On average, the Methodist Medical Center Of Illinois in Peoria charges $26,892.08 for a procedure known as a mastectomy, a total breast removal — but one could get the same care for just $435.60 about 80 miles away in Monticello, according to an analysis of hospital price data by Turquoise Health.
Indeed, the charges for typical procedures vary widely throughout central Illinois. A review of selected hospitals found that the price for a procedure can vary by thousands depending on the area it’s located in, but clear information on cash prices is often missing from the hospitals’ disclosures.
Fortunately, Turquoise Health, a private company, has compiled data reported under the law and lets users search and compare hospitals’ charges for care in their area. But the company cannot do comparisons where hospitals do not provide the data.
Hence, finding the best price for a procedure remains difficult despite a federal law enacted in 2021 that requires hospitals to make their pricing data accessible and available for comparison by patients.
According to the Centers for Medicare and Medicaid Services, the legal text about hospital price transparency says “each hospital operating in the United States will be required to provide clear, accessible pricing information online about the items and services they provide.” This shall occur both through “a comprehensive machine-readable file with all items and services,” and “a display of shoppable services in a consumer-friendly format.”
Turquoise Health’s mission is “to make pricing clearer, simpler and lower cost,” and it offers comparisons of hospital costs based on location, region and zip code. This translates to an equally clear vision of “a not-so-distant future where prices have menu-like clarity at a fair market rate.” The website also provides several tools to navigate data and patient resources and costs related to different insurers.
Using an online list of the 19 most common surgical procedures presented by Johns Hopkins University (JHU) Medicine as a baseline, CU-CitizenAccess looked at seven of these procedures and compared their average cash price rate availability against hospitals around central Illinois. For certain procedures, many hospitals were not listed at all on the database, or the hospital names were listed and did not disclose cash prices.
An example of this arises when looking at hysteroscopy, the examination of the inside of the cervix and the uterus, followed by a biopsy. Carle Foundation Hospital in Urbana charges $10,300 at cash price for this, while 90 miles away in Lafayette, Indiana, the Indiana University Arnett hospital lists a cash price of $1,758, alongside several other hospitals in Indiana. Further, the Lawrence County Memorial Hospital in Lawrenceville, Illinois lists a cash price of only $653.
OSF Heart of Mary Medical Center in Urbana is not listed when searching for this procedure, and Decatur Memorial Hospital doesn’t list a cash price. While distance gaps are not the rule in the cash price rates shown on Turquoise, it occurs quite often, particularly across the Illinois-Indiana state lines.
OSF did not return a request for comment.
Its website consists of four tabs: browse care, solutions, platform and resources. The browse care tab opens the resource page on which patients can search prices and quality of care for procedures, providers, health systems and health plans, such as those offered by Aetna and Blue Cross Blue Shield. Each of those is listed from A-Z and can be modified by selecting a geographical boundary and/or a chosen distance in miles.
The other tabs on the website offer a variety of data and written resources about the company’s internal work as well as its significant influence in the healthcare sector, described by clearly formulated prompts. These include media coverage, blogs, dataset access and partnerships.
Carle Foundation Hospital and OSF Heart of Mary Medical Center have no cash prices available for most of the procedures compared. The legal text says “Discounted cash price means the charge that applies to an individual who pays cash (or cash equivalent) for a hospital item or service.”
For Carle, three out of 19 procedures could be connected to cash prices, whereas for OSF Heart of Mary, this value was indeed zero. Many procedures of the list were not found for the respective hospitals, not necessarily because cash prices were not listed.
Carle Public Relations Manager Brittany Simon provided a small statement in response to a request for comment:
“Carle strives to support patients in understanding their bills. We continually work to add tools that assist in this regard. Carle follows industry standards and works with a range of insurance providers to negotiate fair fees for the services Carle provides to our patients,” she said in an email.