If you're an uninsured New Yorker shopping for a hip replacement, the going rate in Manhattan is $18,260. If that sounds steep and you're willing to try medical tourism, the rate drops to $7,500 in Boston, $7,099 in Baltimore or $6,399 in Washington.
If you're willing to go further afield, there are seemingly bargains available elsewhere including these:
Portland, Oregon: $4,366
Tampa, Florida: $3,039
The point here is not to ask why these price disparities exist, a thorny question that's occupied health researchers for years, but rather to spotlight a glimmer of hope for those of us who've long wished for price transparency in medical services that would not only allow patients to shop for the best deal, but hopefully then put pressure on high-priced providers who'd risk losing business.
This data comes from an outfit called Fair Health, a non-profit agency that also compiles such figures for insurance companies. You can find the cost of most procedures by simply describing them (or their cpt code, 27130 in this instance) and specifying where you are. Shifting location based on nearby zip codes (the system uses the first three digits) can make a big difference. Just across the Hudson River from Manhattan, the price is about $11,000.
Similar data is available on out-of-pocket costs for the majority who have insurance. In Washington, for instance, the out-of-pocket cost for a hip replacement is $1,920.
While this obviously makes the shopping process a bit easier for the minority who try, there's still a lot of, ahem, legwork required to get more specific. If you want to know what a particular hospital charges, you must call them directly and may well meet resistance. The same caveat applies to the specifics of insurance coverage. Obviously, some hospitals and insurers are better than others. It would be helpful if they got credit for being helpful.
Of course, price is seldom the sole factor in buying anything and that's particularly true in the medical area, where issues of convenience (fairly easy to determine) and quality (more important, but still only sometimes possible) must also be on the scale. Not surprisingly, providers stressed the quality question when confronted with a newspaper report where all the hospitals in Missouri were asked the cost of a hip replacement and about half refused to quote a price.
For what it's worth, the average cost to an uninsured person in St. Louis is $12,662. Across the state in Kansas City, it would be about $9,000.
Of course, patients willing to travel further can find significantly lower prices in nations like India, Korea and Malaysia that are promoting medical tourism, but that's a different issue insofar as few Americans are adventurous enough to outsource their healthcare.
For consumers and patients who often feel impotent about rising health care costs, such price shopping allows a way to simultaneously limit their costs and put pressure on providers, now content to market with glossy advertisements that forget price entirely with their focus on quality and technology, to focus on this issue. It could provide a bit of patient leverage in an area where there's no nearly none.
So far, consumers have shown very modest interest in using such information on price or quality. If they flocked to them, it could create a beneficial spiral that would make shopping easier while pushing prices down.