There is widespread variation in what providers charge for musculoskeletal imaging exams, including a nearly 74-fold difference between the minimum and max charge for one CT exam.
Back in January 2021, the federal government started requiring hospitals to share prices for certain “shoppable” healthcare services, including 13 in radiology. Since then, several studies have detailed providers slow progress in meeting the mandate, along with eye-opening differences in pricing from one institution to the next.
Stanford University experts recently analyzed data for the four shoppable MSK imaging services covered by the mandate, sharing their work in the American Journal of Roentgenology. Altogether, the analysis covered 250 of the nation’s top hospitals, according to Newsweek, with about 21% offering incomplete information on imaging prices.
“Total charges were widely variable for all four examinations,” Matthew Petterson, MD, a musculoskeletal imaging fellow with Stanford University’s Department of Radiology, and co-authors wrote Jan. 19. “Variability may reflect hospital-specific differences between published charges and actual charges billed to patients following discounts, differences in economies of scale between large and small hospitals, or differences in hospital costs and market forces at state or local levels,” they speculated.
Those who were compliant and provided complete information had a significantly higher bed count. Petterson et al. believe this suggests the mandate may be more burdensome for smaller hospitals, which often lack money and resources to implement cost transparency solutions.
Charge variation was greatest for contrast-enhanced pelvic CT, running anywhere from $193 to $14,248—a 73.8-fold difference. Lumbar spine radiographs were least pricey among the four MSK exams, logging a range of $100 to $6,614, a roughly 66-fold difference between the top and bottom of the list. Unenhanced lumbar spine MRI saw a more than 37-fold difference between the minimum ($258) and max ($9,662). And unenhanced lower extremity MRI’s max of $9,607 was about 42 times higher than its minimum ($229).
The study has several limitations, including only offering charges for uninsured and self-pay patients, and excluding certain components of total charges such as facility or physician fees. Future research should seek to explore the impact of this information on patients’ decisions, the authors suggested.
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Only 21% of U.S. hospitals comply with price transparency mandate for shoppable imaging exams
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.