Database of medical procedure price lists?

September 15, 2010 1:05 PM

Does there exist anywhere a database of medical procedure price lists to facilitate comparison shopping / competition? One of my local clinics offers a price list on their website, albeit incomplete. I was wondering if anyone had taken the time to pull together a number of these. If not, someone should....perhaps a job for Google.
posted by grammalvsu to health & fitness (7 answers total)

The Centers for Medicare and Medicaid Services compile this information on charges to Medicare patients as part of the Medicare Provider Analysis and Review File (at the level of charges over the course of inpatient stays for particular diagnosis groupings) and the Outpatient Standard Analytic File (at the level of individual medical procedures, and for certain drugs and medical supplies provided in a hospital setting). Unfortunately it's not available to the general public for free - the licenses cost at least a few thousand bucks.

You can find some very limited and high-level data on pricing for common services in the American Hospital Directory's free hospital profiles.
posted by strangely stunted trees at 1:25 PM on September 15, 2010

In a number of states, hospitals must, by law, publish a list of the average or "customary" charge for a variety of healtcare services. This link may make a good starting point.

In Maine, I know there is an on-line database provided and maintained by the State.
posted by anastasiav at 1:34 PM on September 15, 2010

It's my understanding that prices for medical procedures are almost always negotiable - insurance companies essentially never pay what the hospital/doctor/whatever charges and even individuals can usually negotiate a substantial discount. I'm not sure how useful collecting published "customary" charges would be.
posted by mskyle at 2:46 PM on September 15, 2010

As other posters mentioned, it is a state-by-state deal (assuming you are U.S. based here). The Dept. of Health and Human Services was pushing a pricing and quality transparency initiative a couple of years ago and made grant money available to states to build out websites for this purpose. There have also been state-funded and non-profit initiatives (groups like hospital associations) to do the same.

The usual approach by states, referenced by strangely stunted trees, is to use medicaid reimbursement data to sample the prices. So if you are interested in things like costs of prescriptions, you are in luck (the easiest area to get good pricing data). As you move across the spectrum towards procedures done in outpatient surgical centers and procedures that aren't going to be paid for by insurance, it gets progressively harder to figure out the market rate -- as mskyle points out, those procedures are highly negotiable.

You don't mention your state or the procedures you are interested in; I would suggest googling for the name of your state and "medical transparency" or "healthcare transparency" and see what you come up with. Also think about the procedures you have in mind and how likely they are to be covered by something like medicaid (which will give you a clue as to how likely it is you'll be able to find anything).
posted by kovacs at 5:47 PM on September 15, 2010 [1 favorite]

OutOfPocket.com has lots of U.S. fee-for-service healthcare price information. They offer price reports by consumers, Medicare prices, and their search engine checks other price transparency sites. The blog has a lot of good information, too.
posted by Snerd at 6:28 PM on September 15, 2010

If you happen to live in the Minneapolis/St. Paul area, local health insurance company Medica has created a website that lists the costs of common health care procedures, tests, prescriptions, etc. at local healthcare facilities. They say, "The more you know about cost and quality, the better prepared you'll be to discuss care recommendations with your physician." I would imagine they are hoping you will go to the cheapest place because it impacts their own bottom line, but either way the information is handy for MN residents.
posted by vytae at 6:58 PM on September 15, 2010

Thanks everyone. Lots of good stuff here. Outofpocket.com I've found to be an especially useful resource. Also, I *do* live in the Minneapolis area, so that Medica site has been helpful. thanks!
posted by grammalvsu at 12:58 PM on October 2, 2010