IN NETWORK VS. OUT OF NETWORK

 Your doctor charges $1000 for your surgery.

 Your doctor and Cigna have an agreement that your doctor   will accept the usual rate of $600 rather than $1000.

  Assuming you've met your deductible, you are charged 20%   of the $600 usual rate, or $120. The Plan is charged 80%, or   $480. These percentages are your and the Plan's IN Network   co-insurance, which vary amounts depending on your plan.

 Because of this agreement between your doctor and Cigna,   you cannot be billed for the $400 difference between the   charges and usual amount.

 Your IN NETWORK BILL totals $120.

 Your doctor charges $1000 for your surgery.

 There is no agreement between Cigna and your doctor, so   your doctor can charge you more than the usual rate.

 Assuming you've met your deductible, you are charged 40%   of the $600 usual rate, or $240. The Plan is charged 60%, or   $360. These percentages are your and the Plan's OUT OF   NETWORK co-insurance, which vary amounts depending on   your plan.

 There is no agreement between your doctor and Cigna,   therefore your doctor could balance bill you for the $400   difference between the charged and usual amount.

 Your OUT OF NETWORK BILL totals $640.

 BEWARE OF SURPRISE OUT OF NETWORK CHARGES
 Before surgery or procedures that require anesthesia, talk to your doctor and/or billing office to   inquire about their use of out of network surgical assists, anesthesiologists, CRNA;s or other   ancillary  providers. Be informed before your procedure so that you can make a decision about your   potentially substantial out of network charges.