Hospital Pricing vs. Market Pricing 1

Transparency in Hospital Pricing vs. Market Pricing for Medical Imaging

Many patients aren’t able to estimate their out-of-pocket costs for medical imaging exams such as MRIs and CT scans. For medical imaging performed in hospitals, pricing severely lacks transparency which makes it even more difficult for patients to know about and afford the cost of their treatment. 

According to researchers from Massachusetts General Hospital and NYU Langone Health, who analyzed the publicly available chargemasters (pricing guides) and corresponding websites for the top-20 ranked academic hospitals, they determined that most institutions are following the minimum federal requirements, and few offer the clear and digestible pricing information that patient’s need to inform their decision-making. 

In order to get a better idea of how hospitals are publishing their pricing, the researchers looked at several features of the top 20 U.S. News and World Report-ranked hospitals. The group found all institutions made their chargemasters available to the public, with 90% published in Excel spreadsheets. Only 10% of hospitals included MRI CPT codes making it difficult for patients to find the exact cost of their scan or report it to their insurance. CPT codes or Current Procedural Terminology is a medical code set that is used to report medical, surgical, and diagnostic procedures and services to entities such as physicians, health insurance companies and accreditation organizations. 

Without coding information, patients can’t compare charges for the same imaging exam across multiple institutions, the authors noted. Between the 20 hospitals, the group found 19 different descriptions for a brain MRI with and without contrast. Most organizations included institution-specific codes, the authors found. These can help patient’s gauge pricing at a certain hospital, but do not help assess costs across multiple locations. 

Comparing costs across locations is an excellent way to save money, especially if you’re open to getting your scan done at an outpatient facility such as an imaging center. Hospitals are also known to charge far more for medical imaging services than stand alone imaging centers. Imaging centers are medical facilities dedicated to performing imaging services. They use high-tech equipment and advanced techniques to produce clear and accurate images of bones, soft tissues, organs, blood vessels, arteries, and the nervous system, just like the radiology department of a hospital.

Medical imaging can be expensive and because it requires more coordination between patients and providers, a lot of patients get caught up in the normal flow without realizing that they have options on how to cover their test. Some centers offer cash discounts on their imaging services. This is helpful for people without insurance or with complex insurance policies that may only cover part of the cost of a scan. Skipping insurance and deciding to pay cash may lower that amount to $250. Since cash pay discounts are not standard, different imaging centers have different prices depending on the type of scan you need.  

To book a scan, visit us at Medmo helps people schedule radiology imaging tests – such as MRI, CT scans, PET, and more – at nearby accredited centers and identify the payment solution that works best for them.


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