Pricing Healthcare

Pricing Healthcare

Pricing Healthcare

Hello everyone! Welcome back to The Green Swan. Let’s talk today about healthcare and how difficult it is to know you are getting a fair price. I’ve run into this issue every time my wife, son or I have required medical care. I’m sure you have faced similar issues. Especially in today’s world where consumer-directed healthcare plans (i.e. high deductible health insurance) are becoming more and more common, it is important to price shop for the best healthcare options.

Well I have some good news for you! Today I would like to introduce Amino which has recently launched a new service to help you price healthcare. While Amino is not a perfect solution or the end-all-be-all for pricing healthcare, it is a step in the right direction for an industry that has historically been pathetic in terms of price transparency. While Amino is just one of many other public and private companies trying to solve this problem for the healthcare industry, its tools and wide range of details brings the industry the closest it has ever been.

For background, I am introducing you to Amino solely to help you navigate the complex world of pricing healthcare. The services they offer online are free and I have no affiliation to Amino.


Amino is a “health data company” and has been around since 2013 crunching numbers and data to help provide insightful analysis for the consumer looking to buy healthcare services. Based on the in depth work in its first two years of existence, it launched its first service online in the Fall of 2015. This first service they offered was a quality based metrics on a doctor by doctor basis, helping the consumer/patient find the most suitable physician. In addition to this useful information, in the last month they have begun to show prices by doctor and by insurance plan.Pricing Healthcare


  • Amino allows you to search the procedure for pricing based specifically on your geographic location and insurance plan
  • Amino bundles the entire cost of the procedure (e.i. for a pregnancy you may receive multiple bills from the hospital, the doctor, the anesthesiologist, etc.), helping to avoid surprise bills
  • It can highlight regional pricing differences within a city and state
  • Amino’s quality and pricing data covers about 550,000 physicians, 49 procedures, and 129 insurance companies
  • It’s data is based on 188 million individuals’ historical data, hundreds of millions insurance claims totaling $860 billion within the last year


There are a few limitations currently, but I believe these are all things they are working to improve going forward.

  • More procedural data is needed, while Amino has hit a lot of the big procedures there is still significant room for growth
  • More quality information would be beneficial. For instance, it may show the rate of replacement surgery for a knee for an orthopedic doctor or rate of c-sections for an OB/GYN which is good info, but more granular and personalized quality info would necessary for a complete decision making process.

Healthcare is daunting. By introducing you to Amino, I hope you benefit by a bit more price transparency. I know it would have helped my family in the few medical issues we have encountered in recent years. And as Amino continues to grow and add more and more detail and services, it should only improve and become more useful.


Just over two years ago, my wife Lucy and I had our first child. What a magnificent experience, we were both so delighted and our families couldn’t have been happier for us either.

Of course, what we didn’t know was how much this was going to cost us or how much insurance would cover. I had tried calling different hospitals in advance to see how things were priced, but it was shocking how little they knew or were willing to share. I could write a whole post on this alone. And if you’ve been there before, you know what I’m talking about!

Ear Tube Surgery

Unfortunately, the little man suffered through a series of ear infections and we ultimately had to have ear tubes put in for him. This was very tough on both Lucy and I, having to have him put under anesthetics, taking him into a surgery center, putting the little man in gown, the whole nine yards. Fortunately the surgery went very well and it was over quickly.

Prior to the surgery, again I was calling multiple places to find the best and cheapest alternative. Having it completed in a hospital would have been over twice as expensive. Similar to the pregnancy, after the procedure we got multiple bills to pay the operating doctor, anesthesia doctor, the facility fee, and I can’t even remember what else.Pricing Healthcare


Late in 2015, Lucy contracted pneumonia. No idea how, but she was definitely under the weather for a while. As it was progressing and she was feeling worse, we were driving home from work one day and she was telling me how bad it was. We look back and laugh now, but my response was something to the effect of “yeah, you must have a bad cold, but it’s not like you got pneumonia…”. I was speaking from experience since I had it once as well years ago.

But the next morning it was so bad that she went to the CVS MinuteClinic, and sure enough she was told she likely had pneumonia. Boy did I “eat crow” after that diagnosis. She had to go to a doctor for an x-ray and to get prescriptions, etc. While more of an emergency, it would have still been nice to do a bit of price shopping to find the best venue and doctor (e.g. family practitioner, ER, Urgent Care, etc).

Amino would have likely been helpful in this circumstance. She ended up going to Urgent Care which we think was the best option in terms of getting in right away, cost, etc.


