For a long time, one of the most frustrating things about the U.S. health care system was the difficulty of comparing prices for procedures at different medical providers.
That began to change in 2021, when the federal government began requiring all U.S. hospitals to provide “clear, accessible pricing information online about the items and services they provide,” according to the Centers for Medicare & Medicaid Services.
This includes the prices for more than 300 procedures and services.
The increased transparency has revealed that astute shoppers can save a lot of money — sometimes, thousands of dollars — simply by shopping around for the best price, according to a recent study from the U.S. PIRG Education Fund.
U.S. PIRG (U.S. Public Interest Research Groups) looked at how much patients in the Cleveland area might pay for services at a variety of providers.
The federation of nonprofit organizations found a difference of as much as $200,000 between the highest and lowest prices for knee replacement surgery in the Cleveland metro. According to a summary of the findings:
“The listed cash prices for knee replacement ranged from around $26,000 to more than $240,000. For the insurance plan selected for the case study, the price range was much lower — $5,900-$9,100 — because of its specific deductible and limits on out-of-pocket costs. But that’s still a large variance; a $3,200 difference could be a game-changer for patients deciding where to have their surgery.”
Despite the new federal rules promoting transparency, finding the prices for procedures was sometimes challenging, according to U.S. PIRG. It found pricing for knee replacement surgery at 20 of the 27 Cleveland area hospitals it looked at, but noted that pricing information was missing at some hospitals in the Cleveland Clinic system.
The network of organizations is urging the government to engage in better enforcement of its transparency rules as a way of helping customers find pricing more easily.
If you want to boost your odds of getting the best possible deal on health care services, go to hospital websites and:
- Find the billing code for the procedure.
- Find the hospital price transparency tool at the hospital’s website. You will also need to figure out if that is a “price estimator” or “shoppable services list.”
- Search for the billing code using the tool.
You can find more detailed tips for finding hospital prices at the U.S. PIRG website.
For more on trimming your medical costs, check out “7 Ways Anyone Can Save on Out-of-Pocket Health Care Costs.”
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