California provides average prices for inpatient and outpatient procedures as of June 1, 2020, as listed in each hospital’s chargemaster. All CA hospitals are included; however, the prices are now one year out of date. Excel files show prices for at least 25 common outpatient procedures. ER visits, MRI and CT test prices should be included, along with selected outpatient surgery. The average cost (charge) for top 25 types of outpatient procedures or surgery includes CPT codes. Outpatient reports may show hospital prices for Emergency Room visits, office visit code 99213, lab tests, CT, MRI, Mammogram, x-ray, ultrasound, Physical Therapy visit, Arthroscopy, colonoscopy, endoscopy, carpal tunnel, hernia repair, gall bladder removal (laparoscopic cholecystectomy), lumbar injections, tonsillectomy, ear tubes and more, depending on each hospital’s highest volume.
California 2020 inpatient prices are listed only in the massive and complicated Charge Master, which shows the charge for every pill, lab test and hospital room rate. This is where you will find maternity, obstetrics, newborn nursery, labor and delivery charges. But you may need to wade through more than 10,000 individual services listed in the chargemaster to find what you want to know. Files are in Excel file format. Prices are from 2020. Consumers can see one hospital at a time. Provided through California OSHPD, the state government Office of Statewide Health Planning and Development.
Compare average charges at Colorado hospitals and amounts allowed by insurance in 2019. More than 50 types of hospitalizations. Click on View Reimbursement by Diagnosis or Insurance Provider to see average total charge in 2019, and how much the insurance company allowed. Amazingly, the patient’s responsibility (called member liability) is also shown. Consumers can appreciate the transparency between prices and insurance-allowed amounts. Example: Major joint replacement without complications (such as a hip or knee replacement) had an average price near $82,000 in 2019, and had an average insurance allowed cost near $34,000, or about 41% of the charges; member liability portion was an average of $1,607. Uncomplicated delivery had an average price of $16,151 in 2018, with insurance companies allowing $8,104, or about 50% of the charge. The patient responsibility averaged $1,714. (Maternity 2019 prices were not yet available.) Consumers are also able to see actual hospital prices (Click View Hospital Charges, then select year 2019 and procedure). Example: Average 2019 price for major joint (hip or knee) replacement without major complications at CO hospitals that performed at least 100 procedures, ranged from $40,685 in Delta, to $211,612 at North Suburban Medical Center in Thornton (over 5 times higher). Physician charges are not included in the inpatient costs. However, outpatient prices on average for the state, or region, are also available for 2019. Cataract surgery, colonoscopy, emergency room visit, knee arthroscopy, physician office visit and pregnancy test prices are examples of average charges available on the insurance report. Regions are Denver, Ft. Collins, Boulder, Colorado Springs, Grand Junction, Greeley, Pueblo, East and West. The information is jointly published by the Colorado Hospital Association, in conjunction with the state Division of Insurance’s Department of Regulatory Agencies (colo.gov). Updated 2020. Specific hospital prices are listed, showing both charges and amounts allowed by insurance, along with the member patient responsibility. All are excellent features. However, the site is no longer current enough to earn Editor’s Pick in 2021.
Compare Florida inpatient hospital ratings on infections, patient satisfaction, average price (cost estimate), and readmissions. In the Quality Report Card column, find volume (number of hospitalizations) or how many procedures they do each year in various specialty service line, average length of stay, and readmission rate. 2019 and 2020 data. State inspection reports are also shown on each hospital’s individual page. Click on Care Bundle Pricing $ icon to find hospital and an old report on average statewide charge. Prices are old, and estimated to July 1, 2019 only. All age groups (not just Medicare), extensive set of health conditions/diseases, and the ability to sort with best FL hospitals at the top of the list, make this website helpful. While the Quality and Satisfaction scores are current, the cost information is not. Click on the hospital name to additional information about the hospital. Hysterectomy listed under Women’s Health instead of Surgery. FloridaHealthFinder.gov, updated 2021.
