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Patient tool · Insurance & visit costs

Cash-pay vs insurance calculator

Is the self-pay cash price cheaper than using your insurance? Compare both, including deductible credit.

Editorial review in progress · How we review

Uses 2026 figures
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Your insurer's cost estimator or the office can tell you this.

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Your results will appear here.
Adjust the numbers, then press Calculate.

Assumptions
  • Insurance cost uses your remaining deductible, then coinsurance, capped at your remaining out-of-pocket maximum.
  • Cash payments generally don't count toward your deductible or out-of-pocket maximum.
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Sometimes a provider's self-pay cash price is lower than what you'd owe through insurance, especially if you haven't met your deductible. This calculator compares the two so you can decide with real numbers.

How it works

Enter:

  • The cash price the office quoted.
  • The insurance-negotiated price (the allowed amount your insurer pays the provider).
  • How much of your deductible is left, your coinsurance, and how much is left before your out-of-pocket maximum.

The calculator works out your share with insurance: the remaining deductible first, then coinsurance, capped at your out-of-pocket maximum. It compares that with the cash price.

It also shows the deductible credit you'd give up by paying cash. That's the amount that would have counted toward your deductible and out-of-pocket maximum. If you expect more care later in the year, that credit has real value.

Example

Pat needs an imaging test. The cash price is $450. Through insurance the negotiated price is $900, and Pat has $1,500 of deductible left.

  • With insurance, Pat pays the full $900, since it all goes to the deductible.
  • With cash, Pat pays $450.

Paying cash saves $450 now, but Pat gives up $900 of progress toward the deductible. If Pat had already met the deductible, insurance would cost only $180 (20% coinsurance), and insurance would win.

Rule of thumb

Cash prices tend to win for simple, low-cost services early in the plan year. If you expect a big expense soon, using insurance usually makes more sense.

FAQ

Frequently asked questions

Is it legal to pay cash if I have insurance?

Yes, you can choose to pay a provider's self-pay price. Tell the office before the visit, because once a claim is filed with your insurer the process is harder to reverse. Medicare has special rules.

Will paying cash count toward my deductible?

Usually not. Some insurers will credit cash payments if you submit the receipt, so it's worth asking.

Where do I find cash prices?

Ask the office directly. Hospitals must publish prices, including discounted cash prices, and many labs, imaging centers and surgery centers list them online.

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