Big difference between two hospital quotes? Get itemized estimates, then compare the same scope
After receiving two treatment quotes, first check whether the doctors recommend the same treatment goal and scope, then ask the hospitals to fill in the items, quantities, and exclusions. A quote is an estimate based on the information available at the time, not the final bill. Mark blank items as “to be confirmed”; do not assume they are free.
Key points
- Give both hospitals the same version of your medical records. Ask each doctor or department to explain the treatment goal, scope, and uncertainties. If the plans differ, ask for the clinical reasons first; do not compare only the total prices.
- Mark each item as included, excluded, conditional, to be confirmed, or not applicable. Package quotes and itemized quotes must also be broken down to cover the same stages and quantities.
- An advance payment is a payment arrangement. Confirm with the organization collecting it whether it will be credited toward the final bill and under what conditions it is refundable. The hospital and insurer must separately confirm insurance coverage, direct billing, and how much you must pay upfront.
- Estimates may change with test results and treatment. If a hospital cannot give a maximum cost, ask which items may change, how they will be charged, and how you will be notified.
Check whether the plans are comparable
If your condition is urgent, first discuss with your current doctor which assessments need to be completed immediately. Do not delay care while waiting for a second quote.
Give each hospital the same information, labeled with its date and version: your diagnosis or the problem to be addressed, available pathology and original imaging, previous treatments and dates, current medicines and allergies, recovery needs, preferred appointment timing, and whether you will use insurance or pay yourself. First confirm a secure submission channel with the hospital. Unless requested, you do not need to send complete identity documents through ordinary chat.
Ask the receiving care team to explain who reviewed which materials. Record the hospital name, campus, service channel such as standard care or special/international medical services, department, proposed doctor in charge, clinical review date, and billing contact. You can ask the hospital to confirm materials forwarded by a coordinator; a logo alone does not prove that a quote is official.
List the treatment goal, recommended procedure or medicine, body area or treatment cycles, expected benefits, main risks, alternatives, tests still needed after arrival, expected hospital stay and recovery time, and who will provide follow-up after discharge and after you return home. If one hospital recommends mainly diagnostic care while the other recommends surgery, or their treatment goals differ, ask the doctors to explain why. Direct price comparisons are appropriate only after the clinical teams confirm that the plans cover comparable scopes. Also ask about the relevant department’s experience, multidisciplinary support, and ability to handle emergencies and complications. A hospital’s grade, reputation, or price alone cannot replace this information.
Ask the hospitals for itemized estimates
Ask each hospital to use your current condition and proposed care pathway to list, as far as possible, each item’s name, specifications, billing unit, unit price, estimated quantity or number of days, subtotal, currency, and what is included, excluded, or subject to conditions. The estimate should identify its issuer, date, version, validity period, and billing contact. Mark items that cannot yet be determined as “to be confirmed,” and ask when they can be confirmed. If the hospital cannot provide a unit price, ask for the package scope or charging method.
Ask about the following items according to your actual condition; do not assume everyone needs them:
| Stage or item | What to clarify |
|---|---|
| Assessment and tests | Doctor consultations, multidisciplinary discussions, review of existing imaging or pathology, and laboratory tests or examinations that need to be repeated |
| Procedures or systemic treatment | Scope of surgery or procedures, doctor and procedure-room charges, anesthesia monitoring; generic medicine names, specifications, the basis for dose-related charges, cycles, and number of monitoring sessions |
| Materials and medicines | Names or specifications and quantities of implants, special devices, consumables, blood products, supportive medicines, and discharge medicines; how alternatives are charged |
| Hospital stay and recovery | Room type, bed and nursing days, whether meals cost extra; whether intensive care, rehabilitation, nutrition, pain management, or psychological support are included, and the number of sessions |
| Discharge and follow-up | Number of medical-record copies, document translations, follow-up visits, tests, or remote follow-up sessions, and who is responsible |
| Language and other services | Languages and hours available for medical interpreting, document translation, coordination, and courier services; who charges for them and whether they are included in the medical quote |
Ask for the estimated total for the base scenario, the amount without optional items, and any backup scenarios the hospital can describe. For example, ask how charges would apply if test results change the procedure or medicine, or if you need additional pathology, intensive care, a longer hospital stay, treatment for complications, cancellation or postponement, or an unplanned follow-up visit before returning home. Ask who will notify you and how nonurgent additional charges will be confirmed. The hospital may not be able to set a maximum in advance. You can ask it to list the charges for an extra bed day or other known items. List unknown costs separately; do not treat them as zero.
