SUMMARY: How much does an MRI cost the government? Well, in Puerto Rico it’s $307, and in San Francisco it’s $570. Those are the prices paid by Medicare, the federal program for the elderly and disabled. Our awesome search tool will tell you that. Here’s how to find out: Click here to read more, or …
Go to the search box on the front page. Click on “advanced search” to get to the Medicare search tool by region, which catalogs the 70 different pricing regions Medicare uses to place geographic variants on its reimbursements.
Then type in “72148” and pull down “MRI lumbar spine w/o dye.” Click to place that in the box.
Go to the “regions” tab and click “all regions.”
Hit “go” and you will see the results, arrayed alphabetically by state.
Click at the top of the “Medicare price” column, and it will automatically sort lowest to highest.
Why did we do this? The Medicare price is the closest thing to a fixed or benchmark price in this marketplace. The government assigns these prices based on a complicated formula that takes into account city and state, type of facility, complexity of procedure and so on. You can also find a search tool on the Medicare web site, at this link.
I know, wonky, but still.
Aren’t you interested to know that Puerto Rico and West Virginia have the cheapest reimbursement rates for an MRI, and San Francisco, San Mateo and Santa Clara are all at the top, being much more expensive than Alaska? This is the result of the geographic component of the formula for finding fees; in every case, Puerto Rico and West Virginia are at the bottom, and San Francisco, San Mateo and Santa Clara are at the top end — nearly double the Puerto Rico rate.