I once had a patient's spouse inquire about the cost of my services just minutes before I was about to place an epidural catheter for alleviation of labor pains. I hesitated, not because I didn't want them to know what it would cost, rather it was because the answer was complex. Each insurance company has a different negotiated rate of pay for my medical group's services, and the charge for a labor epidural is not a static amount. The management of the epidural could be for 2 hours or for 14 hours. The patient could then go on to a Cesarean section using the same epidural. The rate of pay increases because it is now anesthesia for an operation and requires more intensive management. The negotiated rate of pay for each insurance changes from year to year, and the billing becomes so complex it requires a billing service to keep track of it all.
I told the husband that I could provide him a phone number for my medical group, that he should ask for the billing dept, that he will need to provide information of her insurance. The wife, in the middle of a painful contraction, shot her husband a look of exasperation, and said, "Never mind! I want the d--n epidural!"