A new study co-authored by billionaire entrepreneur Mark Cuban finds that hospitals are missing the mark when it comes to price transparency for imaging and other healthcare services.

Cuban and colleagues conducted a “secret shopper” investigation, sampling 60 diverse U.S. hospitals and collecting their self-posted online cash prices for two CMS-required shoppable services: brain MRI and vaginal childbirth. They then had individuals telephone those institutions, requesting the cash price for those same services.

Among 47 hospitals providing prices for a brain MRI over the phone and online, 26% had differences between the two figures of 50% or more. There was a “complete match” between online and phone prices for brain MRI in only 19% of institutions (9/47), the authors detailed in JAMA Internal Medicine.

“These results suggest that hospitals need to substantially improve the integration of their online pricing data with frontline staff who interact with patients seeking care,” Cuban and colleagues wrote Sept. 18. “Without such improvements, patients will continue to face barriers to comparison shopping.”

Their study sample included 20 top-ranked hospitals (according to U.S. News and World Report), 20 safety-net hospitals located in close proximity, and 20 more that did not fit into either category. Prices were gathered between August and October of 2022. For brain MRI, 85% of top institutions shared the cash cost both online and via phone versus 50% of safety-net hospitals, and 100% of those in neither category.

Safety net hospitals posted lower online prices than top institutions and those outside of the rankings. A brain MRI cost an average of $2,520 at such hospitals compared to $3,623 at top providers and $11,004 at non-safety net hospitals outside of the rankings. Meanwhile, average brain MRI prices provided by phone were $2,603 at safety-net hospitals, $4,138 at top-ranked providers and $2,601 for the third category. Cuban et al. also reported wide variation between the lowest- and highest-priced hospitals. Across all institutions, the online price for a brain scan ranged from $457 to $166,994 (a likely typo on the hospital’s part), the authors found.

“At best, such erroneous prices may be amusing, but at worst, such errors may trigger further public annoyance with and distrust of our healthcare system,” the study noted.

Read much more from the analysis—including pricing results for vaginal childbirth and a corresponding editorial [2]—at the links below. Cuban contributed to the concept and design of the study, along with providing “administrative, technical or material support.” Meanwhile, Peter Cram, MD, MBA, with the Department of Medicine at the University of Texas Medical Branch John Sealy School of Medicine, served as corresponding author.