How much does a CT or MRI scan cost? It varies
The cost of brain scans at U.S. hospitals can vary wildly — some patients paying five times as much — for the same scan depending on their health insurance plans, according to a recent study in Radiology, a journal of the Radiological Society of North America.
ROCHESTER, Minn. — At some U.S. hospitals, a patient could pay five times more than another patient at the same hospital for the same brain scan if they have different health insurance plans, according to a recent study.
The October study titled, “Price Variability for Common Radiology Services within U.S. Hospitals,” and published by Radiology, a journal of the Radiological Society of North America, found that when commercial insurance companies negotiate different prices for the same service within the same hospital, it can lead to widely varying costs.
On average, common radiology prices within the same hospital have a 3.8 price gap, meaning a radiology service might cost as little as $1,000 for one patient and as much as $3,800 for another patient if they have a different insurance plan.
“Many commercial plans are leaving money on the table when negotiating prices with hospitals, especially for expensive CT and MRI scans,” said study co-author Ge Bai in an RSNA news release. “High prices paid by commercial plans eventually come back to bite U.S. employers and workers through high premiums and out-of-pocket costs.”
The study also found that CT and MRI scans have higher prices compared to other radiology services, such as an abdominal ultrasound.
The study's authors found that higher prices relative to Medicare for higher cost services imply higher hospital profitability. RSNA wrote in its news release that this can potentially motivate hospitals to direct investments away from low-cost to high-cost imaging without regard to incremental clinical value.
Up until recently, these price details weren’t as accessible as they are now. The Hospital Price Transparency Rule required U.S. hospitals to disclose pricing information starting January 2021, so consumers can shop and compare prices across hospitals and estimate the cost of care before going to the hospital.
“Price transparency took the blindfold off the eyes of commercial payers, forcing them to recognize the fact that they are often paying too much,” Bai said in the news release. “Equipped with pricing information, radiologists can change the landscape of care delivery to benefit patients and payers.”