In case you missed it, Castlight Health recently released a study showing wild disparities in the cost of common medical procedures.
Depending on what city you live in, the same in-network MRI could cost $536 (Los Angeles) or $3,410 (San Francisco). A lipid panel averages $17 in Raleigh, N.C. but $94 in Austin, Texas.
You’d think the disparity has something to do with the cost of living or with the general health of the city’s population, but it doesn’t. It has to do with “what providers can negotiate with insurance companies,” Castlight’s Jennifer Schneider told the Washington Post. “Those with the biggest market share have the most clout.”
The disparity doesn’t just appear from city to city, however. It’s also seen at different providers in the same city. In my own city of Richmond, Va., for example, the cost of a CT scan varies from $218 to $2,009.
And it’s seen in neighboring cities as well.
Washington, D.C, a much larger and wealthier city than Richmond and only about 3 hours away, is a little more expensive for an average preventative care visit ($141 in D.C., vs. $136 in Richmond) but a lot cheaper for an average CT scan ($681 average in D.C. vs. $1,307 average in Richmond).
The big question is, “how do consumers achieve parity in pricing?” The answer, according to Castlight, is “transparency.”
“By exposing such pricing data to consumers,” Castlight Health CEO Giovanni Colella told the Wall Street Journal, “it can help them make more informed choices that could save money for employers and employees.”
Forbes Magazine looked at all the data and compiled a list of the 10 most expensive healthcare cities overall.
1. Sacramento, CA Sacramento is the most expensive city for CT scans at $1,404 and MRIs at $2,635—just three hours away from a $676 MRI in Fresno. California’s capital also comes in second for preventive primary care at $219. The good news? Lipid panels average just $24, not even breaking into the top ten cities for that procedure.
2. San Francisco, CA With an average cost of $251, San Francisco is the most expensive place to find preventive primary care in the U.S. It also falls right behind Sacramento for MRIs and ranks fifth for CT scans at $1,203. Like Sacramento, lipid panels are a bargain at $24.
3. Dallas, TX Dallas is the fourth most expensive city for CT scans, fifth for MRIs, and eleventh for preventive primary care. At $47, lipid panels are nearly twice the California cities’ cost.
4. St. Louis, MO One of two Missouri cities with notably high healthcare costs, St. Louis is the eighth costliest place for MRIs, tenth for CT scans and thirteenth in preventive care. It’s one of the cheapest places for a lipid panel at just $20.
5. Kansas City, MO Whether or not Kansas City is technically more expensive than St. Louis depends largely on one’s healthcare needs. The third most expensive city in the country for both CT scans and MRIs, it falls to eighteenth when it comes to preventive primary care at just $138. On the other hand, Kansas City is the fourth most expensive city to get a lipid panel at $79.
6. Charlotte, NC Seventh for MRIs at $1,813 and fifth for primary care at $199, Charlotte is barely on the charts for CT scans, ranking twenty-ninth at $619.
7. Denver, CO Denver scores a pair of sixth place rankings for CT scans and MRIs, but falls to nineteenth in preventive care at $134.
8. Miami, FL Miami ranks notably high for the cost of an MRI. It’s the fourth most expensive place for one at $1,968, but falls to ninth for CT scans and ranks thirtieth for preventive care at just $95.
9. Boston, MA The sixth most expensive city for preventive primary care, Boston is also number 10 when it comes to MRIs at $1,737. When it comes to CT scans, however, Boston drops to nineteenth on the list at $853.
10. Portland, OR With one of the widest variations between procedures, Portland is the third most expensive city for preventive primary care at $216, but drops to fourteenth for MRIs and seventeenth for CT scans.
Check out Castlight’s interactive map of the data.
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