Pricing for preventive care varies widely

A mammogram is supposed to be a low-cost preventive healthcare service, but a new survey by Castlight Health concludes that prices for the x-ray image vary wildly within cities and geographic regions.

A patient seeking a mammogram could pay anywhere from $43 to $1,898 for such an examination, according to the survey. New York City has the most expensive mammograms in the country, starting at around $130 and topping out at the $1,898 price tag. Dallas has the biggest price differential, ranging from $50 to $1,045.

"These numbers are eye-opening. It's especially disturbing that women and their employers could be needlessly overpaying for mammograms and other critical health services. Despite mandated insurance coverage for certain services, evidence shows that women forgo basic preventative care due to cost considerations and that delaying preventative care can harm patient health and increase future medical spending," said Kristin Torres Mowat, Castlight Health's vice president of strategic alliances and data operations, in a statement. "Overall, the data demonstrate that medical price variances continue to reflect larger systemic problems in the U.S. healthcare system."

But there were also huge variations in other relatively straightforward tests. A lipid panel--essentially a cholesterol test--ranged in price from $14 to $1,070 in New York, although the average price was just $53. However, the average has risen 51 percent over the past year. In San Francisco, the average price increased 282 percent, reaching $93.

For lower-back MRIs, Indianapolis was the most expensive city in the nation, averaging $2,307 for such a test, more than double the price of a year ago. In the District of Columbia, the average MRI cost $1,059 and actually dropped 24 percent in price year over year.

Geographic price variations have been the norm for healthcare delivery in the United States, and they are tied primarily to differences in health status and hospital costs. And organizations such as the Institute of Medicine have criticized the variations because it makes it difficult to improve the value of care that patients receive. Reference pricing has been suggested as a way to address such variations, but it apparently cannot address increases in healthcare spending.

To learn more:
- check out the Castlight statement
- study the Castlight interactive map