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Your Source for Finding Health Care Prices

Cash or self-pay prices and Medicare pay rates. Our metro areas: NYC, SF, LA, Philadelphia, Miami, Tampa-St. Petersburg, Dallas-Fort Worth, Houston, San Antonio, Austin. Others soon!

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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.

For general health data, there’s no one better than Charles Ornstein of ProPublica, who keeps this Google Doc of datasets. Some of it relates to price, or to payments to providers by drug companies, or to prescribing. It’s a goldmine.

On the money: Here 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” from the National Conference of State Legislatures. These pricing databases all have different rules of access, and only a few offer anything that is helpful for individuals. Here’s a blog post about that; 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 Conference 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. 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

CompareMaine 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

This site lets Massachusetts residents find their health plan’s online cost calculator. Sign-in credentials required.
This site features quality information about doctors in Massachusetts, via Massachusetts Health Quality Partners.
This 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.

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 went down for a while, and now it’s back up.

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

Oregon

Oregon has a lot of information, including average pricing, on its Oregon Hospital Guide site. There’s also info on the state Health Authority site.

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.

Washington

The Washington Hospital Association has a tool. Find it here.

Wisconsin

The Wisconsin Hospital Association has a tool. 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. (Update February 2016: This page is no longer live, but can be seen here on the Wayback Machine, the Internet archive.)

The Ear, Nose and Throat Institute of Atlanta lists prices online, in partnership with the Milton Hall Surgery Center — package rates includes your physician fee, anesthesia and facility, with payment due in full before surgery.

 

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.

International comparisons: A report comparing U.S. costs to other nations’ costs, by the International Federation of Health Plans. Not a shopping resource but a reference.

OutOfPocket An aggregating resource that allows consumers to search for prices of health care services. (Update Feb. 2014: Seems to be inoperative; 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. No longer seems to be active (Feb. 2015).

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

Tools

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 offering a sampling.

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; often they will ask you to pay up front or register before you know the name of the provider. Some of these services have several names; Allevion.com, for example, also seems to be Surgeo. MyHealthMyPrice isn’t running at the time of this writing, but promises to be, and is run by the founder of Cash-Doc, according to LinkedIn. UberColon wants you to sign up in advance for a colonoscopy at a bargain rate. We’ve heard from MDSave, ZeroCard, MyChoiceMD, Medigo and a number of others.

If you want to register and pay first, that’s up to you.

Again, we’re not suggesting that this list is exhaustive, and it changes all the time.

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. (Update February 2016: Site closed; advises visiting Preferred Imaging.)

Doctorpricing.com Looks a lot like the FairCareMD.com model. Says it was founded in 2006. Doesn’t look very active. (Update February 2016: Site says “Please come back later.”)

FairCareMd A health-care marketplace where patients and providers can see costs and bid or negotiate. Kind of like eBay. Doesn’t look very active (Feb. 2015). (Update February 2016: Site no longer active.)

HealthEngine says it will connect providers and consumers. Says it’s primarily for employers and municipalities, though it also seems to have an individual “concierge” service.

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.

Medrepublic Search for a procedure and price, then book (through Medrepublic) and make travel arrangements. Seems to be primarily non-U.S. providers. Categories are orthopedic surgery, plastic surgery, weight loss surgery and travel.

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 very 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. (Update February 2016: Redirects to a site called “GetInsured”.)

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 some of the best pieces we’ve seen recently on the topic of buying prescriptions.

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.

Blink Health Lets you buy meds through them, by paying online, and then you get a coupon or voucher to take to a local store to pick up your prescription.

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

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.

Services for business

CastlightHealth A California company that offers business-to-business transparency solutions; if an employer contracts with them, they share pricing information. As with other similar services, hard for us to compare how good and how actionable their information is because we are not a paying customer.

ChangeHealthcare A Tennessee company that offers business-to-business transparency solutions; if an employer contracts with them, they share pricing information. As with other similar services, hard for us to compare how good and how actionable their information is because we are not a paying customer.

 

MyMedicalShopper Also business-to-business; if your employer contracts with them, they share pricing information. If not, you have to sign up to get info. So: a cross between HealthCareBlueBook, Medibid and Castlight. Based in New Hampshire; as with other similar services, hard for us to compare how good and how actionable their information is.

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); as with other similar services, hard for us to compare how good and how actionable their  information is because we are not a paying customer.

 

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. As with other similar services, hard for us to compare how good and how actionable their information is because we are not a paying customer.

 

Spendwell Health Also business-to-business; if your employer contracts with them, they share pricing information. As with other similar services, hard for us to compare how good and how actionable their information is because we are not a paying customer.

 

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.

Plumfund.com Also does medical fundraising online.

Standbuy.us Also does medical fundraising online.

YouCaring Also does medical fundraising online.

Quality

There are many resources for measuring quality in health care, and many of them come to very different conclusions. Here are some resources.

State medical boards State boards govern medical licensing and malpractice. Here’s a list of state medical boards and their websites via the Federation of State Medical Boards. Also, the Administrators in Medicine (AIM) website, from a non-profit organization for state board executives, collects licensing and disciplinary information from each state’s medical board in its DocFinder physician directory. You may still need to search the individual state’s site, which is on the same page, if the state does not contribute to the DocFinder.

Hospitalinspections.org, a website run by the Association of Health Care Journalists, collects federal hospital inspection reports.

The federal government lists a number of quality tools on this section of healthcare.gov.

The Center for Medicare and Medicaid Services also released a ranking of hospitals on a five-star system called Hospital Compare. You can find it here; here’s a news article about the reaction to the rankings.

The investigative news organization ProPublica built a “Surgeon Scorecard” ranking doctors on several surgical procedures. You can find it here; here’s an article by ProPublica defending its methods by responding to critics.

A state-by-state and category-by-category list has been compiled by consumerhealthratings.com. Another resource: The Informed Patient Institute.

For seeking out quality doctors, here’s a great handbook by Dr. Jay Parkinson, a co-founder of Sherpaa.com.