This Consumer Alert takes a look at the price we pay for healthcare. A new report published by a consumer group, PatientRightsAdvocate.org, shows huge variations in price for patients at the same hospital and between hospitals.  The Price Variation Report demonstrates how dramatically prices vary for the same procedure between hospitals and even within the same hospital. That’s because what you’re charged depends on the price your insurer negotiated with the hospital.

But we now should be able to compare those charges because of a law that went into effect on Jan. 1, 2021. That law mandated hospital price transparency, forcing hospitals to provide published lists the facility charges for procedures. It allows patients and employers to compare the price their insurer charges for procedures, imaging and services.

But PatientRightsAdvocate.org found that only about a quarter of New York hospitals are compliant and post the prices for all procedures as required by law.  Fortunately, it appears that Rochester’s two largest hospitals, Strong and Rochester General, are compliant. And the numbers are shocking.  For example, I found that the price of a breast biopsy at Strong varies from $1,421 to $6,064, all dictated by your insurance plan. And that’s not unique.

“The price of an appendectomy at Rochester General Hospital varies from $4,500 to $19,000,” said Linda Bent, president of PatientRightsAdvocate.org. “This is the same procedure in the same hospital, the same care team. And across the state the price varies from $2,000 to $63,000. And often times, the discounted cash price is lower than your plan’s price.”

So, for folks with high deductible plans, the price difference is a big deal because the price your insurer negotiated with the hospital affects you directly. But even if you’re just paying a co-pay … these outrageous price differences affect us all because they drive up the price of healthcare for all of us.

The group hopes that by mandating transparency, we as consumers will demand price fairness, ultimately leading to a more equitable pricing model that makes sense. Ninety percent of medical procedures are not emergencies. That means you likely will have time to shop around for the best price, and even negotiate for a lower price based on price comparisons you can now see.

Click here to find price comparisons for health facilities in your area.