Diagnostic ultrasound cash price 308% higher than national average in one state
The cash price for a diagnostic ultrasound is seven times higher depending on the state in which it’s delivered, according to a new analysis of imaging prices released Wednesday.
On Jan. 1, the Centers for Medicare & Medicaid Services started requiring hospitals to disclose pricing for various shoppable services on their websites. Digging into the newly available data, researchers found that 2,078 hospitals offered such machine-readable files.
Ultrasound of the abdomen was one of the most common services, shared by 85% of providers, vendor Hospital Pricing Specialists reported. Average exam price ranged from $319 in New Jersey up to $2,295 in Florida.
For radiology providers, understanding the importance of costs and creating prices that reflects them (plus a reasonable profit margin) is the key takeaway, said Managing Director Rich Louie.
“Gross charges and contracted rates are open for interpretation, but cash prices are straight forward, and consumers will reward providers who keep them low,” he said.
Less than 30% of hospitals’ machine-readable files included the total bundled charges for outpatient surgery, the analysis found, oftentimes leaving out radiology and other services associated with the procedure. Abdomen ultrasound cash prices averaged $745 nationally, with Florida’s charge 308% higher, while New Jersey’s was 57% lower.
Because many providers have contracts that pay on a percentage of charges, Louie noted, list prices have become “incongruous” with underlying costs. When providers are mandated to set cash prices, they often apply a discount rate to their list prices, which yields an “unrealistically high” result, he said.
The vendor next plans to analyze bundled pricing for outpatient surgeries, which the new CMS law requires. Many providers appear to be sidestepping the rule and releasing only the line-item price for surgery, Louie said.
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.