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Medical Expenses Calculator

Faster, transparent, defensible medical expense valuation

The Optimalex Medical Expense Calculator helps claims, legal, and medical teams estimate procedure-level medical costs with speed and consistency—grounded in broad market coverage and transparent pricing breakdowns. Users rely on it to assess demands across 155 million procedure–hospital combinations, enabling confident evaluations even when scenarios involve uncommon procedures, remote geographies across the country, or highly variable price ranges.

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What it does

The Medical Expense Calculator provides a structured way to research and quantify medical expenses by:

  • Location (50 States and 3,200 Counties)

  • Medical facility (6,600 hospitals)

  • Procedure selection (select the relevant procedure among 155 million)

  • Pricing statistic (over 1 billion price points from multiple percentiles)

 

Once selected, the tool returns a clear medical bill view with:

  • Discounted Cash (paid by individuals with no insurance coverage)

  • Gross Charge (hospital list price)

  • Contract price (insurance negotiated ranges) 

  • Facility-level results (hospital and medical center)

 

Why it matters

Medical expense demands can vary dramatically by geography, provider, facility, and pricing basis. The Medical Expense Calculator is designed to reduce guesswork by presenting the most relevant price views side-by-side—so you can:

  • Anchor evaluations to consistent market-based references

  • Explain “why this number” with a transparent breakdown

  • Identify when a quoted amount is within a typical range (or an outlier)

  • Move faster from research to decision-making

 

Common use cases

  • Magnitude check medical expense invoiced to you

  • Pre-suit and litigation support: promptly establish defensible medical expense estimates

  • Claims evaluation: support your reserve with or compare demanded amounts  against market-based price points points

  • Negotiation preparation: understand pricing dispersion to support ranges and counter offers

  • Scenario analysis: validate how changes in location or facility affect expected costs

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