New Report Highlights Extreme Price Variation for the Same Medical Procedures Within and Across Hospitals

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Dec 20, 2023, 10:36 ET

WASHINGTON, Dec. 20, 2023 /PRNewswire/ -- Today, PatientRightsAdvocate.org (PRA) released a new report that found patients are being charged drastically different prices for the same care within the same hospitals and across hospitals in the same states.

Within the same hospitals, prices vary by an average range of more than 10 times for the same procedures when comparing insurance plan negotiated rates and the discounted cash price. When looking across different hospitals in the same state, prices vary by an average range of more than 31 times when comparing hospitals and insurance plan negotiated rates.

"Our study reveals wide-scale price variations of more than 10 times for the same care across health plans and 33 times across hospitals," said PRA Founder and Chairman Cynthia Fisher. "It is highway robbery to charge a patient ten times more than another person receiving the same procedure at the same hospital or 31 times more than a patient at a hospital down the street getting the same care. When all healthcare consumers, including workers and employer and union purchasers, have easy access to all actual prices, such discriminatory and inequitable pricing practices will no longer be tolerated. True systemwide healthcare price transparency will give consumers the information they need to protect themselves from overcharged medical bills, hold hospitals and insurers accountable, shop for care, and ultimately create a competitive marketplace that will lower costs."

"The fact that the same procedure can cost 5 or 23 times more depending on what hospital you go to means something is very wrong with health care prices," said Senator Mike Braun (R-Ind.). "We need price transparency to introduce more market competition and clarity into this opaque system that's hurting Americans."

"Knowing the cost of health care shouldn't be a mystery," said Senator Tina Smith (D-Minn.). "The glaring price variations in Minnesota are a symptom of a larger, broken health care system. When patients have access to clear information, competition thrives, and costs come down, paving the way for a more equitable system for everyone. Transparency is key to dismantling the barriers to affordable care."

Click here to read the price variation report.

Click here to read the state-by-state breakdown of price variations.

Background

PRA analyzed 100 hospital files in a sample set of 10 states, including California, Idaho, Indiana, Kentucky, Louisiana, Minnesota, New Jersey, New York, Oregon, and Vermont.
Researchers specifically looked at the prices of five common medical services: Appendectomy, Arthroscopic Knee Surgery, Caesarean Section, Cataract Surgery, and MRI of Lower Extremity Without Contrast.