How much might that MRI cost in an Idaho hospital? The amount could vary by the thousands
Idaho patients pay drastically different prices for the same procedures, even at the same hospitals, according to a new report from Patient Rights Advocate.
The Massachusetts-based nonprofit, which advocates nationwide for price transparency within the health care system, found that prices for common medical services within the same hospital varied tenfold when comparing insurance plan negotiated rates. Prices varied even more, by 31 times, across different hospitals within the same states.
The group analyzed 100 hospital pricing files across 10 states, including Idaho, to determine price variations for five procedures: appendectomy, arthroscopic knee surgery, cesarean section, cataract surgery and MRI of lower extremity without contrast.
In Idaho, the nonprofit looked at Saint Alphonsus Regional Medical Center in Boise, Portneuf Medical Center in Pocatello, Kootenai Health in Coeur d’Alene and Bingham Memorial Hospital in Blackfoot.
Researchers found that the cost for an MRI of lower extremity without contrast at Saint Al’s varied between $133 and $2,074 among insured patients. For a knee replacement at the hospital, the cost ranged from $2,081 to over $6,980. The health system has a price estimates portal on its website.
“That’s a three times price difference,” said Ilaria Santangelo, director of research at the nonprofit.
She told the Idaho Statesman that insurers negotiate different rates for items and services, so some level of variation is expected. But she didn’t expect to see the level of variation that researchers saw. Patient Rights Advocate also found that discounted cash prices are often far lower than insured negotiated rates.
For a C-section at Portneuf Medical Center, the group found prices ranged between $3,115 to over $25,000.
When comparing prices across the four hospitals in Idaho, the biggest discrepancy was for an appendectomy, where some patients paid $2,346 and others up to $66,664. The next biggest gap was for an MRI and for cataract surgery, which ranged from $714 to $10,635.
Santangelo said the vast differences in cost demonstrate an urgent need for transparent hospital pricing so patients can protect themselves from overcharges, billing errors and fraud in their health care payments.
“There is wide, wide price variation in Idaho,” Santangelo said by phone. “It’s important to be able to see these actual prices upfront so patients can shop around for the best quality care at prices they know they can afford.”
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