In the latest volume of the Healthy Marketplace Index (HMI), Health Care Cost Institute (HCCI) analyzed a subset of negotiated rates for specific services to report prices for 6 commonly-used services among individuals with employer-sponsored insurance and found striking variation.
Across metro areas, they found up to 25-fold variation in median prices of the same services. Service prices also varied widely within metro areas –finding up to a 39-fold price difference for the exact same service, even after removing the top and bottom 10% of prices to exclude outlier effects.
For this study, the following services were analyzed:
- Two types of childbirth admissions—the most common inpatient admissions in the HCCI dataset in 2016: C-section delivery and vaginal delivery.
- Two types of frequently performed lab tests: a common blood test (comprehensive metabolic panel) and a screening mammogram (bilateral screening mammographies with computer-aided detection).
- Two types of office visits that accounted for 11% of all professional services in 2016: established mid-level expanded problem office visit, new patient mid-level expanded problem office visit.
- Past the Price Index: Exploring Actual Prices Paid for Specific Services by Metro Area. HCCI. 30 April 2019: https://www.healthcostinstitute.org/research/publications/entry/hmi-2019-service-prices