Learn more about the cost of services under a high-deductible health plan

WHA's Medical Service Cost Estimator gives you an upfront idea of the cost of a specific service you intend to receive. As we continue to develop this tool, your feedback is greatly appreciated.

To price a prescription medication, start here.


Service Cost Estimator Cart

Please note: The ability to price a service using this tool does not indicate that the service is covered. The amount for which you will be responsible may be a simple copayment, a percentage of the service cost, or the entire service cost, depending on the plan you choose. To understand the benefit coverage and share of costs, please refer to the plan Copayment Summary and Combined Evidence of Coverage and Disclosure Forms (EOC/DF).

This Service Cost Estimator presents the estimated cost of each service as allowed by WHA's contractual agreements within the last year. The exact costs for services may vary, depending on the PCP's or specialist's medical group, the number of units rendered, procedure codes billed, whether the service is rendered in-network versus out-of-network, and other factors that are not reflected in this tool (for example, when procedures require anesthesia or other related facility or professional services, these may be billed separately). As such, these costs are simply estimates, and should be used as a guideline only. This tool is intended for member use only. The costs displayed represent the basis for calculating the member share of cost and may not represent the amount WHA actually pays a contracted provider when WHA is responsible for payment.

Individual facilities or health care providers may disagree with the methodology used to define the cost ranges, the cost data, or quality measures. Many factors may influence cost or quality, including, but not limited to, the cost of uninsured and charity care, the type and severity of procedures, the case mix of a facility, special services such as trauma centers, burn units, medical and other educational programs, research, transplant services, technology, payer mix, and other factors affecting individual facilities and health care providers.
Service Cost Estimator

For an estimate on a specific service, search by keyword or request the Current Procedural Terminology (CPT) or Revenue Code associated with this service from your prospective medical group.

Need help? We love to help!

Employer Groups: Call 888.499.3198 or email whasales@westernhealth.com.
Individuals: Call 888.563.2250 or email individualsales@westernhealth.com.

Health Plan and Medical Group Report Cards

A report card on WHA's performance for health care and service measures is available on the State of California's Office of the Patient Advocate (OPA) website. Medical Group report cards that compare overall quality, patient experience, and the total cost of care estimates for medical groups with Commercial HMO Plan members are also available on the OPA website.

WHA’s Quality Improvement (QI) Program

The QI program provides a framework to continuously identify and make improvements in all patient care settings. WHA’s QI Program conforms to the standards and requirements set forth by regulatory and accrediting agencies such as the DMHC and the National Committee for Quality Assurance

Visit mywha.org/quality for more on the QI Program’s goals and objectives, structure and scope, and initiatives, as well as an overview of performance improvement projects.  A printed copy can also be obtained by calling WHA Member Services.  A report card on WHA’s performance for health care and service measures is available from the State of California’s Office of the Patient Advocate at opa.ca.gov.

Quality Reporting Websites