Sacramento leads the country in pricing for an MRI of the lower back (average $2,365), and just a short jaunt up the West Coast, Seattle offers the nation’s lowest average cost for a back scan at $907, according to a new analysis of in-network price differences for four common medical procedures.
Castlight, which supports employers in managing benefits, compared the cost of four common medical procedures in the 30 most populous U.S. cities: MRI (lower back), CT (head/brain), lipid panel, and a primary care visit.
The map provides graphic proof of the wide variation in prices for medical procedures, not just between cities, but also within them. The price of a CT (head/brain) in Philadelphia varied by a factor of 12, from $264 to $3,271. The price of an MRI (lower back) in New York City ranges from $416 to $4,527.
When viewed in infographic form, the price differentials can be breathtaking. The lowest in-network price in the nation for CT (head/brain) was mapped in Washington, DC, at $193. The highest price ($2009) can be found nearby in Richmond, Va.
Castlight president of strategic analytics, Jennifer Schneider, M.D., suggests that patients who think they are getting the lowest price by shopping in network may have a rude awakening.
“There's no way today for someone to know what things will cost if they simply follow the rules and go in-network,” Schneider told Modern Healthcare. “It's like letting someone shop on your credit card without any sort of limit.”
For its analysis, Castlight used medical claims data augmented with other sources of publicly available and private data, including provider rate sheets. The company provides employers with data and services to enable the cost-effective delivery of healthcare benefits.