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The costs of inequality: Money = quality health care = longer life

Posted by on March 2, 2016

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Summary: “If you want to get an idea of the gap between the world’s sickest and healthiest people, don’t fly to a faraway land,” Alvin Powell, writes in The Harvard Gazette. “Just look around the United States. Health inequality is part of American life, so deeply entangled with other social problems — disparities in income, education, housing, race, gender, and even geography — that analysts have trouble saying which factors are cause and which are effect. The confusing result, they say, is a massive chicken-and-egg puzzle, its solution reaching beyond just health care. Because of that, everyday realities often determine whether people live in health or infirmity, to a ripe old age or early death. ‘There are huge inequalities in this country that often get overlooked … If you want to observe the problems of poverty and inequality, you don’t need to travel all the way to Malawi. You can go to a rural house in America,’ said Ichiro Kawachi, John L. Loeb and Frances Lehman Loeb Professor of Social Epidemiology and chair of the Harvard T.H. Chan School of Public Health’s Department of Social and Behavioral Sciences. ‘If you’re born a black man in, let’s say, New Orleans Parish, your average life expectancy is worse than the male average of countries that are much poorer than America.’” Alvin Powell, The costs of inequality: Money = quality health care = longer life” The Harvard Gazette.

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Pittsburgh hospital rolls out price estimator

Posted by on March 2, 2016

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Summary: A Pittsburgh hospital has rolled out a price transparency tool. It’s interesting not just because it is an official hospital estimate of cash or self-pay pricing, but also because the hospital offers a “point of service” discount — and also because their partner in creating this tool is Experian Health, a wing of the credit and financial services giant Experian.

 


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An early crowdsourcing project: Our PriceOfBC interactive

Posted by on February 26, 2016

Summary: We did an early crowdsourcing project asking women to share the price of their birth control pills, called the “PriceOfBC” map. We loved it so much we left it up on the site so people could see it, and see our progress in crowdsourcing, from this project through our WNYC pilot and on to the partnerships with public radio stations in San Francisco, Los Angeles, Philadelphia and elsewhere, as well as my work on the “How-To Guide to Crowdsourcing” at the Tow Center for Digital Journalism at Columbia University in New York, under funding from the John S. and James L. Knight Foundation. Here’s a link to the map.
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Hospitals struggle to get patients to pay debts: Bloomberg Business

Posted by on February 24, 2016

Summary: “A type of pain that hospitals thought they had relieved has come back with a vengeance: it’s called bad debt. Hospitals have long struggled to collect bills when patients aren’t covered by insurance — creating delinquent accounts,” John Lauerman writes over at Bloomberg Business. “The Affordable Care Act was supposed to relieve some of that strain by helping pay for coverage for millions of Americans and expanding Medicaid in some states to cover the poor. Yet while millions of people have gained coverage since Obamacare became law in 2010, there’s also been an increase in insurance that comes with high deductibles and cost-sharing. Under those plans, the first few thousand dollars of annual medical expenses come out of patients’ wallets. That’s money that hospitals like Childress Regional Medical Center in the Texas Panhandle region are unlikely to collect. ‘It feels like a sucker punch,’ said John Henderson, the nonprofit hospital’s chief executive. ‘When someone has a really high deductible, effectively they’re still uninsured, and most people in Childress don’t have $5,000 lying around to pay their bills.’ The rate of uninsurance in the U.S. has fallen to 9.1 percent from 15.7 percent in 2009. Yet in the first nine months of 2015, about 36 percent of the U.S. insured were covered by high-deductible or consumer-directed health plans that can require considerable out-of-pocket payments, compared with about 25 percent in 2010, according to a CDC survey.” John Lauerman, “Bad Debt Is the Pain Hospitals Can’t Heal as Patients Don’t Pay,” Bloomberg Business.
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Texas health official out after study on Planned Parenthood

Posted by on February 22, 2016

Summary: “A top Texas health official is stepping down after co-authoring a study that drew strong backlash from Republican leaders for suggesting that cuts to Planned Parenthood are restricting access to women’s health care statewide,” Paul J. Weber writes for The Associated Press. “Rick Allgeyer, director of research at the Texas Health and Human Services Commission, was facing possible discipline for the study published this month in the New England Journal of Medicine. [Editors note: The original study is here.] He was eligible for retirement and will leave in March, agency spokesman Bryan Black said Thursday. Black said that Allgeyer — who has worked in Texas government for more than 20 years — broke policy by working on the study on taxpayer time. Other co-authors included one of Allgeyer’s subordinates at the health commission, University of Texas researchers and an Austin attorney who represented Planned Parenthood in lawsuits over being excluded from the program the study examined. ‘He should have never been putting in time on this study during the normal business day, he was paid to perform state business,’ Black said in an email. Published in one of the nation’s most prominent medical journals, the study found that fewer women in Texas have obtained long-acting birth control, such as intrauterine devices, after the GOP-controlled Legislature barred the nation’s largest abortion provider from a state women’s health program in 2013. Births paid for under Medicaid also increased among some women.” Paul J. Weber, Texas health official out after study on Planned Parenthood<,/a> The Associated Press.

