost Estimator link on the left side of the screen.
- Please read the important notes before you click the Search for Costs link on the middle of the screen.
- From there, you can click Search by Billing Code specifically or type a short description of a billing code.
- You’ll get a list of providers with a rate for that code and estimated costs. You can click on the provider’s profile for more cost details.
- Costs may vary at different places of service. Choose the appropriate place of service to see what your care may cost in that setting.
NOTE: A billing code identifies a single service provided, which may only be a part of your total care. A complete visit or procedure may include multiple billing codes and negotiated rates. If you need care at a hospital or surgical center, you may need to look up facility charges for multiple codes at that facility to get an estimated cost.
How can I find the billing code for my procedure?
- All healthcare providers use standard billing code sets in U.S. healthcare settings.
- Providers document diagnoses and services provided in your medical record at the time of your care.
- Billing codes are assigned for those services provided, based on the provider's documentation in your medical record.
- The billing codes are submitted to your health plan when the provider seeks payment for your care.
- You may contact your healthcare provider's office or billing personnel and ask them to help you match billing codes and services.
What is a billing code?
- A billing code is a code used by healthcare providers to identify healthcare items or services for purposes of billing, processing, and paying claims for a covered item or service, including the Current Procedural Terminology (CPT) code, Healthcare Common Procedure Coding System (HCPCS) code, Diagnosis-Related Group (DRG) code, National Drug Code (NDC), or other common payer identifiers.
Can I search all billing codes?
- You can search any billing code, but the tool will only show results for codes, or code types, that our system uses and are covered by our plans.
How are the results from this search bar different than the “Procedure” (homepage) search bar?
- When using this search bar, you will be able to search by specific billing codes. Your estimated cost of care will be shown using the negotiated rates that your health plan has agreed to pay a provider (doctor, medical facility, lab, etc.) for the billing code that you have searched.
- A billing code is used to identify a single service provided, which may be only part of your total care. A complete visit or procedure may include multiple billing codes and negotiated rates.
- When using the search bar on the homepage, you will be able to search for procedures by name (rather than by billing code).
- Your estimated cost of care will be shown using historical claims information from actual claims paid by your health plan.