Transparent Pricing for Medical Services Remains Murky, But Change is on the Horizon

If I want to get my vitamin D levels checked, for instance, or have to schedule a colonoscopy, how much might these tests cost? Is there a way to know upfront how much I’d pay at one facility versus another?

The answer right now is generally no. Hospitals are required to have a master list of prices for their services but the thing is…no one pays these prices. What you pay depends on who your insurer is and what kind of deal they’ve negotiated with any given provider. So the list is a relic of the past, says Bill Ryan, the president and CEO of the hospital advocacy group Center for Health Affairs. "Charges are largely fictional. And they are not very informative for the general consumer," said Ryan.

There’s a national trend—spurred in part by the Affordable Care Act—to change this so people can be more savvy consumers of healthcare.

Don’t expect to see price tags on diseases like cancer or heart attacks any time soon, but Ryan says non-urgent tests and procedures are out in front in terms of pricing transparency. "I would hope that we see more movement all the way across the board but I think where we’ll see movement first is in those areas," he said.

Ryan also says hospitals have a role to play in pricing transparency but that insurers really need to be helping people understand where they can find the best value in healthcare.

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