The Price Is Right? Not for Mammograms

Healthcare price transparency continues to be an ongoing struggle for payers and patients. While grocery stores service competitive prices for a box of cereal, the variability in prices for the same healthcare service sees a huge differential. A new report released by Castlight Health underscores this problem, with the pricing of mammograms in 30 largest cities in the United States as a case study.

For the study, Castlight Health examined the pricing of OB/GYN follow-up visits, preventative gynecological exams, mammograms, and HPV tests across states, using medical claims data. Additionally, provider information, provider rate sheets (payer-provider negotiated rates), and some publicly available information was included in the data set. Employee out-of-pocket cost added to the amount paid by the employer was defined as the price of a service.

The results were astounding—a 44x variation in the cost of a mammogram across the 30 cities, ranging from $43 (Sarasota-Bradenton, FL) to $1898 (NY, Northern NJ, Long Island). The analysis notes that women in the larger metropolitan areas are charged exorbitantly higher—with huge price variations—for an important preventive test. While some cities included in the study (including Holland, MI; Sharon, PA; Columbia, MO; Daytona Beach, FL) had no price variation, some saw a variation that ranged from 2-fold (including Pittsburgh, PA and New Orleans, LA) to nearly 21-fold (Dallas-Fort Worth, TX) in the same city.

According to Jonathan Rende, chief research and development officer at Castlight Health, these findings speak to our broken healthcare system. “We’ve seen over the years that women are bigger consumers of health care than men in general and we wanted to drill into some of the more common services and see how those varied,” Rende said when speaking about their study.