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Patient tool · Insurance & visit costs

Visit and procedure cost estimator

Estimate what you'll owe for a visit or procedure after your deductible, coinsurance or copay.

Editorial review in progress · How we review

Uses 2026 figures
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Ask the office for the insurer-negotiated (allowed) amount if you can.

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

Assumptions
  • Assumes in-network care billed at the amount you enter. Facility fees, anesthesia or lab work may be billed separately.
  • Deductible is applied first, then coinsurance, capped at what's left of your out-of-pocket maximum.
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Knowing what you'll owe before a visit, scan or procedure makes it much easier to plan. This calculator takes your plan's deductible, coinsurance or copay and out-of-pocket maximum and turns them into an estimate for one service.

How it works

First, choose how your plan covers the service:

  • Deductible, then coinsurance: You pay the full price until you meet your yearly deductible. After that, you pay a percentage (your coinsurance) and your plan pays the rest.
  • Flat copay: You pay a set amount, often for office visits.

Then enter how much of your deductible you've already met and how much you've already paid toward your out-of-pocket maximum. The calculator never charges more than what's left before that maximum. Once you reach it, covered in-network care is free for the rest of the plan year.

Example

Chris needs an MRI with an allowed cost of $2,000. His deductible is $1,500 and he's met $500 of it, so $1,000 is left.

  • The first $1,000 goes to his deductible.
  • He pays 20% coinsurance on the other $1,000: $200.
  • Chris pays about $1,200 and his plan pays about $800.

If Chris had already spent $5,700 toward a $6,000 out-of-pocket maximum, he'd pay only $300.

Before you go

Ask whether the provider is in your network, whether the service needs prior authorization, and whether other providers (like a radiologist) will bill separately.

FAQ

Frequently asked questions

Where do I find the cost of the service?

Ask the office or your insurer for the allowed amount, which is the price your insurer has negotiated. Many insurers also have an online cost estimator, and hospitals publish price lists.

Why was my bill different from the estimate?

Common reasons are separate charges for the facility, lab work, anesthesia or a specialist, and different billing codes than expected. Ask for an itemized bill if something looks wrong.

What's a good-faith estimate?

If you're uninsured or paying without insurance, providers must give you a written good-faith estimate before scheduled care. If the bill is $400 or more above it, you can dispute it.

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