Head CT scan more price transparent than other healthcare services

While obtaining pricing information for a medical imaging exam like a non-contrast head CT may be difficult and time consuming, it's likely that exam is going to be more price transparent than other healthcare services, according to a study published online in the Journal of the American College of Radiology.

For purposes of the study the authors, led by Aaron B. Paul, MD, Department of Radiology, Harvard Medical School and Massachusetts General Hospital, contacted 18 upper-tier academic hospitals identified by U.S. News & World Report and 14 of the 100 largest private radiology practices in the country identified by the Radiology Business Journal to see whether they were able to provide pricing on a non-contrast head CT scan.

One of the authors called each of the hospitals and private practices posing as a patient without health insurance who had been given a prescription for a head CT and wanted price information. The authors chose to ask about the price for a head CT because it is a relatively standard imaging examination with minimal differences in quality between upper-tier academic hospitals and private practices.

The authors found that 14 of the upper-tier academic hospitals (78%) and 11 of the private practices (79%) were able to provide prices.  The average total price for the upper-tier hospitals was $1,390 (ranging from $391.62 to $2,015), while the average price for the private practices was $681.60 (prices ranging from $211 to $2,200).

According to the authors, the results “compare favorably” with previous studies involving other healthcare services. For example, one prior study found that only 45% of top-ranked orthopedic hospitals and 10% of non-top-ranked hospitals were able to provide cost estimates for total hip arthroplasty.  Another study found that just 15% of hospitals were able to provide price information for ECGs.

“The results suggest that routine medical imaging is more transparent than other healthcare services,” the authors wrote.

However, the authors noted that getting this price information is difficult and time consuming. They determined that multiple phone calls were often required, involving conversations with different staff members as well as long wait times.

“Price transparency can thus be thought of conceptually as encompassing both the availability of accurate price information and the ease with which consumers can obtain such information,” the authors wrote. “ The greater availability of pricing information for medical imaging in our study compared with other medical services should therefore be balanced by the difficulty in accessing this information.”

The authors also noted that while head CT is a standard imaging exam involving minimal differences in quality between institutions, prices for the exam varied widely both within and between the groups of upper-tier hospitals and private practices. Considering there was a 5-fold variation in cost among upper-tier hospitals and a 10-fold variation among private practices, the authors observed that “tremendous” cost savings can be achieved by consumers who comparison shop and use low-cost providers.

“[W]hether increased price transparency for consumers can reduce costs is still a question that will require further research,” the authors concluded. “We as a specialty must commit ourselves to cost-effectiveness research in this new environment of increased price transparency.”