BOSTON ( TheStreet) -- While a Nevada candidate's suggestion of bartering for medical care was the butt of jokes -- "In the olden days, our grandparents, they would bring a chicken to the doctor," Republican Sue Lowden said in April -- haggling over medical bills is starting to become an accepted strategy. The potential prize: medical tests and procedures for half the cost. Faced with high-deductible plans and uncovered procedures, even those with health insurance are facing increasing out-of-pocket expenses. But the uninsured, bereft of the clout of big insurance companies -- among them UnitedHealth Group ( UNH), WellPoint ( WLP), Aetna ( AET), Humana ( HUM) and Cigna ( CI) -- can pay up to 2.5 times more for the same services. As a result, and with unemployment rates at an all-time high, one in five Americans chose not to seek medical care for a recent illness or injury, according to a recent Deloitte Center for Health Solutions survey. Four out of 10 cited cost as the primary factor. Angie Hicks, founder of Angie's List, a site that posts consumer reviews on doctors, dentists and service companies, says negotiating over medical care is a trend in its early stages. In a May poll of 1,237 Angie's List members, 57% said they have never negotiated a medical bill. Nearly 25% didn't even know they had that option. But, of those who did negotiate, 74% did so successfully, with some reporting that they cut their bill in half. More than 40% of those who bargained with their medical provider said they did so because their insurance didn't cover as much of their bill as they had expected. "By no stretch of the imagination do we just suggest that you should shop your medical treatment only by price," Hicks says. "But there are ways you can shave some dollars off your expenses without impacting quality at all." "The health care community has been negotiating with insurance companies forever," she says. "Negotiation is not foreign to them at all. The difference here is that consumers are sitting in the pay seat more today than they used to be, so it is just changing who is doing the negotiating. Consumers should feel comfortable asking these questions." "It is very hard to get a fair price if you worry about it after you get your care," says Dr. Jeffrey Rice, CEO of HealthcareBlueBook.com. "It is like buying a car and waiting for them to send a bill in the mail before you know what you will be paying."