How Much Should You Pay for Medical Care?

New website offers simple cost estimates but falls short. On pricing, operations aren't like used cars.


Estimating the cost of a medical procedure or service ought to be as straightforward as pricing a used car—or at least that's the idea behind a new website, www. healthcareblue b . You pick a procedure, type in your ZIP code, and, presto, the site tells you the average fee accepted by providers in your area for that service. If you're uninsured or if your plan has a high deductible or coinsurance amount, you may be able to use this information to negotiate a lower rate similar to what typical insurers pay, according to the site. It even provides a handy "binding price estimate agreement," which spells out the estimated charge, that you could present to the doctor or hospital to sign before you receive services.

If only it were that simple. While it may be reasonable to shop for uncomplicated services like an MRI by comparing prices, most medical care isn't that clear cut. Take brain surgery. According to the website, in the Boston area, adult brain surgery to remove a tumor costs $42,827, on average. That price includes $4,490 for the surgeon's fee, $36,671 for the hospital, and $1,666 for anesthesia services. The site notes that if someone spends more than the estimated 13 days in the hospital or requires more than three hours of surgery, the figures could change. Talk about understatement. Anyone who's ever examined a hospital bill knows they often contain hundreds of moving parts that affect the cost. Because of all those unknowns, providers aren't likely to sign any agreement before the fact that limits how much they can charge, as my colleague Avery Comarow noted last week. (Here are four steps you can take to lower your medical bills, however.)

Then there's the question of quality. As Jeff Rice, founder of Healthcare Blue Book, notes in a new release announcing the site: "Patients should not assume that a high price means good quality." Fair enough, but since doesn't incorporate any quality information, consumers have nothing else to go on. And, unfortunately, "in its absence, some people use price as a proxy for quality," says Ha Tu, a senior health researcher at the Center for Studying Health System Change who has examined consumer shopping behavior for medical services.

There's general agreement that the trend toward increased transparency around healthcare pricing and quality is a good thing, and many providers, state governments, and private organizations are starting to make this information available to consumers. Eventually, experts hope that consumer-friendly "cost-efficiency" ratings that incorporate both price and quality will become widespread. But much of what's out there right now is pretty rudimentary, as this new site demonstrates. Go ahead: Kick the tires, and check it out. But for now, sites like this are a pretty unreliable way of getting you where you want to go.