What You Actually Owe Calculator

The number a provider bills has little to do with what you owe. What matters is the allowed amount — the rate your plan and the provider agreed on — and then how your deductible, coinsurance, and out-of-pocket maximum divide it.

Working this out yourself is the only reliable way to catch the two most common errors: being billed against the full charge instead of the allowed amount, and being billed after your out-of-pocket maximum was already met.

Compare this against the EOB, not the bill

The explanation of benefits from your plan and the bill from the provider are different documents produced by different parties. When they disagree, the EOB is the one that reflects the contract. Ask the billing office to rebill against it.

The three errors worth checking every time

1. Billed on the full charge. If your share was calculated on the billed amount rather than the allowed amount, it is wrong.
2. Deductible already met. Claims processed out of order routinely apply a deductible twice.
3. Surprise out-of-network charges. Emergency care, and care from providers you did not choose at an in-network facility, carry federal protections against balance billing.