Health insurance or paying cash? Price a year of care both ways

Hospitals publish two kinds of prices: a cash price for patients who pay themselves and the rates they negotiated with insurers. Across 29 common services, the median cash price is below the median highest rate insurers negotiated for all of them, though not below the median lowest negotiated rate for any. Until you meet your deductible you pay the plan's rate, so for routine care cash can cost less; insurance caps a bad year at its out-of-pocket maximum. Put in a plan and the care you expect, and see the year both ways.

Open enrollment for 2027

On HealthCare.gov you can enroll from November 1, 2026 to January 15, 2027. Enroll by December 15, 2026 for coverage that starts January 1, 2027. States that run their own marketplace can set different dates.

Your year, both ways

Your plan

Monthly premium Deductible Coinsurance, % Out-of-pocket max Plan's rates Cash prices in

The plan numbers are an example: use the premium after any subsidy and the deductible, coinsurance and out-of-pocket maximum of the plan you are looking at.

Care you expect this year

Doctor visits

Annual physical, returning 18–39 · preventive, often $0 with a plan $131
Annual physical, age 18–39 · preventive, often $0 with a plan $147
Returning patient visit, 20 min $142
Returning patient visit, 30 min $178
New patient visit, 30 min $178
New patient visit, 45 min $236

Lab tests

Comprehensive metabolic panel $123
CBC blood test $57
Lipid panel $88
A1C test $60
Rapid strep test $59
Urine dipstick test $20
EKG $90

Imaging

Chest X-ray $248
Abdominal ultrasound $688
Pregnancy ultrasound $552
Screening mammogram · preventive, often $0 with a plan $250
Head CT scan $1,200
CT abdomen and pelvis $2,682
Lower back MRI $1,912
Knee MRI $1,857

Emergency room

Level 3 ER visit $650
Level 4 ER visit $1,049

Therapy

Physical therapy, 15 min $93

Procedures

Colonoscopy $1,744
Knee arthroscopy $5,652
Hernia repair $5,911
Gallbladder removal $8,227
Appendectomy $7,737

If something big happens

Appendicitis
Gallbladder attack
Torn knee meniscus

With insurance

Paying cashmedian hospital cash prices

Nothing you type or pick leaves your device, and this page carries no ads. A cash payment may not count toward your deductible, and cash does not protect you from a large bill the way an out-of-pocket maximum does.

Cash price and negotiated rates, by service

Medians across US hospitals that publish both, one price per hospital, from their machine-readable price files (45 CFR 180.50). The plan's rate is what an insured patient pays until the deductible is met.

Service	Cash	Lowest negotiated	Highest negotiated
Annual physical, returning 18–39 CPT 99395	$131.08	$66.25	$228.58
Annual physical, age 18–39 CPT 99385	$146.65	$74.79	$257.50
Returning patient visit, 20 min CPT 99213	$142.00	$54.70	$264.00
Returning patient visit, 30 min CPT 99214	$177.50	$74.00	$337.75
New patient visit, 30 min CPT 99203	$177.76	$70.02	$305.21
New patient visit, 45 min CPT 99204	$235.90	$99.00	$401.16
Comprehensive metabolic panel CPT 80053	$123.10	$10.56	$200.30
CBC blood test CPT 85025	$56.80	$7.53	$99.00
Lipid panel CPT 80061	$87.50	$13.00	$155.00
A1C test CPT 83036	$60.45	$9.43	$105.40
Rapid strep test CPT 87880	$59.05	$14.81	$92.00
Urine dipstick test CPT 81002	$19.92	$3.21	$33.34
EKG CPT 93000	$89.93	$28.03	$171.75
Chest X-ray CPT 71046	$248.00	$62.12	$410.40
Abdominal ultrasound CPT 76700	$688.08	$106.01	$1,012.50
Pregnancy ultrasound CPT 76805	$552.00	$105.00	$843.00
Screening mammogram CPT 77067	$249.60	$82.49	$434.38
Head CT scan CPT 70450	$1,200.00	$110.61	$1,866.75
CT abdomen and pelvis CPT 74177	$2,681.50	$335.92	$3,933.77
Lower back MRI CPT 72148	$1,912.00	$239.82	$2,893.51
Knee MRI CPT 73721	$1,856.50	$244.98	$2,997.60
Level 3 ER visit CPT 99283	$649.50	$218.98	$1,338.61
Level 4 ER visit CPT 99284	$1,048.93	$328.16	$2,061.27
Physical therapy, 15 min CPT 97110	$93.31	$27.89	$174.42
Colonoscopy CPT 45378	$1,743.50	$567.19	$3,045.00
Knee arthroscopy CPT 29881	$5,652.32	$1,644.87	$8,427.00
Hernia repair CPT 49505	$5,911.08	$1,365.77	$8,654.11
Gallbladder removal CPT 47562	$8,226.70	$2,019.29	$12,440.66
Appendectomy CPT 44970	$7,737.00	$1,375.77	$13,051.00

Questions

When is open enrollment for 2027 health insurance?

On HealthCare.gov, open enrollment for 2027 Marketplace plans runs from November 1, 2026 to January 15, 2027. Enroll by December 15, 2026 for coverage that starts January 1, 2027. States that run their own marketplace can set different dates.

Is it cheaper to pay cash than to use health insurance?

For routine care it often is. Across 29 common hospital services, the median cash price is below the median highest rate insurers negotiated for all of them, though not below the median lowest negotiated rate for any. Until you meet your deductible you pay the plan's rate, so with a high deductible a cash price can cost less. Insurance is for the bad year: it caps what you pay at the plan's out-of-pocket maximum, while a hospital appendectomy alone has a median cash price of $7,737.00.

Does paying cash count toward my deductible?

Not automatically. A cash payment counts only if your plan accepts the claim, and many plans do not credit care you paid for outside the plan. Ask your plan before you pay cash for anything expensive.

What does a Marketplace plan cover before the deductible?

Certain preventive services, such as screening tests and immunizations, are covered without a copayment or coinsurance even before you meet your deductible, when you use an in-network provider. HealthCare.gov notes that $0 is not guaranteed in every case, so check what your plan counts as preventive.