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Insurers actually are making a mint from Obamacare: The L.A. Times

Posted by on February 19, 2016

Summary: “For months now, headlines about the Affordable Care Act have focused on complaints from big insurers that they haven’t been making money from individual insurance plans mandated by the act,” Michael Hiltzik writes in The Los Angeles Times.  “The big insurer UnitedHealth Group has even whined about losing so many millions it’s thinking about withdrawing from the Obamacare marketplace as soon as next year. Others, including Anthem and Aetna, have mentioned that their exchange business isn’t yet profitable, though they’re not talking about pulling the plug. Here’s what they haven’t been saying so loudly: They’re making scads of money from Obamacare — so much that almost universally, they’re expanding their participation.  What’s the catch? The big profits have come not from the insurance exchanges, but via the ACA’s Medicaid expansion, in which the largest insurers have been playing a major role. The same insurance executives who go out of their way to badmouth the ACA’s individual exchange plans talk as though they can’t get enough of the Medicaid business, especially its managed care component.” Michael Hiltzik, “Dirty little secret: Insurers actually are making a mint from Obamacare,” The Los Angeles Times.

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We’re featured in a Wall Street Journal piece on paying cash

Posted by on February 16, 2016

Summary: People are finding that they can sometimes save money — often a lot! — by paying cash for health care rather than paying the insured rate. Others are noticing too: we were quoted as experts in The Wall Street Journal when Melinda Beck wrote about this recently. Here’s the beginning of her piece: “As consumers get savvier about shopping for health care, some are finding a curious trend: More hospitals, imaging centers, outpatient surgery centers and pharmacy chains will give them deep discounts if they pay cash instead of using insurance. When Nancy Surdoval, a retired lawyer, needed a knee X-ray last year, Boulder Community Hospital in Colorado said it would cost her $600, out of pocket, using her high-deductible insurance, or just $70 if she paid cash upfront. When she needed an MRI to investigate further, she was offered a similar choice—she could pay $1,100, out of pocket, using her insurance, or $600 if she self-paid in cash.” For Beck’s full story, click here: “How to Cut Your Health-Care Bill: Pay Cash,” and for a related article, also by Beck and quoting us as experts, click here: “How to Shop Around and Save on Health Care.” Also, my blog post on this topic from 2014 is here: “Saving money: Paying cash for health care even if you’re insured.”

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Isn’t every colonoscopy free now? Well, not exactly.

Posted by on February 14, 2016

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Summary: Aren’t all colonoscopies free now? No. While the Affordable Care Act includes free preventive procedures like colonoscopies, we’re hearing more and more that people are being asked to pay, from community members in  our partnerships with public radio stations KPCC in Los Angeles, KQED in San Francisco and WHYY in Philadelphia. We don’t know anyone who keeps overall records on how big this problem is, but we can tell you this: “How much does a colonoscopy cost?” is one of our busiest posts.

 


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Our new PriceCheck partnership: Florida, here we come

Posted by on February 11, 2016

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Summary: We’re adding a Florida PriceCheck partnership soon. Our partners are WLRN public radio in Miami/south Florida; WUSF public radio in the Tampa Bay area; and their collaboration, Health News Florida. “Consumers skeptical about the real cost of health care will soon have a resource where they can ask and share with their neighbors the price of common medical procedures,” Mary Shedden, news director of WUSF, wrote in announcing the partnership. “Health News Florida in April will be launching PriceCheck, a database that blends together prices we’ve collected with information from consumers living in South Florida and the Tampa Bay area.”

 


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BuyER beware: $441 bag of salt water: KUSA news in Denver

Posted by on February 11, 2016

Screen Shot 2016-02-11 at 1.07.50 PMSummary: At a time when high-deductible health care plans are starting to dominate the health insurance market, patients like Dave Paulides are finding themselves more and more befuddled by the myriad of seemingly nonsensical charges on their hospital bills,” Chris Vanderveen writes at KUSA television in Denver. “The practice, long embraced within a system critics say lacks overall transparency, allows providers to make complex billing decisions behind closed hospital doors, outside of the view of patients who stand the most to lose. It also leads to a disconnect between number-crunching hospital executives and patients who frequently fail to comprehend why, for example, a hospital like Swedish Medical Center would bill someone $441 for a sterile bag of salt water.” Chris Vanderveen, “BuyER beware: $441 bag of salt water,” KUSA 9news.com/em>.

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