Care you needed and did not seek
Was there care you knew you needed but did not go and get?
For example: couldn't afford the copay · no specialist within driving distance · no childcare
Published figures for this pattern of care
Published figures for this pattern of care: $1,304 across 5 priced lines.
5 priced lines
Price table 2026-09-09.1. Every priced line is read from a published federal file, and the file is named on each line. how this is versioned
Medicare reference · national
The total above prices care that happened. Care you needed and did not get leaves no bill, no claim and no row in any federal cost file. National surveys count that it happened; none attaches a dollar to it. So it has no price here, and it is never given one. Count it instead.
Was there care you knew you needed but did not go and get?
For example: couldn't afford the copay · no specialist within driving distance · no childcare
Did a clinician or insurer refuse something you asked for?
For example: doctor wouldn't order the test · insurer denied it · told I didn't meet criteria
Only the numbers go. No name, no journey, no diagnosis, no IP address.
Kept only in this browser until you send it. Count the rest of what went uncounted
Open any line to see who its figure describes. Kept in this browser until you save it.
Sources in this ledger: CMS (5 lines).
Every line carries a thumb. What the public sends back is counted in the open — see the running count.
| What happened | Times | Figure | Line total | Is this figure right? |
|---|---|---|---|---|
| Doctor visits | ||||
you said “saw my regular doctor three times” | 3 | $95.19 | $285.57 | |
you said “then a cardiologist” | 1 | $177.36 | $177.36 | |
| Emergency room | ||||
you said “then the ER once when my heart was racing” | 1 | $544.54 | $544.54 | |
| Scans and imaging | ||||
you said “the heart ultrasound thing” | 1 | $196.73 | $196.73 | |
| Heart, lung and other tests | ||||
| AI read you said “then they put electrodes on my legs” | 1 | $99.87 | $99.87 | |
| No federal figure matched | ||||
and shocked the nerves No federal figure: nerve conduction study: the number of nerves tested wasn't said, and Medicare prices these by that number. Say how many ("they tested four nerves") and it will price; until then it stays unpriced Choose a unit if you know it. | 1 | — | — | |
Beside the money, never inside it
Ranked by the people who carried them at /survey — we price them apart and never weight them. The money is the ledger above. These are the other four: two have a published federal figure behind them, and two do not, so they stay blank.
How many workdays did the search for a diagnosis take from you?
Priced at
blank until you enter a count
Published weekly earnings (All full-time workers) divided by five, times the days you entered. BLS publishes this figure weekly and never daily, so the daily number here is arithmetic on this page, not a government statistic.
Roughly how many hours did someone look after you without being paid for it?
Which kind of care was it
blank until you enter a count
What it would cost to buy the help you were given: bathing, dressing, meals, getting to appointments. The wage is the published BLS median for that occupation, times the hours you entered.
How many times did you travel to get care during the search?
blank until you enter a count
No published federal figure prices a trip to care, so this column stays blank rather than get filled with an estimate. The table does carry the federal mileage rate — GSA, $0.76 a mile from 1 July 2026 — which reimburses federal travellers for a mile driven on official business. It is an input you can apply to your own miles, it is not a medical price, and nothing here adds it for you.
How many times were you told your symptoms were anxiety, stress, or nothing at all?
blank until you enter a count
No dataset records being dismissed. MEPS, HCUP and CMS files record care that was delivered and billed.
Only the number goes. No name, no journey, no diagnosis, no IP address.
Nothing here is filled in for you. Enter a count and the arithmetic appears with the federal row it came from.These figures are never added to the itemized total above, and never added to each other: a missed workday and an hour of someone else’s time are different quantities, and adding them would be the weighting we say we do not do. What you type here stays in this browser under waypoint-ledger.burdens.v1 and is never sent.
Where the cost sits
Medicare fee-schedule lines are allowed amounts. Choose your coverage and where you live above, and every line will say whether that figure describes you.
Take it somewhere
An image drawn in this browser: the number, how long the search took, and where the cost sits. Nothing is uploaded to make it.
This ledger is kept in this browser until you save it. Saving gives you a link that opens it on any device.
Something you can act on
Not our analysis, and not two different visits. One code, CPT 99213, priced by CMS twice in the same year: once where the doctor bills alone, once where the hospital bills too.
$193.47 − $95.19 = $98.28 · 2.0× the price, same code, same year
CMS Physician Fee Schedule (CY2026) and CMS Hospital Outpatient PPS Addendum B (January 2026). The doctor’s share falls to $57.45 in the hospital setting — 1.72 facility RVUs × the same conversion factor — because the practice-expense half of the payment moves to the hospital, which then bills $136.02 of its own.
