An analysis from Hospital Pricing Specialists of Los Gatos, CA, found that the cash price for an abdominal ultrasound scan in Florida was an average of $2,295, with the national average being about $745. Meanwhile in New Jersey, the cash price for the same procedure was $319 on average, about 57% below the national average.
"We were quite shocked, because this is the cash price and should reflect a reasonable cost, plus profit markup," said Rick Louie, managing director for Hospital Pricing Specialists. "We're used to seeing a wide variance among gross charges."
Under Medicare's hospital price transparency rule, which went into effect on January 1, every U.S. hospital is required to make their prices for shoppable services available for consumers to see. This includes explaining their respective services for consumers to easily understand.
The U.S. Centers for Medicare and Medicaid Services began sending warning letters in April to hospitals that were deemed to be out of compliance with the rule.
Hospital Pricing Specialists wanted to determine the percentage of U.S. hospitals complying with the new rule as part of the firm's project to develop machine-readable file of healthcare prices. Then, they wanted to import the prices into a database and compare data.
The team identified 2,078 hospitals that had machine-readable files on their websites that list prices for various services. Of these files, the group found that less than 30% included the total bundled charges for outpatient surgeries.
While prices for packaged services such as outpatient surgeries were found to be inconsistent, Hospital Pricing Specialists could compare prices across nonpackaged services such as medical imaging and lab tests.
One of the most common items found within about 85% of these files was abdominal ultrasound.
"We determined that the listed cash price was the best metric to compare across hospitals and found ultrasound of the abdomen to be the most frequently reported service among our download of machine-readable files," Louie said.
|States with most expensive and least expensive prices for abdominal ultrasound
Louie said the high average cost seen in Florida is because of the "large number" of payor contracts with hospitals that pay on a percentage of charges.
"Therefore, Florida hospitals have a financial incentive to have high prices," Louie told AuntMinnie.com. "Because most hospitals do not have a good understanding of their costs, they set their required cash prices as a straight discount of their gross charges. In other words, if their gross charges are high, their cash prices will be high too."
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