True costs: Prices vary a wide margin between regions and insurance status

A new crowdsharing site that discloses the true cost for patients of common, and expensive, procedures could pave the way for important dialogue between insurance providers, physicians and the customer/patient.

Lisa Aliferis, a journalist with KQED News in San Francisco, published an article on the price transparency tool this month in the JAMA. In it, Aliferis details the formation of a cooperative database project called PriceCheck—an effort between KQED, KPCC and ClearHealthCareCosts.com.

“Since June 2014, hundreds of people have submitted their charges for common medical tests and procedures, and the amount they paid,” Aliferis wrote. “We entered all the information into a free, searchable database.”

The project requested the public enter the costs they were charged, and paid, for procedures that included mammography and lower back MRI, among others. Aliferis said thousands of people responded to the call to participate.

For mammography, a test performed 38 million times a year in the United States, results varied between $128 to $694 in the Los Angeles and San Francisco Regions. Moreover, women reported they were charged copays when they should not have been.

For lower back MRI procedures, Aliferi found that commercial insurers paid between $467 and $1,567. Additonally, a Medicare patient’s MRI cost $255 (a fraction of the facility’s $2,450 price tag) and a self-pay patient paid $6,221 at an academic medical center.

Aliferi noted significant feedback and interest from physicians and others in the medical profession.

“Our belief was that people want quality at a fair price and that shining a bright light on health costs would help drive discussions about quality,” she noted. “But we also found physicians who were fascinated by our project and wanted to share their own cash prices.”

Despite website logistic complaints and vented frustrations about the complex and murky world of healthcare pricing, Aliferi believes the project is headed in the right direction.

“The window is cracked open on health cost transparency,” she wrote. “We have been here before—with car sales, with airline tickets. Now, technology in combination with transparency can do the same for health care.”