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Medical Cost Estimate Calculator

Work out medical cost estimate instantly with clear inputs, formula shown and shareable results.

About Medical Cost Estimate Calculator

Applies the deductible first and then your coinsurance percentage to the remaining balance, the standard order of operations on a medical bill.

Formula

Cost sharing

Patient cost = remaining deductible + coinsurance x (billed amount - deductible applied)

Worked example

With the default values below, Medical Cost Estimate Calculator returns Your estimated cost of $3,200.00. Change any input above and every figure here is recalculated in your browser.

Inputs used

Billed amountaccepts 1–1,000,000
12,000
Your coinsurance shareaccepts 0–100
20
Deductible still to payaccepts 0–50,000
1,000

Results

Your estimated cost
$3,200.00
Insurer pays
$8,800.00
Coinsurance portion
$2,200.00
Effective coverage
73.3%

Step by step

  1. 1Values used
  2. 2Cost sharing
  3. 3Your estimated cost= 3,200.00
  4. 4Insurer pays= 8,800.00
  5. 5Coinsurance portion= 2,200.00
  6. 6Effective coverage= 73.3

Assumptions and limits

  • The result is derived only from the 3 inputs listed above. Anything not among them is not part of the calculation.
  • In particular, this calculator does not take inflation, fees or charges or compounding frequency into account.
  • Figures are rounded for display to 2 decimal places, so totals built from several rounded parts can differ slightly from the unrounded arithmetic.
  • Educational estimate only. Not a substitute for professional clinical judgement, and must not be used to make treatment or dosing decisions.
  • This is an estimate for general information and not professional medical advice. See the full disclaimer for the limits that apply to this kind of calculator.

How these calculators are built and tested is described on the Methodology page. If a figure looks wrong, please report it.

Educational estimate only. Not a substitute for professional clinical judgement, and must not be used to make treatment or dosing decisions.

Frequently Asked Questions

Does the out-of-pocket maximum cap this?

Yes. Once the annual out-of-pocket maximum is reached, covered in-network costs are paid in full by the insurer.

Why is the billed amount not what is paid?

Insurers pay a negotiated allowed amount, so cost sharing is usually calculated on that rather than the list price.

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