Billionaire ‘Shark Tank’ entrepreneur Mark Cuban comments on price variation in radiology: ‘It’s insane’

Billionaire entrepreneur Mark Cuban—who announced his departure from reality show “Shark Tank” last year—recently remarked on pricing variation in U.S. radiology.

Physician and blogger James V. O'Leary, MD, started the conversation after using the online transparency tool Radiology Assist. The blogger and OB-GYN specialist searched for the price of a CT of the abdomen/pelvis with contrast (CPT 74177) in his own community. He came up with $2,541.38 at a hospital versus $476.04 in a freestanding outpatient location.

“The imaging center uses board-certified radiologists, and the site is certified by the [American College of Radiology]. Always ask what the cash price is,” O’Leary, who tweets under the handle @RealDocSpeaks, wrote July 17.

Cuban responded shortly after, sharing his opinion with 8.8 million followers on the website formerly known as Twitter.

“This. And if you are self insured, NEVER allow your insurance company to bill you for out of network care,” Cuban wrote, with the message garnering over 975,000 views and almost 200 replies as of Monday. “They negotiate the lower cash price with the out of network provider but charge you the higher price. Always require that you pay the out of network provider directly if you have had many out of network claims, go back and look at them. Call the provider and ask for the cash rate for the care on the claim and compare it to what you were charged. It’s insane.”

Cuban is no stranger to healthcare business, having launched CostPlusDrugs.com alongside radiologist Alex Oshmyansky, MD, PhD, in 2022. The pharmacy service cuts out the middleman and has achieved 90% savings on ultra-high-cost drugs, according to its website. It’s also improved adherence via increased affordability and access, with accredited facilities delivering drugs to all 50 states. Cuban also co-authored a study about imaging price transparency published by JAMA Internal Medicine last year. 

“Mark, you have an amazing platform to increase literacy in our convoluted healthcare system—this doesn’t help. Insurance companies don’t bill for care, your provider does. Patients need to negotiate payment with the provider (which really can work!),” responded X.com user Andrew Smith.

“Your insurer tells the self-insured employer how much they have to pay. So, they bill the employer. Unless you pay cash. Then the provider determines how much you pay,” Cuban responded.

“The physician does NOT bill the facility fee; the hospital does. When you get a bill for $2,000 more for a CT done in the hospital, the physician never sees that money. The physicians are NOT in charge of the healthcare system as 80% are now employed,” original poster James V. O'Leary added later.