You can send the same message to each hospital:
Please provide a written estimate for your hospital and campus based on the dated medical summary attached and the proposed treatment pathway. Please list the main items’ names, specifications, estimated quantities or days, billing units, available unit prices, subtotals, and currency, and explain what is included, excluded, conditional, or to be confirmed. Please state the basis of the estimate, its validity period, the main reasons it may change, advance-payment and refund rules, and the contact responsible for explaining charges. Please have the receiving clinical department confirm the clinical scope.
The National Health Commission’s rules on internal price management at medical institutions apply to public medical institutions; nonpublic medical institutions may use them as a reference. The rules require publication of commonly used prices and provision of itemized cost statements, except for billing by disease category or diagnosis-related group (DRG). An advance estimate is different from a statement listing costs actually incurred. During care, you can ask the hospital how to access your cost statement. However, these rules do not guarantee that every hospital can provide final unit prices for all items in advance. Refer to the documents the hospital can provide and its actual billing rules.[1]
Put both quotes in one table
Record each line using the same treatment stages, number of cycles, room category, and service channel. For each line, enter “included / excluded / conditional / to be confirmed / not applicable” and the amount. Specify whether the amount is per session or for the full course, and per day or for the estimated total hospital stay. If a hospital offers a package, ask which items and quantities it includes, and do not add included charges again.
For example, Shanghai United Family Hospital’s published surgery package includes a preoperative assessment after the decision to proceed with surgery, surgery, and some postoperative care. It excludes the initial consultation and diagnostic tests before the decision to proceed with surgery. The hospital’s doctors determine eligibility, and the page specifies self-payment. This describes only the published scope of that hospital’s particular package; it does not represent other packages or your current quote. Ask the hospital to confirm the current terms before relying on it.[2]
Separate hospital medical charges from charges for outside laboratories, outside pharmacies, coordination, transfers, hotels, accompanying assistance, visas, translation, insurance administration, and banking. Record who receives each payment, what receipt or invoice is provided, and the refund rules. Also confirm EastMedGo’s coordination fees separately from hospital medical charges; see Services and fees and Cancellation and refund terms.
For quotes in different currencies, keep the original amounts and choose one common currency for comparison, recording the exchange-rate source and date. List currency-exchange fees separately. Exchange-rate changes and hospital price changes are separate matters. Send each hospital the same numbered questions about missing items, ask for a revised quote or written response, and save each version. Do not forward the other hospital’s confidential quote.
Use the table below to ask both hospitals about individual items. Write “to be confirmed” for anything unknown; do not treat it as free.
| Item | Quantity / days | Hospital A: currency and amount | Hospital B: currency and amount | Included / excluded / to be confirmed |
|---|---|---|---|---|
| Tests, treatment, room, etc. |
Finally, write a one-page decision record: clinically feasible options, differences between plans, the conditions that matter most to you, base costs and any backup costs that can be described, unresolved questions, and what changes would lead you to compare again. Price is only one factor; language support, timing, travel feasibility, and care after discharge must also be arranged. Be cautious of quotes that guarantee results without adequate assessment, pressure you to pay a personal account, refuse to identify the campus and doctor, or claim to be “all-inclusive” without explaining exclusions.
Calculate total costs and the money you need to have ready separately
First total the estimated medical costs and the separately listed nonmedical costs over the same time period, without subtracting deposits. Then check the payment schedule: when advance payments, top-ups, and final settlement are due, and how any remaining balance will be refunded. Ask which costs are refundable if you cancel, reschedule, face visa delays, or have your plan changed by the doctor, and whom to contact. Keep official receipts, and verify the payment recipient through the hospital’s official channels before paying.
