Jama Internal Medicine article on consumer hospital prices
How much does hip arthroplasty cost?

It’s hard for patients to find prices for medical procedures in advance, even for common things, a new study finds.

Our readers won’t be surprised, but this was a  thorough investigation by a trio of respected scholars, published in the Journal of the American Medical Association.

The study catalogs the  scholars’ attempts to find prices for a total hip replacement. They picked two hospitals in each state plus Washington D.C., and called those hospitals as many as five times to get the information.

Just 16 percent of hospitals could answer the question.

The scholars had a hard time getting answers, and when they did find prices, those estimated prices varied by a factor of 10: the complete estimated prices for such a surgery ranged from $11,000 to $125,798. 

Titled “Availability of Consumer Prices From U.S. Hospitals for a Common Surgical Procedure,” the study is also the topic of an article on Reuters today by reporter Genevra Pittman. I’m quoted in the Reuters piece. (Thanks, Genevra!)

“Patients seeking elective [total hip arthroplasty] may find considerable price savings through comparison shopping,” the authors conclude.

This is one of our favorite topics. If you haven’t recently, go to our PriceMap interactive page and play around with the search; for a range of procedures, in cities all over the United States, we show you what the government is paying via Medicare, the program for the elderly and disabled. You’ll be shocked at the range.

The study’s authors, Jaime A. Rosenthal; Xin Lu, MS; and Peter Cram, MD, MBA, are members of the internal medicine department at the University of Iowa Carver College of Medicine, in Iowa City, and the study was published in the Journal of the American Medical Association, online Feb. 11. They refer to total hip replacement, or arthroplasty, as THA throughout the study.

The design, as described by the authors: “We randomly selected 2 hospitals from each state (plus Washington, DC) that perform THA, as well as the 20 top-ranked orthopedic hospitals according to US News and World Report rankings. We contacted each hospital by telephone between May 2011 and July 2012. Using a standardized script, we requested from each hospital the lowest complete ‘bundled price’ (hospital plus physician fees) for an elective THA that was required by one of the author’s 62-year-old grandmother. In our scenario, the grandmother did not have insurance but had the means to pay out of pocket. We explained that we were seeking the lowest complete price for the procedure. When we encountered hospitals that could provide the hospital fee only, we contacted a random hospital affiliated orthopedic surgery practice to obtain the physician fee. Each hospital was contacted up to 5 times in efforts to obtain pricing information.”

The scholars add:  “The results of this study provide insight into the availability of pricing information for a common elective medi- cal procedure, THA. We found that only 16% of a randomly selected group of US hospitals were able to provide a complete bundled price, though an additional 47% of hospitals could provide a complete price when hospitals and health care providers were contacted separately. Obtaining pricing information was difficult and frequently required multiple conversations with numerous staff members at each hospital as well as affiliated physician offices. Finally, we found that price estimates varied nearly 10-fold across hospitals, which is surprising considering that all hospitals were provided with standardized information about the procedure being requested. In aggregate, our results highlight the difficulty that consumers may have in obtaining price estimates for common medical procedures, but also that comparison shopping might yield significant price savings for savvy consumers.”


Jeanne Pinder

Jeanne Pinder  is the founder and CEO of ClearHealthCosts. She worked at The New York Times for almost 25 years as a reporter, editor and human resources executive, then volunteered for a buyout and founded...