Many consumers will check half a dozen gas stations for a few cents difference in price, but would never think they could save thousands of dollars by checking prices for a medical test like an MRI, or Magnetic Resonance Imaging.
An investigation by Colorado Public News, one of 9NEWS' partners, has found the costs for an MRI vary dramatically. A survey of 18 clinics and hospitals in locations around the state found a seven-fold difference in prices for a shoulder MRI - even though medical professionals say it's exactly the same test.
Many patients must pay cash for tests like an MRI, either because they are uninsured, or because they have high deductibles. Insurance companies pay different prices, set in negotiations.
At the Salud Clinics in suburban Denver, Dr. Virgilio Licona is frustrated by the huge gap in the price of medical procedures. Half his patients have no insurance and many must choose between medical care and buying food, he said. Some wait months to get a test like an MRI, because they must save up to pay for it.
Currently in Colorado, the only way to compare prices is to call the provider directly. Yet many are reluctant - and even refuse - to disclose their prices for services.
"If you go into a restaurant or any store, the prices are clearly marked," Dr. Michael Pramenko, president of the Colorado Medical Society, said. "In health care, we've sort of locked out the ability for consumers to determine costs for procedures."
"For the uninsured person, there's no mechanism to do this, aside from calling up each [hospital and clinic] and spend a week doing this," Pramenko said. "Even then, the answers can be a bit muddy because no one really knows. No one person in the hospital is generally assigned to provide these types of price quotes."
Vast price differences in survey
The Colorado Public News survey asked for the cash price of a basic MRI of a shoulder - a test used to diagnose injuries like torn rotator cuffs, arthritis, bone tumors and worn-out cartilage.
The survey found freestanding clinics in Front Range urban areas nearly always charge far less than hospitals.
Least expensive of those surveyed were Thornton Imaging Center northwest of Denver, and at Touchstone Imaging in Lakewood. Both came in at $450, which included the radiologist's fee, which is extra at many other facilities.
Colorado Springs Imaging charges $600. Health Images of City Place in Aurora charges $625, but will discount that price to $500 if patients can pay up front.
Hospitals generally charged the highest prices for the same service. A shoulder MRI at Memorial Hospital in Colorado Springs came in tops, at $3,460. Boulder Community Hospital and St. Anthony North Hospital in Westminster were just $100 less.
St. Anthony Central Hospital in Denver was the exception among hospitals. It refers patients to a clinic across the street, Denver NMR, Inc., which will cut its fee of $1,050 to just $525 if the patient pays in full at the time of the test.
Mary McCabe, Chief Financial Officer at Banner Health in northern Colorado, explained that hospitals like hers incur greater expenses since they are open 24 hours a day, 365 days a year. By contrast, most freestanding diagnostic centers are able to charge less because they have lower overhead, and are open during regular business hours, Monday through Friday.
Dana Dixon, head of patient financial services at Banner Health, said the hospital charges $2,228 for a basic shoulder MRI. The hospital will cut that price in half for people with annual household income of less than $125,000, she said.
Many of the facilities promised discounts for cash or proven hardship. Not having to deal with insurance company paperwork or collecting bills cuts their costs, and they share that savings with customers.
Some providers, including The Medical Center of Aurora, declined to disclose their prices. Others, including the Vail Valley Medical Center, did not respond to several phone calls seeking information.
Finding the best deal
Pramenko says MRI machines generally produce similar results. Added costs can come into play when facilities market themselves as having the newest, often more expensive, gadgets when older-model machines they already own work just fine.
"Right now the incentive [for some hospitals] is to have the best, highest-tech equipment, instead of competing with patients for best price," Pramenko said. "Boy has that driven costs up."
Price shopping for medical care doesn't have to be this difficult.
Eleven states have databases that allow people to easily compare prices, such as this one in New Hampshire at www.nhhealthcost.org.
Colorado is due for a similar online service, under a state law passed last year.
"We have a game plan to have ours in place sometime in the next year," said Phil Kalin, executive director of Colorado's Center for Improving Value in Health Care, which is coordinating the effort.
Colorado Plains Medical Center in Fort Morgan on the Eastern Plains quoted a cost of $2,863 for a basic shoulder MRI.
Avista Adventist Hospital in Louisville says it charges $2117.50 for a basic shoulder MRI and will discount that another $318 for cash up front.
Open MRI of Pueblo says it charges a cash price of $600, which is due at the time of service. That cost includes a radiologist's fee.
The Greeley Medical Clinic says it charges $2,281 for a basic shoulder MRI.
Patients can save thousands of dollars on a MRI
Patients who must pay for their own basic shoulder Magnetic Resonance Imaging Test can save up to $3,000 by shopping around. This survey asked for prices for a no-contrast image of a shoulder. Some facilities include the radiologist fee for free.
Medical Facility - Price
Thornton Imaging Center - $450
Touchstone Imaging, Lakewood - $450
Radiology Imaging Associates, Denver - $585
Colorado Springs Imaging - $600
Open MRI of Pueblo - $600
Health Images, Aurora - $625*
St. Anthony Central Hospital/Denver NMR, Inc. - $1,050*
Penrad Imaging in Colorado Springs - $1,077*
Twin Peaks Medical Imaging, Longmont - $1,320*
Community Hospital, Grand Junction - $1,932*
Poudre Valley Hospital, Fort Collins - $2,112*
Avista Adventist Hospital, Louisville - $2118
Banner Health in northern Colorado - $2,228*
Greeley Medical Clinic - $2,281
Colorado Plains Medical Center, Fort Morgan - $2,863*
Boulder Community Hospital - $3,360*
St. Anthony North Hospital, Westminster - $3,366
Memorial Hospital, Colorado Springs - $3,460*
* Fee at these facilities can drop five to 50 percent if the patient pays cash up front.
This story written by Cara DeGette and Jeremy Hoover, Colorado Public News.
(©2011 Colorado Public News)