Each of these situations were unique, but all would have benefitted by greater price transparency as well as a simpler and easier to understand healthcare system. For each situation we had to try to determine where to go for the best treatment at the best cost, but it was not easy and it was more or less a crap-shoot.

These situations are normal too, they happen to everyone, there is nothing unique about them, and they all happened in just the last couple years. This is a very routine problem! Amino is here to help and will hopefully continue to get better.

I’m sure you’ve all had similar situations. We are all in this together trying to find the best care for ourselves and our loved ones. If you’d like, please share your experiences with healthcare and the lack of price transparency in the comments below. Could Amino be a useful resource for you? Will you be bookmarking it in your browser?

Thanks for taking a look!

The Green Swan

Work Harder, Work Smarter, Retire Earlier and Find Your Beach





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  1. The lack of pricing transparency in healthcare is truly amazing. Regardless of your feelings about the Affordable Care Act, I think that one benefit is the move to high-deductible plans which puts the onus on the consumer to know how much things cost. Over time, I think the consumer pressure will move the industry towards greater transparency. I also think that companies like Amino offer a fantastic service and I will certainly check them out the next time we need healthcare. Given history, and a full house, it may not be very long! 🙂

    Perhaps the healthcare industry will see the innovation flourishing like FinTech has had for the past several years – that would be fantastic! There is another company, and the name is escaping me now, that will actually pay you to go to a low-cost provider. For example, assume you need an MRI. You call them up and they will say, if you go to so-and-so facility, we will give you a check for $50. The difference in pricing between a high and low-cost provider is so great, that insurance companies can cut you checks to go to the low-cost once. Amazing.

    1. I’m hesitant to say we need more legislation, but that may be the solution to force greater transparency from both insurance companies and the healthcare provider.

      If you think of it, let me know the company you mentioned. Sounds like it may be the actual insurance company. That’s an interesting business model!

      Thanks for giving it a read, Jon.

  2. Amino (acids!) sounds good JW, health insurance is similarly complicated to compare in Australia, luckily there’s a Govt-run website that helps compare, but it isn’t advertised.

    It’s sad that we think of health providers (doctors, hospitals etc) of all wanting to do their best and they would all provide value, but sadly that isn’t the case. It’s worth it just as much for research health-related-things as looking for car insurance, a new TV or anything else.

    I really like this selfless post JW, nice one.


    1. Thanks Tristan!

      Healthcare purchases definitely call for greater research by the consumer. The problem is how difficult it can be to find good info compared to the vast resources available online to research car purchases etc. Like you said, it’s too bad!

      Thanks for sharing how it works in Australia!

  3. I never know if Going to the doctor (or dentist) is going to be a 20 copayment or a $200 bill in the mail a few weeks later. It. Is incredibly frustrating. I try to look through our insurance coverage but it is confusing and time consuming.

    I will bookmark Amino for later, if it has common procedures/treatments I’m sure it will come in handy.

    1. Yeah it’s so tough to find out. And calling the provider isn’t much help because they can’t even tell you how much it’ll cost! Frustrating!

  4. I’ll have to look into Amino, that sounds really helpful! You guys are like our health doppelgangers. 🙂

    Last year we had a bout of ear infections with our then 2 yr old, followed by a couple of trips to the specialist for ear tube surgery. Thankfully, when we got there her ears were clear, so we took the “wait for the next one” approach before having surgery and she hasn’t had one since, whew! However, going to the regular dr. every two weeks for almost 3 months, along with meds, and then twice to a specialist blew through our pre-tax health savings by April. We were caught off-guard by the specialists’ bills almost 3 months later because what “should have been covered” when we were looking into it before going, turned into a $400 after that fact charge to us for those visits.

    Our health insurance during the pregnancies had fairly transparent pricing, and we toured the hospitals prior to delivery and got packets on typical costs, and were able to get a good number to plan for ahead of time. However, in LA it was only maybe $1200 out of pocket, but TX was almost twice that. The bill sent to our insurance was closer to $20k, $20k! It’s ridiculous considering we were in the hospital prior to delivery less than 40 minutes, had no drugs (all natural), and only stayed 1 night before being discharged.
    The LA birth was still all natural, but due to timing of water breaking, Mrs. SSC had to get Pitocin to move things along. Plus, we were there 2 nights and 3 full days, and it was considerably less on what got sent to insurance and overall bill. It just didn’t make sense comparing the two a few years later.

