My doctor is in network. Her usual office is in network.

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She scheduled me for a procedure that couldn't be done in her usual office. It never occurred to me that her current location could be in-network, but another one couldn't be. And to be clear, this is another location she practices out of regularly.

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As the title says, the facility she used is out of network. And of course, nobody thinks to tell a patient this up front, so they can cancel the procedure.

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Insurance (Cigna) has confirmed the facility it out of network. Still waiting to find out if the anesthesiologist is also out of network and will cost thousands of dollars.

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I cannot afford to pay these charges and I am toweringly furious that something that would be vastly cheaper - were it in network - is costing me this much. This is one of the most enraging parts of our totally fucked medical system in the US. And yes, I have "good" corporate health insurance.

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What are my options here? Cigna said I can appeal, which I intend to do. But I was hoping that people who know more than I could point out how and what I should appeal. In a prior surgery I had with a different insurance, where the hospital was in network and the doc was and the original anesthesiologist was, but then he had to drop out and another was subbed in who wasn't in network, the insurance company allowed the anesthesiologist to be treated as in-network, due to the circumstances.

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So I am wondering what legalese I'd need to appeal with.

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For now, I have contacted my doctor's billing office. They do not communicate at all by phone. They only communicate through email OR they will consider scheduling a 3 way call with my insurance. I have told them that I cannot afford to pay this bill.

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Any help knowing what to ask for or what to look for would be greatly appreciated. I have a sonogram scheduled with the same doc's office for in a few weeks, and I am cancelling it unless they can confirm to me that the sonogram will be covered.

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Update: I spoke to the billing head for my doctor's practice. It turns out that the facility they used never takes insurance and that that should have been disclosed to me up front when booking the appointment. It 100% wasn't. I would absolutely, positively have remembered that and refused to book with them. I feel so strongly about this what I will definitely say to them "Your service says you record your calls. Pull up my call. Show me the proof that you told me you don't take insurance and I verbally consented to that. Or show me the paper I signed that says I consented to this". I read my paperwork very carefully, and I do recall the standard "you're on the hook for what your insurance doesn't pay" paperwork, but I am pretty sure that paperwork was specifically between me and my doc, not the facility. The doctor's office also told me to wait until they get back to me, because at a minimum, they should work with me on the bill, but also they may consider forgiving it. I would still like to know if there's anything in particular that I should ask to see or phrases I should use that have meaning and will help me on this.