Your Source for Finding Health Care Prices

Cash or self-pay prices. Our metro areas: NYC, SF, LA, Dallas-Fort Worth, Houston,
San Antonio, Austin. Others soon!

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For procedure, start typing and let it complete, or use the government pricing system described here. Advanced search page here

Useful Links

Clearhealthcosts.com is joining a rapidly growing ecosystem of web-based resources concerned with the price and cost of health care. Here are some public and private sources. The public databases, especially the federal ones, can be daunting, but there’s a lot of information here.

Price lists for medical treatment are just about our favorite thing over here at ClearHealthCosts. We think people should be able to know what stuff costs in health care, and anything that sheds light on that — however fragmentary or imperfect — is good, as far as we’re concerned.

Here, then, is a listing of some of the best resources we’ve come upon for finding out what you’re likely to pay for a medical procedure. There are also some useful guides for locating free or low-cost care and discounted prescription drugs. We’ve also listed some services to help companies lower their health care costs.

Warning: These price lists, especially those from the federal government, can be mind-numbing to use. There should be a better way.

U.S. Government Price Lists

The Medicare home page

A comprehensive resource for all costs pertaining to Medicare and Medicaid, compiled by the Centers for Medicare and Medicaid Services. Medicare and Medicaid reimbursement rates are set by the government and are a benchmark of sorts for costs of care. These databases are huge and hard to use; there should be a better way.

Medicare’s physician fee schedule search tool

This tells you what Medicare pays for procedures. Often payment rates from insurers, doctors, hospitals and other providers are based on these tables. Some providers have a sliding scale based on hardship that depends on this data.

This price list is about the closest thing you can get to standardized pricing in health care in this country.

Health Care Consumer Initiatives page

Here the Centers for Medicare and Medicaid Services lists its big databases of prices it pays for selected procedures across the nation annually, broken down by hospital inpatient, hospital outpatient, ambulatory surgical center and physician fees.

These price lists vary a great deal by geographical area, and they can be mind-numbing to use. Maybe you heard us mention: There should be a better way.

A list of “all-payer claims databases” in the form of a clearing house, run by the Agency for Health Care Research and Quality, an agency of the Department of Health and Human Services.  You heard me say: there should be a better way.

Various price lists from the Centers for Medicare and Medicaid Services

A Sampling of State Resources

The various states have abundant resources, some more useful than others. If your state is not included, check out “State and Federal Actions Related to Transparency and Disclosure of Health Charges and Provider Payments”, an exhaustive roundup from the National Association of State Legislatures, a research organization offering a wealth of data and geographically specific resources. It’s updated relatively frequently. This is our go-to guide for state-level information and other resources.

California

The Office of Statewide Health Planning and Development provides a searchable tool of hospital price lists (a “chargemaster” in health care bureaucracy jargon). There’s also a way to search for free and discount pricing in California hospitals.
Colorado
Colorado has launched an all-payer claims database. For now it’s a bit hard to use as a consumer seeking care; the state promises to add more information.

Kansas

The Kansas Health Policy Authority collects a large amount of health cost data and  in cooperation with the Kansas Insurance Department,  maintains the Kansas Health Insurance Information System (KHIIS), which includes health care data from individual and small-group private insurance plans.

These reports are developed under the aegis of the Kansas Health Data Consortium, a committee  with membership from key health industry sectors. The reports provide data on health care cost, utilization, service patterns and trends, and information.

Maine

Maine HealthCost compiles the prices for many medical procedures for both insured and uninsured citizens.

Maryland

Maryland Health Care Commission  publishes a Maryland Hospitals Pricing Guide.

Massachusetts

MyHealthCareOptions is a useful tool that lets you compare cost and quality of hospitals and doctors.

Minnesota

Minnesota is working on a comprehensive system to collect data on health care costs. Here’s the tool.  Minnesota Health Scores provides information on a limited number of conditions with information other than cost.

Nevada

Nevada has a price tool also. It’s here.

New Hampshire

NH HealthCost allows visitors to choose a procedure, insurance plan and provider  to estimate the cost of care. It’s down as of January 2014, with a note reading: “Unfortunately, a failure in the data reporting process has made updating price estimates at the moment impossible. These delays are temporary, but may last for several months.” Too bad — this was a pretty good site.

New York

Quality of care reports abound, but not pricing reports.

http://www.health.state.ny.us/statistics/

One of a number of state databases with information on quality of care. This website focuses on health care in New York.

http://www.health.state.ny.us/health_care/managed_care/complaints/index.htm

Actions to take if you’re an unhappy consumer.

http://hcrc.abouthealthquality.org/index.php

The New York State Health Accountability Foundation’s resources, the fruit of  a public-private partnership working for transparency in the health care system and providing employers and consumers with reliable information on healthcare pricing and quality. Information about Connecticut, New Jersey, Rhode Island and Vermont may also be found here.