    Also last year, Mrs. SSC got a cough which we thought was allergies, but a month later had developed into walking pneumonia… It was expensive in the healthcare realm that year. 🙂

    1. Woah! You are our healthcare doppelgangers! That’s crazy how similar it has been for us, not only illnesses, but timing of them as well. Hopefully no more unanticipated healthcare related expenses for a while now, huh?

      I’m surprised, but not surprised about how different your healthcare expenses were for your pregnancies. The shocking part is how Texas was so much more expensive for such less actual care. What can you do?!

      How cool we are doppelgangers though. You’ll have to let me know if anything else happens so I can look out for it and vic-a-versa :).

  5. I like the concept of what Amino is trying to do. Comparing costs is next to impossible, and most of us physicians are completely disconnected from the billing side of things. There is a huge differences between charges and billing, and payments are negotiated separately with the many different payers. It’s a mess.

    I plugged in a couple common procedures into Amino, and the site failed miserably to identify who can do them and what it might cost. For total knee replacement, rather than identifying any of the 6 local orthopedic surgeons who do them, I got physician’s assistants from an hour away as matches. I had to go to the 20th result to get one of the local docs.

    I tried ear tubes, and again, similar poor result. Only 1 of the 2 local ENTs made the long list, and there was no price estimate for ear tubes.

    If there’s a way to get reliable results, it could be a great service. As of now, I wouldn’t bother with it. Thanks for sharing, though.


    1. True, and none of that is available information regarding what the insurer negotiates on your behalf etc.

      Yeah still a bit of a work in progress unfortunately. It’ll be good to reference in the future as things improve.

      It may be a better idea to get referrals for procedures from the family practitioner and then use amino for price comparisons and quality data.

      Thanks for your perspective, PoF.

    2. Hi Physician on FIRE (love the pseudonym!). Hannah from Amino here. Really appreciate all of the thoughtful feedback on our product, and appreciate the time you spent trying out a few different searches. We take data accuracy very seriously, and your specific feedback and first-hand knowledge of your local physicians’ expertise will help us improve the quality and accuracy of our matching algorithm and doctor profiles.

      I want to make sure I capture all the context of what you’re seeing versus what you were expecting. Would it be possible to share the specific parameters of your search for knee replacement and ear tubes? If you could send the URLs that were generated after you went through the search cards, that’d be super helpful – you can send them to [email protected] or share them here.

      Thanks in advance for helping us improve Amino for everyone.

    1. Hi Matt, thanks for your comment – if you do end up using Amino to find a doctor, would love to hear what you think of the experience. Also, I saw that Vox video when it came out – such a frustrating but not uncommon experience. We’re trying to use our data to help people understand the cost of pregnancy, so keep your eyes peeled for that in the future. In the meantime, we have done a lot of analysis around C-section rates, and have an in-product decision factor related to C-sections (you can see what an individual doctor’s predicted C-section rate is, based on their patient mix). Check it out: Thanks again – if you’d like to share any other feedback please don’t hesitate to reach out, I’m [email protected].

  6. Health is expensive business! Companies like Amino help us navigate through the fluff of the industry and explains it is lay-mans terms.
    Nice find Mr Swan

  7. Interesting company – thanks for writing about this.

    Pricing health care ex ante is complicated stuff. This Amino thing seems to be a step in the right direction of enhancing transparency a little. But, even with perfect transparency (which is unlikely to ever be achieved in a multi-layered system like health care), actual cost can differ materially from anticipated cost simply because of minor wrinkles experienced in the course of care. Which introduces added complexity in forecasting expenses because of on-duty specialists that may be out-of-network but in the same facility and used by default. Etc., etc.

    Amino’s an interesting idea, and I’m glad you covered it – thank you – but the company’s swimming upstream against tough currents in providing even reasonable benchmarks.

    1. How true! I know what you mean about the minor wrinkles. For example, going in for a routine annual examine can turn into something more just based on the questions you ask and things the Dr. may look into more to find answers.

      Thanks for the comment!

  8. I have never heard of Amino – but it is really interesting. I totally get what you mean about calling to find out costs of procedures. I did that when I had my hip scoped and it was almost like no one had ever asked those questions before. It was just – oh, you’ll have co-pays and it things aren’t covered fully – you might need to cover something. OK – that’s vague… Heading off to try Amino now.

