Healthcare price transparency is more important than ever. Blue Cross NC's Cost Estimator tool empowers members to compare procedure costs across providers, estimate out-of-pocket expenses based on their specific plan, and make more informed healthcare decisions.
How would you feel if you were expected to buy a car, a television, or even a meal without knowing first how much it would cost? Confused? Helpless? Frustrated?
Unfortunately, that's exactly how many of us feel when faced with planning a medical test or procedure. We often have no idea how much an MRI or a series of blood tests will cost, much less a major procedure or surgery. This makes a stressful situation even harder to navigate.
Healthcare price transparency has become a national priority, and Blue Cross NC has been leading the way in giving members the information they need to make informed healthcare decisions.
Healthcare price transparency is no longer optional—it's federal policy. Since January 2021, hospitals have been required to publish their prices publicly, and enforcement has intensified significantly in 2025.
February 2025 Executive Order: President Trump signed an executive order titled "Making America Healthy Again by Empowering Patients with Clear, Accurate, and Actionable Healthcare Pricing Information," directing federal agencies to implement and enforce healthcare price transparency regulations rapidly. The order emphasizes disclosure of actual prices rather than estimates and increases enforcement actions against non-compliant hospitals and insurers.
The potential impact is significant: one economic analysis estimated that full implementation of transparency regulations could result in as much as $80 billion in healthcare savings for consumers, employers, and insurers. Another report suggested healthcare price transparency could help employers reduce healthcare costs by 27% across 500 common healthcare services.
Despite these requirements, compliance remains inconsistent. As of 2024, only about 34.5% of hospitals were fully complying with federal price transparency rules. This makes tools like Blue Cross NC's Cost Estimator even more valuable—they provide actionable price information that members can actually use.
At Blue Cross NC, thousands of healthcare claims are processed every day. With all those claims comes valuable data—data that can change the way people shop for healthcare when they have access to it.
Blue Cross NC makes this data available to the public. Everyone in North Carolina, whether they are Blue Cross NC customers or not, can quickly search for common procedures such as MRIs, knee replacements, or hernia repairs and see how costs compare across nearby hospitals and providers.
For example: If you live in the Triangle and need a knee replacement, the price you pay could vary by as much as $21,000 depending on which provider you choose. That's real money that could stay in your pocket.
The Cost Estimator tool includes over 1,200 non-emergency and elective procedures. This robust database means consumers can make more informed decisions about how they spend money on healthcare. It helps tackle rising healthcare costs by preventing consumers from paying more than they have to.
Blue Cross NC's Cost Estimator is designed to be user-friendly and accessible:
Search using everyday terms: Look up procedures using simple language like "back," "neck," or "knee" to find related elective procedures and their costs
Compare costs side-by-side: View pricing comparisons based on Blue Cross NC's broad-network plans (Blue Advantage and Blue Options)
Mobile-friendly access: Use the tool on any device—desktop, tablet, or smartphone—through Blue Connect or the Blue Connect Mobile app
Compare multiple providers: See what doctors and hospitals around the state are charging for the same treatment
View quality ratings: See which providers rank highest for the procedure you're planning
For all North Carolinians (public access):
Visit bluecrossnc.com
Navigate to Find Care
Use the cost comparison tools to search for procedures
For Blue Cross NC members (personalized estimates):
Log in to Blue Connect at bluecrossnc.com or through the Blue Connect Mobile app
Access the Cost Estimator tool from your dashboard
Search for procedures to see personalized cost estimates based on your specific plan
The Cost Estimator tool allows all North Carolinians, including Blue Cross NC customers, to compare both the cost and quality of medical procedures. You can see which doctors and hospitals are in-network and choose the ones that rank highest for the procedure you're planning.
For Blue Cross NC Members Only:
When you log into Blue Connect, your plan is taken into account when viewing procedures. The tool will estimate your out-of-pocket costs based on:
Your specific health insurance plan benefits
Your current deductible balance
Your copayment and coinsurance amounts
Your progress toward your out-of-pocket maximum
This means fewer surprises when the bills hit the mailbox. You can plan ahead and budget for expected healthcare expenses.
Blue Cross NC uses historical claims data to determine cost estimates and create averages. The amounts shown typically include:
Physician and professional fees
Hospital and facility fees
Lab work and diagnostic tests
Medical supplies
Prescription medications related to the procedure
Important note: The Cost Estimator provides estimates, not guaranteed prices. Actual costs can vary based on factors such as anesthesia choices, complications, length of stay, and additional services required during your care. Always discuss expected costs with your provider before scheduling a procedure.
The Cost Estimator is just one of many tools available to Blue Cross NC members through Blue Connect. Other features include:
Provider Search: Find in-network doctors, specialists, and facilities with patient reviews and quality ratings
Drug Cost Estimator: See what's covered, the cost to you, and find new ways to save on prescriptions
Rx Savings Solutions: Tools that find coupons and discounts for the lowest-cost prescriptions
Claims Tracking: Real-time status details on your claims and spending toward deductible and out-of-pocket limits
Urgent Care Finder: Locate nearby urgent care centers as an alternative to costly ER visits
Digital ID Card: Access your member ID card anytime from your phone
Bill Pay: Pay monthly premiums, view payment history, and set up autopay
Compare multiple providers: Don't assume all hospitals or doctors charge the same. Price differences can be significant, even thousands of dollars, for the same procedure.
Check quality ratings too: The lowest price isn't always the best value. Consider quality scores and patient reviews alongside cost.
Know your deductible status: Your out-of-pocket costs depend on how much of your deductible you've already met. Log in to Blue Connect for personalized estimates.
Ask about all costs: When scheduling a procedure, ask your provider for a complete cost estimat,e including facility fees, anesthesia, and any tests.
Consider outpatient options: Some procedures may be available at lower-cost outpatient surgery centers rather than hospitals.
Plan non-emergency care strategically: If you're close to meeting your deductible or out-of-pocket maximum, timing elective procedures can affect your costs.
Healthcare doesn't have to be a mystery. With Blue Cross NC's Cost Estimator and other transparency tools, you have the information you need to make wise decisions about your care. Whether you're planning a routine screening or a major procedure, taking a few minutes to compare costs could save you hundreds or even thousands of dollars.
The more transparency members receive, the more affordable their healthcare becomes. Blue Cross NC continues to invest in tools that make healthcare less complicated and less costly—from cost estimators to prescription savings programs to customer service advocates who provide answers and guidance.
Ready to start comparing costs? Log in to Blue Connect at bluecrossnc.com or download the Blue Connect Mobile app to access the Cost Estimator and start making more informed healthcare decisions today.