With her first three pregnancies, Amanda Partee-Manders didn’t think twice when she received her hospital bills. She looked at the total and paid what she was asked.

But in October 2021, after giving birth via Cesarean section to her youngest daughter, Partee-Manders took inspiration from a viral internet trend where users share their outrageous medical charges, and requested an itemized breakdown of her bill. The detailed list of her charges, which totaled $47,091.01, shocked her.

“It said $5,600 for my room, the recovery room is $12,000, [and] the labor room is $2,500,” Partee-Manders said. “IV Tylenol was what caught my eye the most. It made no sense that it would be nearly $4,000 for four doses of it.”

Partee-Manders knew that since President Donald Trump signed an executive order in June 2019, hospitals were now required to provide prices for their services online. But the bill she received after the fact was written in her hospital’s computer code, which made it difficult to understand. Fortunately, Partee-Manders had a friend who worked in hospital billing and coding, who was able to decipher the itemized list. Now equipped with de-coded bills and empowered to research prices online, Partee-Manders learned that the IV Tylenol she was charged almost $4,000 for was a fraction of the cost elsewhere.

“The other thing was physical therapy,” Partee-Manders said. Shortly after giving birth, a pelvic floor therapist came to her room for an initial consultation, which she was charged for. But during that visit, she said the physical therapist was interrupted, having to leave and come back. “There is a second charge that is listed as a follow-up visit with exercises and everything,” Partee-Manders said, continuing,

“It was maybe 12 hours post-major abdominal surgery. There was no physical therapy to be done. I was sitting in a chair, I think, holding the baby, freshly cut open, and we just had a discussion, a talk. It was 15 minutes maximum with both visits. And so the way that it’s even written in the bill, it’s as a follow-up, an eval follow-up, and that all amounted to hundreds and hundreds of dollars.”

While reading through her bills, Partee-Manders began researching a code that she discovered was meant for an outpatient clinic visit. The $522 outpatient charge confused her because Partee-Manders was an inpatient in the hospital during her C-section, and she already had a bill accounting for those costs.

In trying to understand the exorbitant charges for services and treatments like Tylenol or an outpatient visit she didn’t receive, Partee-Manders noticed how her insurance company and billing department appeared to point fingers at one another in an attempt to shift blame. 

Inspired by nurses she saw on TikTok who share informative videos about how to understand your own medical bills, Partee-Manders said she refused to pay a dime until she could negotiate what she felt were erroneous charges. Though Partee-Manders has what she considers to be good health insurance, both her hospital and insurance company would not reduce any of the charges. 

“I didn’t want to pay it, I wanted to continue to fight,” she said. But because she and her husband were in the process of buying a house and needed to secure a loan, Partee-Manders eventually gave in and paid her outstanding balance of $3,677.70. Despite that, more than a year later, a collections agency is still claiming that her medical bill is unpaid.

“I’m not giving them another dime, especially since so much of the bill was wrong,” she said. 

Instead of receiving a shocking medical bill for giving birth after the fact, Partee-Manders said she’d much prefer to have seen the estimates upfront. “Just knowing, hey, if you go this route, if your baby is born this way, you’re looking at this much, and if it’s born this way, maybe you’re looking at a range,” she said. “At least it gives you kind of a number in your head so you can plan and you can budget.”

Federal law now requires hospitals and insurers to display prices upfront so patients can shop for healthcare services, tests, or procedures, just as you shop for anything else on the market.

But that isn’t happening. Americans like Partee-Manders are still getting hit with surprising medical bills, often when it’s too late to negotiate. Nearly 60% of people report receiving a medical bill they weren’t expecting.

“It shouldn’t be so cryptic and you shouldn’t have to resort to an app to get information,” she said, adding, “With how much information we have at our fingertips, it’s just funny how much information is still underneath a veil.”

When Partee-Manders posted her story on TikTok, her video went viral, receiving almost 230,000 views. She said that she felt upset reading through the comments of other young moms sharing their own outrageous medical billing stories, such as being charged for skin-to-skin contact with their babies.

“It’s important to connect with other people and to talk about these issues, to be vocal. 

Because if you just sit at home and cry over your bill, which I mean I’m sure I did, no real change can come from that,” she said. “If we knew what things were actually going to cost, I do think it would make a difference in choices that you make, in hospitals that you go to, and practices that you see.”