By Dr. Mercola
Diagnostic tests such as X-rays, CT scans, and MRIs can be very expensive if you don't have insurance.
In fact, they can be expensive even if you DO have insurance, depending on your policy's deductibles and co-pays.
Diagnostic imaging accounts for 57 percent of the cost of cancer care, according to this 2010 report in JAMA.
While I always recommend your being very judicious in your use of medical diagnostic procedures—especially those involving radiation exposure—there are certainly times when it is appropriate and useful for you to have a certain test, and you may be paying much more than you need to.
Most people don't realize that the fees for these procedures can vary tremendously, depending on where they are performed.
Many people use hospitals for outpatient procedures, not even realizing there are alternatives.
Hospitals tend to be the MOST expensive option for diagnostics and outpatient procedures—sometimes by an enormous margin.
Imagine going to the grocery store and buying a dozen eggs, but not knowing the price until a bill arrives in your mailbox.
Furthermore, imagine that the range of prices for one dozen eggs is from $2.00 to $30.00, and your bill could be anything in between. Well, that is EXACTLY what is happening in our current medical system, especially with diagnostic imaging.
Independent Diagnostic Centers Can Stretch Your Healthcare Dollar
Freestanding diagnostic centers are alternative places to obtain services, such as lab studies, X-rays, and MRIs, often at a fraction of the cost charged by hospitals. You may have driven by some of these centers in your city. Private imaging centers are not affiliated with any particular hospital and are typically open for Monday through Friday business hours, as opposed to hospital radiology centers that require round-the-clock staffing.
Hospitals often charge higher fees for their services to offset the costs of their 24/7 operations. Hospitals also may charge exorbitant fees for high-tech diagnostics, like MRIs, to subsidize other poorly reimbursed services. And, hospitals are allowed to charge Medicare and other third-party insurers a "facility fee," leading to even more price inflation.
When I need a medical imaging study myself, I use a freestanding diagnostic center in my neighborhood called Medical Imaging Center. In an effort to be frugal and minimize my medical expenses, I have an insurance policy with a very high deductible, so I pay for all my own tests. By using the Medical Imaging Center, I save between 50 and 70 percent over having the exact same tests done at a hospital—and there's no difference in quality.
If you're one of the many people who have an aversion to setting foot in a hospital for any reason, the "less sterile, friendlier" atmosphere of neighborhood imaging centers is an added advantage.
"Price Check on MRI, Aisle Nine, Please"
The United States has the most expensive diagnostic imaging in the world. According to this article on Huffington Post, an investigation into the price of abdominal CT scans among most developed countries showed that the U.S. "blows everyone out of the water."
Now please understand that I strongly encourage everyone to avoid having a CT scan unless absolutely necessary ,due to the massive amount of radiation exposure. So your first step would be to make sure that you could avoid this test. But, if for whatever reason you determine you need to have one, the average cost of an abdominal CT in the US is $1,600, which is about twice the cost of the next highest country (Australia), and towers above what you would pay in Europe, including France, Germany, Spain, UK, and the Netherlands, whose prices for the same CT range from $161 to $319.
If you read the featured article, you'll see a similar bar graph for CT of the head that shows the same relative costs. We also lead the world for highest MRI prices, although the margin isn't as wide.
MRIs are the current "cash cow" of the imaging industry and present the perfect example of how much money you can save by doing a little investigating. For example, according to Jeffrey Wolf of 9News in Colorado, you can dish out as much as $3,460 for a basic MRI of your shoulder, but with some shopping around, you can cut that cost to $450—a savings of nearly 90 percent!
As you would expect, the two places found to offer a shoulder MRI for $450 were private imaging centers. And the $450 price tag included the radiologist's fee, which is extra at many facilities. The highest prices were charged by hospitals, with Memorial Hospital in Colorado Springs at the top of the heap at $3,460. Wolf writes:
"Many consumers will check half a dozen gas stations for a few cents difference in price, but would never think they could save thousands of dollars by checking prices for a medical test like an MRI."
Below are three more examples of the mind-bogglingprice differences you'll typically find, obtained using the New Choice Health searchable database. In these examples, the highest and lowest pricesare listed for a particular city, but realize there are many other prices in between:
- Need a Chest X-ray in Portland, Oregon? You can pay $3,300 to get one from Legacy Salmon Creek Hospital, OR you can pay $200 at Legacy Imaging St. Helens
- Want an Abdominal Ultrasound in New York City? You can fork over $2,775 to Hudson Valley Hospital Center, OR you can pay $380 to have it done by Northeast Radiology
- Need a colonoscopy in Seattle? Hand over $8,200 to Schick Shadel Hospital, OR have Providence Everett Medical Center do it for $2,250
You can find similar disparities for just about every medical procedure, in just about every city… and it seems like the larger the city, the more choices you have as a consumer and the wider the price disparity among them.
The Bigger the Facility, the Costlier Your Bill
The price disparities are related, at least in part, to differences in operating costs.Regents Health published a report comparing average costs to imaging centers for conducting seven common medical imaging tests. (Please note, these are costs to the facility—not costs to the consumer.) The data was based on 2009 and 2010 revenue for 55 different service centers (33 hospitals and 22 imaging centers), presumably in the U.S., although that wasn't made clear.
They found the following differences in operational costs between hospitals and independent imaging centers. Clearly, you can see how independent imaging centers can offer you a better deal than hospitals. Of course, there are also other factors at play, as mentioned earlier.
Tired of Enduring Frustrating Phone Calls?
You might have better luck doing some Internet research, as opposed to (or in addition to) making phone calls to potential medical imaging centers to obtain price quotes. Some states are not waiting for federal action. Eleven states now have databases that allow consumers to easily compare prices, from New Hampshire to South Dakota to Nevada. Here are four examples:
- New Hampshire: www.nhhealthcost.org
- Massachusetts: hcqcc.hcf.state.ma.us
- New Hampshire: www.nhpricepoint.org
- Maryland: mhcc.maryland.gov/consumerinfo/hospitalguide/hospital_guide/cost_report.html
In addition to state websites, some healthcare organizations are beginning to voluntarily post their fee schedules online, hoping to gain public favor. And there are also some enterprising companies offering medical cost comparison services, sometimes charging a small membership fee for more comprehensive services. Two such companies are New Choice Health and Compass Professional Health Services. New Choice Health has free databases that are searchable by geographic region (city, state, zip code), facility, and procedure.
So, if you are banging your head against the wall from days of frustrating phone calls to uncooperative medical imaging staff who refuse to disclose their fee schedules, you might want to check out one of the websites above. Just plug in the test you want, and your city and state, and a table pops up with dozens—sometimes hundreds—of options by price. The bottom line is that, with a little detective work, you can significantly stretch your precious healthcare dollar. And who doesn't want that these days?