Why do MRI prices vary so much? And a note about our data

 

MRI cost

Summary: MRI pricing is fascinating because the disparities are so wide. It’s basically a fairly routine procedure (I’ve had one myself) and yet we have providers reporting prices to us ranging from as little as $295 to to $10,246 at UCSF-Mount Zion.

 

 


Wide price disparities, and incomprehensible bills. It’s the health-care marketplace.

Our PriceCheck project has been collecting mammogram prices, and now we’re getting ready to switch to MRI prices.

A quick note about the prices in our database: There are two kinds.

  1. Cash or self-pay prices collected by ClearHealthCosts journalists, under our pricing survey methodology. These prices are reported to us by providers, and any conditions or additional information is included in the information in the “notes.”
  2. Prices reported by our community via our PriceCheck form (they have a “crowdsourced” flag to identify them, while the reported prices have no such flag).

The cash or self-pay survey price lists collected by our journalists are intended to be not comprehensive or exhaustive, but rather representative across a metro area — hospitals, clinics, individual providers, in a range of neighborhoods and suburban areas. Our goal is to shine a light on pricing. (We’re now in seven major metropolitan areas.)

Another note about the reported cash or self-pay prices: Some providers report an all-inclusive price, meaning that a reading fee, facility fee, lab fees or other add-ons are included. Some report “40 percent discount available for same-day or pre-pay patients.” That material is included in the notes field on a price entry. We try to envision ourselves as a person in the marketplace, trying to find out what something will cost, and work hard to give you the most comprehensive information possible.

If a provider cannot or will not give a price over the phone, we enter “$0” because our database requires a price, and then add a note.

Sometimes the cash or self-pay price ranges are startling

In the San Francisco area, then, you will see our reported cash or self-pay MRI prices can be as low as $500 at Premierescan in San Jose, and as high as $10,246 at UCSF Imaging Center at China Basin in San Francisco, with a note that self-pay patients receive 40 percent if they prepay or pay the same day.

Hospitals tend to charge more than self-standing radiology centers. Still, that’s a big disparity, but it’s what our journalists learned during their pricing survey.

In the Los Angeles area, the reported cash or self-pay MRI prices can be as low as $390 at Shin MRI, on South Harvard Boulevard in Los Angeles, and as high as $1,265 at St. John’s Health Center in Santa Monica.

It pays to shop around.

Note: How to read an explanation of benefits

When you’re sharing prices for our database, we’ve noticed that the confusing nature of bills and “explanations of benefits” have resulted in some anomalies.

We’re asking for three prices: Charged price, insurance paid, you paid.

Please take care to look at whether the insurance company has paid the full rate that was billed, or if it has instead paid something labeled as “member price” or “negotiated rate” or “contract rate” or “amount allowed” or “paid by plan.”

Reading an explanation of benefits is confusing — my friend ePatient Dave de Bronkart insists that calling them an explanation is incorrect, because they explain exactly nothing.

Take a look at the examples here.

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