Ask whether your specialist has an office-based location as well as a hospital clinic, and ask whether the clinic is provider-based — that is the word that turns one visit into two bills. For someone being sent from specialist to specialist over months, this is the largest single lever over what the search costs, and most people have never been told it exists.
Sometimes the hospital setting is the only option, or the clinically correct one. This is a question to ask, not a rule to follow. And a Medicare patient’s minimum copay on the hospital half alone is $27.21.
Doctor's office visit, established patient, low complexity — A follow-up visit with a doctor you have seen before, for a straightforward problem. HOW THIS NUMBER WAS MADE: CMS does not publish a dollar column in the fee schedule. It publishes Relative Value Units and a conversion factor and defines the payment as their product. This figure is 2.85 Total RVUs x $33.4009 (the CY2026 conversion factor for a non-qualifying APM), at national geographic indices of 1.000. Both inputs were read in the CMS file; the multiplication is ours, so this is marked DERIVED rather than VERIFIED. You can redo it yourself. Who this describes: people on Medicare fee-for-service — that is, people 65 and older, plus people under 65 who qualified through 24 or more months of disability benefits or who have end-stage kidney disease. Who it does NOT describe: people on a plan from work, a Marketplace plan, Medicaid, or no insurance, and those usually pay more than Medicare, so read this as the floor, not your bill. Read it as a PRICE FLOOR, not as your bill: commercial insurance normally pays more than Medicare, and an uninsured person is billed the provider's charge instead, which is shown beside this figure where CMS publishes it. For scale, the average CHARGE providers submitted for this same service in 2024 was $189.25 — that is what an uninsured person is billed against, and it is a different kind of number, not an addition to this one.
Hospital's own fee for a clinic visit (billed on top of the doctor's fee) — This is the fee the HOSPITAL charges for hosting the visit, and it is billed IN ADDITION to the doctor's own fee — which is also reduced when the visit happens in a hospital clinic. The arithmetic on a low-complexity follow-up, CPT 99213: $57.45 to the clinician plus $136.02 to the hospital is $193.47, against $95.19 for the exact same visit in a freestanding private office. The service is identical; the address changed the price. This matters more for long COVID than for almost any other condition, because long COVID clinics are disproportionately hospital-based and academic, so the two-bill structure is the norm rather than the exception. A Medicare patient's minimum copay on the hospital half is $27.21. Who this describes: people on Medicare fee-for-service — that is, people 65 and older, plus people under 65 who qualified through 24 or more months of disability benefits or who have end-stage kidney disease. Who it does NOT describe: people on a plan from work, a Marketplace plan, Medicaid, or no insurance, and those usually pay more than Medicare, so read this as the floor, not your bill. Read it as a PRICE FLOOR, not as your bill: commercial insurance normally pays more than Medicare, and an uninsured person is billed the provider's charge instead, which is shown beside this figure where CMS publishes it. This is a national unadjusted rate; every hospital's actual payment is adjusted by its own local wage index, and in some markets that moves it by more than 30 percent. It does not apply at an independent physician's office at all.
The hospital-setting physician payment. DERIVED, same file, same conversion factor. What Medicare pays the CLINICIAN for this exact code when the care happens inside a hospital-owned clinic instead of a freestanding office: 1.72 facility total RVUs x $33.4009 = $57.45. It is lower than the office figure because the practice-expense half of the payment moves to the hospital, which bills its own facility fee on top.
An older, wider corroboration. Across all payers and all ages, AHRQ’s MEPS put the average office visit at $190 and the average hospital outpatient visit at $927 in 2014. That is a much larger gap than the one above, but it compares two different mixes of patients and services and is 12 years old, so it belongs here as background rather than as the finding.
CMS, CY2026 National Physician Fee Schedule Relative Value File (RVU26C, July release, published 2026-06-30) — open the file and check it yourself · CMS, January 2026 Hospital Outpatient Prospective Payment System Addendum B — open Addendum B
After the number
Your doctor · the next specialist
One printed page: every step so far, what each costs in the government’s own figures, and three questions worth asking.
Make the sheetThe agency that published the number
A correction is bound to the exact source row, so it can be handed to the agency that published it. None has been delivered to an agency yet. See the running count.
HR · a benefits administrator · a leave request
An itemized, cited account of what a search for a diagnosis has cost is evidence in a conversation about accommodation or leave.