If using insurance, ask the insurer to confirm whether your specific policy covers the campus, department, and services, whether preauthorization is required, and any limits and deductibles. Then ask the hospital whether it can bill the insurer directly for this policy and service, and whether it has received the required guarantee documents. Any unconfirmed insurance payment remains unknown and must not be deducted from your budget as guaranteed funds. Even if direct billing is available, ask which costs you must pay upfront, when payment is due, and how settlement works. If you must pay first and claim reimbursement later, prepare enough money to pay on site and keep the medical records, itemized statements, and proof of payment required by the insurer. If a deposit has already been credited toward the bill, do not add it to the total cost again at settlement.
For example, Jiahui Health publishes direct-billing arrangements with some insurers and states that certain eligible clients can apply for approval in advance. This does not mean your policy or all your costs have been approved. Ask both parties to verify the arrangements for this service.[3][4]
Check charges during treatment and at discharge
Ask the ward or billing office how to review itemized charges regularly, and check tests, medicines, materials, and hospital days. If something is unclear, appears duplicated, or involves a room-type change, ask the billing office and clinical team to explain. Ask the hospital to update the estimate after a treatment-plan change. For large, nonurgent additions, try to confirm the cost and document the discussion before the cost is incurred. In an emergency, let the medical team provide care first.
Before discharge, request the final itemized cost statement, invoice or receipt, records of deposit credits and balance refunds, and medical records required by your insurer. If the final bill exceeds the estimate, identify added items, quantity changes, or price differences line by line. Ask the hospital’s billing inquiry or complaints service to explain, and keep its responses. For outstanding payments and pending refunds, record the person responsible and the next step.
Frequently asked questions
What if the hospital gives only one total price?
Use the table above to ask about anesthesia, medicines, implants, hospital stay, and follow-up, which can have the greatest effect on the total. Ask for inclusions and exclusions. Keep items the hospital cannot break down as packages and state their scope. Mark anything unconfirmed as “to be confirmed.”
Can I still compare if the two doctors recommend different plans?
You can record each plan’s goal, reasons, risks, and follow-up care side by side, but do not treat the totals as quotes for the same plan. Ask the doctors to explain the differences and what additional information is needed.
Can a hospital guarantee the final cost will stay within budget?
Not necessarily. Tests, treatment response, and length of stay can all change costs. Clarify the current assumptions, possible changes, and charging methods. Do not enter a maximum cost yourself unless it has been confirmed.
What if a package does not specify the model of a medicine or implant?
Ask the hospital to explain its current assumptions, available specifications, quantities, and how substitutions are charged. If the clinical team cannot yet determine the choice, mark it as “to be confirmed.” Do not treat one product’s price as the price for all options.
If the hospital says it accepts insurance, does that mean I do not need to pay?
Not necessarily. Ask the insurer and hospital to verify your specific policy, this service, preauthorization, direct billing, and any uncovered costs. Ask whether you need a deposit or funds to pay upfront when you arrive.
Can I ask about prices before I have time to provide complete records?
You can first ask for a price range and what information is needed for a formal estimate, but label the initial response “pending assessment.” After your information or plan is updated, ask the hospital to reissue or confirm the estimate.
Whom should I contact if the discharge bill is higher than the estimate?
Take the estimate and final itemized statement to the hospital billing office and check the differences line by line. Ask the clinical team to explain any treatment changes. If the issue remains unresolved, use the hospital’s published complaints channel. Keep invoices, supporting documents, and written responses.
Sources
Date checked: 2026-11-06. Prices, services, and insurance policies may change. Your individual quote is subject to the relevant organization’s written response.
- National Health Commission: Rules on Internal Pricing Practices at Medical Institutions: Publication of commonly used prices and provision of itemized cost statements.
- Shanghai United Family Hospital: Surgery Bundle: Scope, exclusions, and eligibility conditions of the listed package.
- Jiahui Health: Insurance Direct-Billing Partnerships: Partnership information published by the hospital.
- Jiahui Health: Partnership with HSBC Life Hong Kong: Advance approval and direct-billing information for specifically eligible clients.