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It is a good start, but he doesn't have the detail at the local level to see what is going on - the prices are all over the map and there is no way to rationally determine what is expensive.

I have a weird plan where I pay a percentage of the total cost, but have to pay for everything first and then get reimbursed; but ultimately a more expensive operation ends up costing me more, so it always makes sense to shop around.

As a result, I know all the cash costs for an upcoming outpatient surgery I am having, and whether they offer cash discounts.

The difference between various hospitals and service centers is HUGE, like 5 to 8 times from one place to another.

Imaging center "A" : CT scan $232 ; Chest Xray: $33; EKG: $21

Hospitals "A" and "B" : CT scan >$1000; Xray $185; EKG: > $100

You end up renting the operating room (the surgeon has privileges at 4 different locations):

(new, shiny, modern) Surgery Center "A": $1200 with cash discount

Hospital "A" : no exact price, "range is $7K to $11K, typical is $9500"

Hospital "B" : no exact price, "range is about $7500, cash discount = $5000"

HOW can it even be reasonable that there is such a discrepancy in pricing? For one hospital, the CT scan "interpretation charge" was more than the $232 I spent on the entire scan + interpretation at the imaging place I went to.

(And yes, I used the exact same billing code in discussions with all the medical billing people I talked to.)

I should add, that I think that part of what is going on with the hospitals, is to make cash payments so cumbersome, that people are herded into the arms of the insurance companies.

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