Oregon

Oregon is working on an all-payer all-claims database. Meanwhile, there’s a lot of information on their state site. Here’s a consumer price lookup tool.

Tennessee

Tennessee is working on an all-payer database.

Texas

Texas has launched one of the best cost transparency sites we’ve seen. Clear search, thorough information, nice interface, good explanations.

Utah

Utah’s home for quality and cost information on maternity care, heart and gall bladder treatment and the like.

Vermont

Vermont’s collection and analysis of data from a variety of sources including health insurance carriers and managed care plans licensed by the state, Vermont’s acute care hospitals, home health agencies and other sources. Vermont is working on a health-care reform system, but we couldn’t find a price list.

Virginia

Virginia has a cost comparison tool that’s won praise. Find it here.

Providers Listing Prices

Providers have started to post on-line price lists for various procedures. Here are several surgery centers and hospitals that have online price lists for cash or uninsured customers.

Others pledge to deliver a price in advance of your procedure, but won’t list prices online so they are less valuable: can you compare? How does the price given you stack up to their standard “rack rate”?

Banner Health systems, with headquarters in Phoenix and 24 hospitals across seven states. Lists cash or self-pay rates for many hospitals in Alaska and Arizona; also refers to state pricing resources in other states.

Regency Healthcare. New York City, orthopedics primarily.

Good Shepherd Medical Center. Longview, Texas, has cash pricing program.

Surgery Center of Oklahoma. Oklahoma City Online price list for various procedures.

Southwest Orthopedic.  Fort Worth, Texas–Online price list.

Rochester General Hospital. Rochester, N.Y. Posts prices for uninsured people — careful to say that doctor and anesthesiologist will charge separately.

 

Comparison Shopping and Other Resources

FairHealth A national not-for-profit that was born when an investigation revealed that insurers were under-reimbursing New York State customers because the database of rates they were using was itself created by an insurer. This is an independent resource that lets you calculate, based on your location, plan, and condition, how much a procedure is likely to cost you.

HealthCareBlueBook: A consumer guide to the prices insurance companies pay for medical procedures. Gives what it calls “a fair price” for various procedures. Site says: “It represents a payment amount that many high-quality providers accept from insurance companies as payment in full, and it is usually less than the stated ‘billed charges’ amount.”  We have found provider prices considerably lower than what this site lists.

OutOfPocket An aggregating resource that allows consumers to search for prices of health care services. (We come up pretty high on their list of results!) Update: seems to be inoperative as of 2/14; whois.com says the domain name has been purchased by Cambia Health.

LesliesList Chicago and Dallas/Fort Worth only. Price comparisons for prescription medicines, medical testing, and routine procedures.

Truecostofhealthcare.org Site written by Dr. David Belk, a California doctor who’s revealing the inner workings of the health-care marketplace.

Online booking: Pay first, get service later, etc.

This is a sampling, not an exhaustive list. New ones crop up frequently, and old ones go out of business or become inactive.

We are unable to offer guidance on how good or bad any of these sites are in terms of booking, billing, services rendered or anything else — we are simply listing them.

A number of these sites offer prices, while others offer an opportunity to book through them (and the site takes a cut, or the provider pays to be on the site, or some other business model). Our brief sampling was puzzling for results and prices. If you want to register and pay first, that’s up to you.

Carepilot Sort of like ZocDoc (scheduling) meets FairCareMd (published prices), with discounts for available slots, serving mostly Colorado.  You pay up front.

Concila.com. Seems to be in stealth. Looks a bit like Pokitdok.

CostHelper A collection of advice on various costs, ranging from funerals to dental bonding, mammograms to Alaska cruises.

DealWell.com Dallas-Fort Worth. Discretionary (massage, cosmetic surgery) and a few medical procedures. Lists a price, invites bids.

Doctorpricing.com Looks a lot like the FairCareMD.com model. Says it was founded in 2006. Doesn’t look very active.

FairCareMd A health-care marketplace where patients and providers can see costs and bid or negotiate. Kind of like eBay.

HealthInReach Merged recently with PriceDoc. An open auction for medical care: Name your price for a procedure, and see if a provider will accept your offer. Heavy on the cosmetic, dental and other optional procedures and services.

Medibid.com Calls itself a “marketplace for solutions.” A doctor-patient bidding system: you register then ask for bids.

MyHealthandMoney Subscription and membership-based Web resource that claims to tell patients how to reduce their out-of-pocket costs and affordably manage their medical care.

NewChoiceHealth A comparison-shopping marketplace. Their listed prices seem high to us. You can also ask for a quote, and they have featured providers whose prices are lower than the list prices.

