Out-of-network billing rates for outpatient, inpatient visits in 6 specialties

Angie Stewart - Print  |

Most specialty providers who bill out of network do so less than 10 percent of the time, according to a recent analysis by the Health Care Cost Institute, an independent, nonprofit research institute.

HCCI analyzed 13.8 million visits to over 35,000 unique providers to find the percent of providers with at least one out-of-network claim.

Percent of specialty providers that billed out of network at least once for inpatient and outpatient visits:

1. Emergency
Inpatient: 44 percent
Outpatient: 49 percent

2. Pathology
Inpatient: 44 percent
Outpatient: 33 percent

3. Radiology
Inpatient: 28 percent
Outpatient: 33 percent

4. Anesthesiology
Inpatient: 26 percent
Outpatient: 32 percent

5. Behavioral Health
Inpatient: 30 percent
Outpatient: 15 percent

6. Cardiovascular
Inpatient: 18 percent
Outpatient: 17 percent

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