Medical doctor © tetra images, Getty Images

Philip Reed, senior consumer advice editor for car site Edmunds.com, negotiates purchases and leases for his company’s fleet. He never expected his bargaining skills to come in handy at the doctor’s office.

Phil was considering knee surgery, and his doctor’s office told him his out-of-pocket costs would be $5,000. But when Reed balked at the price, his share of the cost suddenly dropped to $3,500.

“I felt like we were at a used car lot,” Reed said.

Many people don’t realize that medical costs are negotiable, said Jeff Yeager, the author of “How to Retire the Cheapskate Way” and the Ultimate Cheapskate website.

“By and large, most Americans don’t think they can negotiate anything except a car,” Yeager said. Yet as with cars -- perhaps even more so -- the cost of medical services is rarely fixed.

Even people who are skilled at haggling down other costs may be hesitant to seek a better deal from a medical provider. A Consumer Reports survey of 2,000 adults found that nearly half had tried bargaining down the price of an antique or collectible, and 89% were successful, saving an average of $72. One third had tried haggling the price of a cellphone plan, with a 76% success rate and savings of $80.

But only one in five had tried negotiating a medical or dental bill. Most of those -- 69% -- were successful, and the average savings was considerably higher: $300.

Some people try bargaining because they don’t have health insurance or have big deductibles, Yeager said. But any out-of-pocket expense may be negotiable. Diane Ostrowski Martin of Rancho Cucamonga, Calif., told her dentist’s office that the fee it was charging for crowns was too high. Immediately, she reported, the price came down.

Image: Liz Weston

Liz Weston

Offering to pay cash is one way to win a speedy discount, as Chris Peplinski of Plymouth, Minn., discovered.

“For the birth of our child, I called the billing (department) and told then I could pay $1,500 today but had to make payments on the $2,300,” Peplinksi wrote on my Facebook fan page. “They took my offer.”

Not every reader reported success, however. Joyce Taylor of Stillwater, Okla., wrote that her request for a break “didn’t go well.”

"My doctor looked at me and said, 'I don't have any idea how much anything costs,'" Taylor wrote.

Knowing whom, when and how to ask are the keys to getting a deal, Yeager said. His advice:

Bring it up early in the conversation. Your ability to pay is a relevant factor in medical discussions. If money is tight, alerting your medical provider in advance is often better than trying to fight unmanageable bills after the fact. “I would never encourage anyone to plead poverty if that isn’t the situation, but these days a lot of people are hurting,” Yeager said. “Disguising that fact until after the procedure doesn’t make any sense.” (What if you’ve already incurred the costs? You’re not out of luck. There are plenty of ways to get a break, as I wrote in “How to haggle over medical bills.”)

Talk to the billing department. As Taylor discovered, the person providing you the medical service often isn’t the one who sends out bills and wrestles with insurance companies for reimbursement. Talking to that person or department may take you further in your efforts to get a break.

Research the blue book cost. The Kelley Blue Book can help people figure out what they should pay for a car. The Healthcare Blue Book offers a similar service, posting average prices for thousands of medical and dental treatments. You may be able to negotiate a better deal, of course, but the averages can help you in your negotiations and alert you if a quoted price is far out of line.

Ask what insurers pay. Insurance companies negotiate significant discounts off the “rack rate” of what medical providers supposedly charge, said Nicholas Newsad, a senior associate at HealthCare Appraisers and the author of “The Medical Bill Survival Guide.” If you don’t have insurance, it’s fair to ask that you be charged no more than what your area’s largest insurer would pay for the same procedure.

Offer to pay cash, if you can. Paying with cash means the medical provider doesn’t have to wait months for money or pay a cut to a credit card processor.

Settle for an affordable payment plan. If all else fails, ask for more time to pay the bill. “A longer repayment term is a pretty easy get,” Yeager said. Many providers offer interest-free, two-year repayment plans that you may be able to extend even further.

“The bottom line,” Yeager said, “is that it always pays to ask.”

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Liz Weston is the Web's most-read personal-finance writer. She is the author of several books, most recently "The 10 Commandments of Money: Survive and Thrive in the New Economy" (find it on Bing). Weston's award-winning columns appear every Monday and Thursday, exclusively on MSN Money. Join the conversation and send in your financial questions on Liz Weston's Facebook fan page.

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