OKCopay Chicago, Milwaukee, Indianapolis, Washington, D.C., Seattle. A price list focused primarily on typically non-reimbursed, out-of-pocket procedures.

 Pokitdok.com Search a database of  providers and request a quote from them. Not much data on prices that’s publicly visible.

Pricing Healthcare A collection of prices — the more prices you give them, the more you can see. Book through them and in some cases you get a discount.

SaveOnMedical You have to register with them to get a price they offer from a provider. You pay SaveOnMedical, not the provider.

SnapHealth A pair of doctors found a site to help patients pay for care without using health insurance. Based in Texas.

ZocDoc A site where you can find a doctor online and book an appointment. They started in New York, and now are in Los Angeles, Chicago and several other cities. Addressing the problem of scheduling in a very efficient way.

ZoomCare A Portland, Ore., network of clinics with on-line booking; describes itself as “healthcare on demand” and an “alternative to the traditional doctor’s office and urgent care.”

Insurance resources

Health-Insurance-Forum, a place for people to seek information about being their own advocates. 

Vimo Pricing information for insurance, and some other health-care information.

EHealthInsurance Health insurance purchasing information for consumers.

MyUHC An example of the pages insurance companies offer, some of them with pricing information for subscribers.

Billing advocates

Advo Connection A directory of patient advocates, including billing advocates.

Medical Billing Advocates of America A consumer advocacy group that has training and referrals for people wanting help with bills, and people who want to take up such advocacy as a profession.

 

 

 

Medications

Here are three of the best pieces we’ve seen recently on the topic of buying prescriptions.

Are generics always cheaper? No. Listen to our friend Leslie Ramirez from leslieslist.org.

Are those drug discount cards really a bargain? Maybe not. Listen to Richard J. Sagall, M.D., who wrote this post for costsofcare.org.

Are manufacturers coupons a bargain? Also maybe not. Joseph S. Ross, M.D., and Aaron S. Kesselheim, M.D., J.D., M.P.H. explain in the New England Journal of Medicine.

GoodRx.com Search engine for medication prices, based on coupon model.

CouponDoc.com Manufacturers’ coupons for medications.

WeRx.org Search engine for medication prices, based on coupon model.

NeedyMeds A thorough guide to patient assistant programs that provide free and low-cost prescription drugs to those who need and can’t afford them. Includes a nationwide listing of  clinics with free or discounted services.

VIPPS The National Association of Boards of Pharmacy has a certification program called Verified Internet Pharmacy Practice Sites (VIPPS).

LegitScript Website that says it’s a certifier of online pharmacy sites.

Pharmacychecker Website that says it’s a certifier of online pharmacy sites.

Xubex.com Patient assistance program: an online pharmacy.

A compendium of places for people to seek free medications or low-cost medications.

Services for business

CastlightHealth A California company that offers business-to-business transparency solutions; if an employer contracts with them, they share pricing information.

ChangeHealthcare A Tennessee company that offers business-to-business transparency solutions; if an employer contracts with them, they share pricing information.

HealthcareBlueBook (mentioned above) sells services to businesses that are more refined, and more specific, a kind of white-label service. Their paid services seem pretty comprehensive (I saw a demo) and the free, consumer-facing ones are more limited.

FairHealth (mentioned above) also sells services to businesses that are more comprehensive than what’s available to consumers free.

ClearCostHealth A business-to-business company, founded after us, with a similar name.

SymbiosisHealth A startup helping employers with high-deductible plans get employees good prices.

Other big companies including Thomson-Reuters have employer solutions.

Facts and Figures about Health Care

The Kaiser Family Foundation has compiled StateHealthFacts, an extraordinary collection of state-by-state data. The Foundation’s home page includes just about any fact or figure you might want to know about health care and health care costs. The only thing they can’t tell you: how much will it cost?

Health care safety and quality statistics A list kept by Mark Graban at Leanblog.org.

Mayoclinic.com The big Minnesota clinic’s straightforward, thorough, reliable and easy-to-understand site.

Crowdfunding Health Care

Healthline recently opened a medical fundraising section of its site.

GoFundMe. Officials say the site’s users raised more than $6 million for medical causes in 2012.

GiveForward GiveForward charges a 7 percent fee on money raised, but allows donors to donate the fees so that 100 percent of the gift goes to the recipient.

Causewish.com/ Also does medical fundraising online.

Plumfund.com Also does medical fundraising online.

Standbuy.us Also does medical fundraising online.

YouCaring Also does medical fundraising online.

Cost Does Matter

Study shows cost does matter.
(SALT LAKE CITY)—Consumer price comparison is almost nonexistent in the U.S. health care system, but a new study shows that when given the choice between a less costly “open” operation or a pricier laparoscopy for their children’s appendicitis, parents were almost twice as likely to choose the less expensive procedure – when they were aware of the cost difference.