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Study Details Lack of Correlation Between Out-of-Pocket, Insurance Costs for Medical Procedure at Different Hospitals

A newly released study details the wide variations not only in the cost of a medical procedure, but the vast differences in how much a patient pays out of pocket and how much the patient’s insurance company pays for the same procedure at different hospitals.

The Pioneer Institute evaluated the prices charged by 14 different hospitals in Massachusetts for a Magnetic Resonance Imaging (MRI) test of a patient’s knee, and looked at how much individuals were required to pay and how much was billed to the individual’s insurance company.

Overall, the total amount billed for the same procedure at the different hospitals varied from a low of $475.61 to a high of $1,423.37. What was interesting, was the lowest amount a patient was required to pay — $55.25 at Mount Auburn Hospital — was not the lowest price charged. Mount Auburn’s fee for performing an MRI was $686.53, which ranked it 7th on the list of 14 facilities. The most a patient was asked to pay was $205.59 at South Shore Hospital, whose price of $733.62 ranked it 6th on the list.

All told, patients were required to pay as little as 8% of the total cost of the procedure to as much as 30%, depending on the facility.

The study concluded there was “virtually no relationship between a consumer’s out-of-pocket costs and the total price of a procedure.”

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