Medical procedures vary in price from facility to facility

Posted at 3:16 PM, Feb 01, 2018
and last updated 2018-02-01 15:16:22-05


(RNN) - An MRI - and many other vital health-care procedures - are performed exactly the same way, no matter where a patient receives care. But huge differences can be found when patients receive bills to pay for those tests.

Mitch Brandon found that out the hard way. The Army veteran, 20 years removed from service, wanted to know what was wrong with his back.

"A lot of back pain, stiffness, really impacting my way of life," Brandon says about the pain.

A doctor with the U.S. Veteran's Affairs Administration sent Brandon to Lakeview Regional Medical Center in Covington, LA. for two MRIs in 2016.

Seven months later, Brandon received a bill for those scans, totaling more than $8,000.

"I was quite surprised how large it was," Brandon said.

The VA hasn't yet paid the bill and Brandon is unsure if they will. In the meantime, Lakeview's collection's department is calling him for payment.

But, less than a two-minute drive from Lakeview, there is a different medical center, where an MRI costs $350, a Raycom Media national investigation has found.

"It doesn't make sense," said Jeanne Pinder, who runs Clear Health Costs, a New York-based company that is trying to bring transparency to healthcare. "Nobody has any idea what things cost in healthcare."

Across the country, the cost of medical procedures can vary widely between facilities that, in some cases, are a stone's throw apart, the news' organization's investigation found.

In Richmond, VA., the cost of a lower-back MRI at Virginia Commonwealth University Medical Center is $3,000. At nearby Tuckahoe Orthopedics, the same procedure is $399.

The University of Alabama at Birmingham Hospital charges $5,800 for an MRI, but a few blocks away, at American Health Imaging that MRI is $525.

"A $300 MRI and $6,000 MRI, what's the difference? The $6,000 one must be twenty times better, right? Wrong," Pinder said.

Even a simple blood test can vary in price.

In Memphis, the cost of a metabolic panel at Baptist Memorial Hospital is $171. At nearby Quest Diagnostics, the charge is $73.45, almost $100 less.

Pinder said there are ways to save money.

Call two or three clinics or hospitals to compare prices. Ask how much of the cost will be paid by your health-insurance company and what the cost is without insurance. And ask for this information in writing.

After a doctor has recommended a procedure, ask for the CPT code, which is a unique number assigned to every medical test by the American Medical Association. Hospitals and diagnostic facilities are reluctant to release pricing information without the code because it ensures everyone is talking about the same thing. For example, the CPT code for a lower back MRI is different than the one for an upper back MRI.

Ask if the procedure could incur any additional costs. In some cases, a clinic can charge a lab fee, a doctor fee, an anesthesiologist fee and/or a facility fee.

Also talk directly with your health insurance company to find out your out-of-pocket costs after insurance has paid on the claim and deductibles have been factored.

Paying for a procedure at the cash rate will not count toward any deductibles, so it will take longer to reach the insurance company's out-of-pocket maximums during the year.

Pinder's company publishes on its website the prices of medical procedures and offers that information to the public for free.

"I'd like to put myself out of business," Pinder said. "You can't keep this secret forever. You can't."

Patients need to treat health-care procedures as if they are looking for a house, car or TV.

"We're not really programmed to think about shopping for medical care," Pinder said. "But we should be."

Copyright 2018 Raycom News Network. All rights reserved.