estimate_procedure_cost
Estimate medical procedure costs in a US state, including allowed-amount range, billing components, risk flags, and out-of-pocket expense based on insurance details.
Instructions
Estimate what a medical procedure costs in a US state: allowed-amount range (low/median/high), billing components, risk flags, and — if insurance details are given — the patient's expected out-of-pocket. Use resolve_procedure first if the user gave a free-text procedure name. Always present ranges, not single numbers, and cite the returned data_vintage.
Input Schema
| Name | Required | Description | Default |
|---|---|---|---|
| state | Yes | 2-letter US state code, e.g. 'CT' | |
| zip_code | No | Optional 5-digit ZIP for locality | |
| plan_type | No | Insurance plan type (default commercial) | |
| procedure | Yes | Procedure slug or plain name, e.g. 'colonoscopy' or 'mri-knee' | |
| oop_remaining | No | Dollars left to the member's out-of-pocket max | |
| coinsurance_pct | No | Coinsurance percentage, e.g. 20 for 20% | |
| deductible_remaining | No | Dollars left on the member's deductible |