I Made $1,201 on My Colonoscopy (No, Really)

A colonoscopy came with an $11,000 price tag. One simple question dropped that bill to $799. Then an indemnity plan paid out $2,000 — leaving $1,201 in profit. Same procedure. Same doctor. Same hospital. Completely different result. Here's why this works, and how small business owners can set up benefits that make this possible for their employees.

The One Question That Changed Everything

The question was simple: "What's the cash price?"

That's it. No negotiating. No insurance haggling. Just asking for the self-pay rate. The bill dropped 93% on the spot.

This isn't a fluke. Cash prices at hospitals and surgery centers are often 50–80% lower than what insurance companies are billed. The "list price" — called the chargemaster rate — is inflated on purpose. Then insurers advertise their "network discount" off that inflated number. It looks like a deal. It isn't.

When you skip the insurance game and just ask for the cash price, the real cost shows up fast.

Why Indemnity Plans Make This Even Better

Here's where it gets interesting. An indemnity plan pays a fixed benefit for covered procedures — no matter what you actually paid.

In this case, the indemnity plan paid $2,000 for the colonoscopy. The out-of-pocket cost was $799. That left $1,201 in the employee's pocket.

That's not a loophole. That's the design. Indemnity plans have no deductibles and no copays. The employee gets a set payout, shops for the best price, and keeps whatever's left over. That financial incentive changes how people think about healthcare spending.

When employees know they keep the difference, they shop. When they shop, providers compete. When providers compete, prices drop for everyone.

How Small Businesses Can Offer This

This is exactly the kind of benefit The Benefit X-Change helps small businesses set up through an ICHRA — an Individual Coverage Health Reimbursement Arrangement.

Here's how it works:

• The employer sets a defined monthly contribution amount — no ICHRA maximum, so it's completely flexible.
• Employees use that contribution to buy their own individual health insurance plan with Minimum Essential Coverage (MEC).
• Employees who prefer a different path can opt out of the ICHRA and choose the employer-sponsored indemnity plan instead.
• If the indemnity premium is less than the employer's defined contribution, the employee pays nothing. If it's more, the difference comes out of their paycheck.

The indemnity option is what makes stories like this colonoscopy possible. Employees have real skin in the game — and a real reward for being smart healthcare consumers.

The Bigger Picture

Most group health plans hide the true cost of care behind deductibles, copays, and "network rates." Employees never see the real prices, so they never shop. That's not an accident.

Indemnity plans flip that model. Employees see the prices. They ask questions. They find cash rates. They keep the savings. That's how you build a benefits package that actually works for the people using it — and for the business paying for it.

Ready to Rethink Your Employee Benefits?

The Benefit X-Change makes it simple for small businesses to offer flexible, affordable health benefits through ICHRA — with the indemnity option available for employees who want to shop smarter.

Visit benefitx.com to learn how to set up a plan that could put money back in your employees' pockets — starting today.