Shocking Difference in Cost of Mammograms Nationwide, NY Ranges from $130 $130 - $1,898


Oct 8 2015 - 4:08pm
Cost of mammogram is wide

Can someone explain why is the cost of a mammogram so widely different in the United States for breast cancer screening?

Health is often a topic of conversation between friends, but, not many would think to compare health care costs. However, a new report just released by Castlight Health, Inc, detailing dramatically different costs around the country for women’s health services like preventive care office visits and routine procedures like pap smears (HPV tests) and mammograms may change that. The second annual U.S. Costliest Cities Analysis, which is based on medical claims data, provider information, and actual provider rate sheets that list the negotiated price between a provider and an insurer, ranks the cost of health care in the 30 most populous US cities. The results about the cost of standard health procedures, such as mammograms, are shocking.

Cost of a Mammogram

Need a mammogram? Well, here’s the reality. It pays to shop around for prices and companies like Castlight Health are trying to make the process a little more streamlined and user friendly by providing an online interactive data analysis map.

In New York, according to data collected by Castlight, the cost of a mammogram can range from a reasonable $130 to an outrageous $1,898 for the exact same test. If you’re like most women, you may be thinking, “That’s a lot of shoes.”

If you live in Merrick, NY you’ll pay $221, still lower than the average cost ($371) of a mammogram in NYC but, you might want to consider popping in your favorite tunes and driving the 40 miles to Teaneck, N.J., where the same test is $95. If you live anywhere in NYC, it would certainly be worth the trip to Jersey.

Now imagine you and your friends are having a nice lunch at your favorite restaurant. You all order the same item and yet your friend’s tuna melt costs $14 while your waiter hands you a bill for $1,898! That is outrageous and may be leaving you asking if you get fries with that. But, that is the difference in price for a lipid panel in NYC.

In Dallas the cost of a lipid panel ranged from $15 to $343.

If you are unfortunate enough to need an MRI in New York City, and you are not a discerning consumer you could pay $4,527 for the procedure rather than a meager $416 in comparison. That is a whopping difference of $4,111, enough to purchase 5 round trip tickets from the Big Apple to London.

Confused yet? Even health professionals, unless they work in billing usually don’t know what cost to expect when scheduling an office visit or test and prices can vary greatly even within short distances. The problem is, you’re not paying the difference between a discount and designer shoe because it’s the same test and there should be some continuity in pricing.

As both a consumer and a health care professional, these disparities are a glaring example that changes in health care over the last couple of years have done nothing to fix the health care system. It is perhaps more fractured than ever before.

Why such disparity? Michelle Scott, general counsel for Fair Health, a consumer organization that attempts to make health care costs more transparent explains that certain circumstances such as rental costs or operating overhead may reflect some of the difference in pricing but that there should be some transparency from health care institutions and providers and more continuity. She comments that, "I think consumers need to take a more proactive role in their health care future. There are tools they can use in order to make proper decisions so they can be the educated consumers which we need to be in this day and age."

Pages