Paying for surgery
Surgery is a major decision, and we want you to understand the costs clearly before you make it. Here is how your surgeon's fee works, who bills for what, and how to use your out-of-network benefits.
Three simple steps
Verify your benefits
Check your out-of-network benefits before you come in. Reimbursify is free and lets you see what your plan covers for out-of-network care.
Verify with Reimbursify →Review your surgical fee
Our office sets the surgeon's fee for your procedure. Our team goes over it with you before you schedule and answers your questions.
Submit and get reimbursed
Submit your superbill through Reimbursify, which is free for patients, or directly to your insurer. What you receive back depends on your plan's out-of-network deductible, coinsurance, and allowed amounts.
Who bills for what
Your Pearl surgeon's fee is paid to Pearl. The hospital bills its own fees, so call your insurer to ask whether the hospital is in network. If it is, the hospital bills your insurance. If not, ask the hospital about its payment options.
Pearl Health is out-of-network with all insurance plans beginning February 1, 2027, and is not able to see Medicare or Medicaid patients at this time. Outside labs, hospitals, and anesthesia bill separately. Your insurer, not Pearl, sets reimbursement amounts.
Verify your benefits and get reimbursed faster
We use Reimbursify so patients can check their out-of-network benefits and submit their superbills in one place. It is free for patients.
Opens Reimbursify in a new tab.
An investment in your health
Surgery is a major decision, and cost is part of it.
At Pearl, we focus on finding and treating the cause of the problem. That means time spent planning your care, and surgery performed with skill and attention to detail, so you can move forward rather than repeat treatments.
Your surgeon's fee is set by our office for your specific procedure. We walk through it with you before you schedule, so you can weigh the cost and plan with confidence.
In short
You will know your surgeon's fee before you decide, and our team will help you understand the hospital and anesthesia bills too.
Common questions
How much does surgery cost?
The surgeon's fee depends on the procedure and is set by our office. We will give it to you before you schedule. The hospital and anesthesia providers bill separately, and their charges depend on your plan and the facility.
Will my insurance reimburse me?
That depends on your plan. Reimbursement depends on whether your plan includes out-of-network benefits, your out-of-network deductible and coinsurance, and the plan's allowed amounts. It is never guaranteed, which is why we recommend checking your benefits with Reimbursify before your visit.
Do you offer financing or payment plans?
We do not currently offer financing. Our team is happy to talk through your options, and many patients use HSA or FSA funds. The hospital may have its own payment options, so ask them directly.
How is surgery paid for?
Surgery usually involves more than one bill: the surgeon's fee, charges from the hospital or surgery center, and anesthesia. Facility and anesthesia charges are billed separately and may be covered under your in-network benefits. Our team will help you understand which charges go where before your surgery date.
What if my plan doesn't cover out-of-network care?
Your fees are the same for every patient, and you pay at the time of your visit. You still receive an itemized superbill, which some plans, including health shares, will accept for reimbursement. A few plans will also consider a network exception, sometimes called a gap exception, when the care you need isn't available in-network. Your insurer can tell you how to request one.
Can I use my HSA or FSA?
Many patients do. HSA and FSA funds can generally be used for medical expenses, but eligibility depends on your plan, so confirm with your plan administrator.
This page is general information, not a guarantee of coverage or reimbursement. Please check your plan documents or contact your insurer for details.
Want to know more?
For questions about surgical fees or what to expect from your plan, send us a message and our team will walk you through it.