    1. Hi Vicki! Thanks for your comment. I visited your blog “Make Smarter Decisions” – would you be open to chatting? I’d love to learn more about your audience on the blog and what they’re interested in, and would also like to hear what you think of Amino, too. Let me know – I’m [email protected]. We could set up a call or I could send over more specific questions via email! Thanks, Hannah

  9. Sorry to hear that she (and you!) had pneumonia. Not good! I feel so lucky to be in the UK where our healthcare is ‘free’ whenever I see posts from you guys across the pond about healthcare. If I had to worry about that as well it would be so stressful. Good to see that you have some good plans to help you.

  10. Amino sounds like a very interesting service. With all the changes and premium increases here in TN (they just announced another 40% increase starting in October), we went to a self-pay health-share ministry. The responsibility is on us to find the lowest cost provider and sounds like Amino can help!

  11. Whoa, that’s quite a horror story with the lack of public pricing information. Thank you for sharing Amino, I’ve never heard of them and I think I’m going to keep it in the back of my mind. I just started out being independent last month so I’m having to learn the ropes of everything life alone (in the past, my parents just always knew what was wrong with me) and I understand how important health is. Very informative!

    1. I remember when I was in your shoes! Learning health care insurance and how it worked was a challenge. I’m sure your parents will continue to help but it’ll be good to have Amino as a resource as well. Thanks for sharing!

  12. I’m a Certified Managed Care Nurse and I’ve worked for health plans for 8 years. Even within health plans, making a really well-made search engine that gets a consumer what they exactly need is difficult. I should know, I helped our IT department at work refine ours somewhat, and it still leaves much to be desired.

    I ran a few searches and, though this gets some information, it isn’t as helpful as it could be.

    Search 1: I searched for an ultrasound in my local area. It brought up only OB/GYNs. What if I wanted to get a gallbladder ultrasound? If I am a 35 year old female and I put in ultrasound, will I only get a list places for pregnancy ultrasounds? One of the OB/GYNs on the list was the perinatologist I saw for my own pregnancies, and it had him incorrectly listed as a fertility specialist, when his specialty is high-risk pregnancies, and main focus is autoimmunity.

    Search 2: I looked for eating disorder treatment. My specialty is behavioral health and I know my state is slim pickings when it comes to this. It gave me a few names for pediatricians and psychiatrists. There were no therapists listed. I tried to search for psychotherapists or therapists but there were no listings for therapists unless it was PT or OT. Speech therapy only pulled up ENT docs or pediatricians. One of the most frequent questions I vet at work is “who can I see for outpatient therapy?”

    Search 3: The Medicaid plan I work for also has a commercial Affordable Care Act plan. It was not listed, so I could not search for providers who accept that coverage. None of the ACA plans in my state were listed.

    Another issue, even providers who are specialists will further specialize. Our health plan members are frequently frustrated trying to find who they need to go to. For example, there might be many psychiatrists in one city, but there may be only 1-2 of them who perform electroconvulsive therapy (ECT). There may be 5 high-risk OBs, but there may be one of them that does all of the high-order multiples (triplets, quads, quints) in the city. There may be 4 hospitals that do deliveries, but only one has a Level III NICU. Amino had no way to further refine the search.

    That said, I am 100% in favor of price transparency and helping people estimate costs. I want that for myself as much as anyone else. It’s so hard to do because for every health plan a provider accepts, it’s a different contracted price. A search function that works would be fantastic.

    1. Wow, that’s great information, Jen. Thanks for doing the deep review in your area and also sharing your inside information of how difficult it can be. I agree with you, I wish this was a better way and it is amazing how difficult it can be to find good answers. The quest will continue, but here is to Amino and others in the industry helping us out a bit more. Thanks again for the great comment!

  13. Opaque medical care pricing is probably one of the biggest health care cost drivers. It’s so hard to compare where the best places to get procedures, and price seems to have no relation to quality. I’m glad to see Amino stepping into the information gap.

    1. So frustrating, huh! Hopefully Amino can continue to make strides and help folks out. It’s definitely a step in the right direction! Thanks for the comment!

  14. While I have good coverage on most things with the VA and tri-west. I found emergency room visits are hard to cover. I am glad I found this out on a cheap visit and not some expensive visit.

    To me while there has been some good advances in healthcare coverages the government seems to step in create a problem then needs to go back and attempt to fix the problem, which leads to more problems.

    1. Hi Doug, thanks for sharing. Glad you’re getting good coverage overall from the VA.

      I think you’re spot on with regards to the government fixing and creating more problems. It reminds me of the saying “good enough for government work.”

      Thanks for stopping by!

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