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Brain MRI In The Same Town: $3,500 Or $1,540?

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The same advanced imaging procedure may vary in cost by thousands of dollars—within the same town.

change:healthcare, a national company “on a mission to arm employees with the weapons necessary to reverse the escalating upward trend of U.S. healthcare costs,” according to its Web site, has released a new report on imaging costs. The report is part of a quarterly series called the Healthcare Transparency Index that’s designed to give consumers more information regarding the costs of all kinds of medical procedures.

This quarter, imaging is in the crosshairs. change:healthcare mined its proprietary, HIPAA-compliant database, generated from medical claims by its clients. It looked at price variations for such advanced imaging procedures as MRI of the brain, lumbar spine, and lower extremities, CT scans of the pelvis and abdomen (with and without contrast), and PET scans of the area from the base of the skull to the thigh. In each town, the survey focused on an outpatient facility, freestanding imaging center, or medical office, then looked at prices charged by other imaging facilities within a 20-mile radius.

Results were startling. You might not be astonished that a brain MRI might vary in price between regions, though a high of $3,600 in the Southeast and a low of $425 in the Southwest might seem a little extreme.

Even wide differences within broad regions might make some sense—such as a high of $2,500 versus a low of $560 (a 346 percent difference) in the Southeast for a lumbar spine MRI.

But who knew that, within the same town in the Southwest, one patient was charged $1,800 for a CT scan of the pelvis with contrast, while the same procedure cost another patient only $230—a 683 percent difference? Or that, in a Northeast town, you could get a brain MRI for $3,500 or $1,540, depending on which facility you patronized?

Christopher Parks, founder of change:healthcare, told USA Today:

There’s been a barrage of studies that show differences from region to region. That makes sense — California’s more expensive than Alabama. But this is within a 20-mile radius in your own town.

Such seemingly random pricing brings fire to the eyes of health-care reformers. But Howard McClure, CEO of change:healthcare, pointed out that legal issues sometimes prevent providers from discussing cost differences with consumers. Providers, he said, sometimes don’t even know the cost themselves, saying they have to check with the insurer.

Don’t think change:healthcare overflows with concern for the plight of providers, however. Parks and McClure said they released their study in the hope that insurers will refuse to cover treatment by providers who seek unusually high payments.

Related seminar: Abdominal & Pelvic Imaging: CT/MR/US


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