Illinois hospital and ambulatory surgery center ratings and prices, from IDPH. Compare IL hospitals on patient satisfaction ratings; heart attack, heart failure, pneumonia, surgical infection prevention, knee arthroscopy, cardiac surgery, safety measures, infection rates, some survival information, more. See volume and 2019-2020 median charges (closest you’ll get to average cost) for selected types of inpatients (e.g. birth, c-section, appendectomy, COPD, gall bladder), and outpatients at ambulatory surgery centers (such as arthroscopy priced at $42,000 average in IL), bunionectomy (which had a statewide list price at $23, 374), hernia repair ($24,600), colonoscopy ($7,400), lens, lumpectomy, tonsillectomy (almost $15,000). Prices may be found under the SERVICES tab after you select the hospital or facility. May get a full report for one hospital or ambulatory surgery center at a time, or one measure at a time for multiple facilities side-by-side, with state averages. Hospital Report Card by IL Dept. of Public Health (IDPH) for all IL cities incl. Chicago area, Peoria, Rockford, Springfield, Champaign. Updated with 2018-2020 prices, 2019 and 2020 quality data, and 2019 patient satisfaction scores. Add medical inflation costs of at least 7%.
Find the average cost for both hospital and doctor visits in Maine in 2020 to 2021. These “costs” may be less than charges or prices, since they are what 35 commercial payers actually paid for the service in the 12 months ending March 31, 2021. Compare costs at different clinics and hospitals. Average cost for an ER visit in Maine was $604 for a moderate severity emergency department visit (before adding lab, imaging and other tests). A high severity visit (code 99284) to the ED cost $1,029 before other test costs were added in. Average vaginal delivery costs (median payment) was $16,451 for Childbirth delivery and 60 days of related care. This was up 15% from the prior year. (Does include physician care, but probably not newborn charges). An uncomplicated C-Section averaged $24,257, up 8%. Find costs for other surgeries by hospital, such as hip or knee joint replacement, arthroscopy, colonoscopy, hernia repair, tonsillectomy and gall bladder surgery. Find many median (middle) payments here physician office visits ($116 average cost for 15-minute appt for an established patient 99213), CT, MRI, x-ray, lab tests and more. A one hour crisis psychotherapy visit averaged $218. An ongoing 60 minute psychotherapy visit (90837) cost $100 on average. Uses CPT codes. All “average cost” figures are actually median payment. Almost 8 million claims were analyzed. However, no Medicare or Medicaid claims were included. More surgery costs were added this past year, so we are giving this the Editor’s Pick award. From Maine Health Data Organization in State of Maine
Compare costs in Maine for surgery, x-ray, imaging and lab tests across hospitals and medical groups. MHDO Maine Health Data Organization’s website shows average amount paid (median “cost”) by commercial insurance for surgery such as hip or knee replacement, shoulder arthroscopy, carpal tunnel, gallbladder removal; skin growth removal; lab tests such as strep, blood tests, urine. Imaging tests such as mammogram, x-ray, CT, MRI, ultrasound. Diagnostic procedures such as colonoscopy. Good news is that both physician and hospital charges for surgery are shown to give you an idea of total cost (and discounts); CPT codes listed. Costs for surgery, office visits and tests are from 2020-2021 claims, excluding Medicare and Medicaid. Search by city or zip code radius. From maine.gov; updated 2022.
Compare hospital prices in Maryland for 2021. Volume (number of cases) and average charges (prices) at each Maryland hospital (by name) and statewide are available for more than 300 of the most common inpatient diagnoses. Includes newborns (average cost $2,371), childbirth vaginal delivery ($9,625), c-section (avg. $12,203), septicemia, heart failure, COPD, pneumonia, hip replacement ($32,015), knee joint replacement (average cost $33,602), cardiac arrhythmia, major depression ($14,207), bipolar admissions ($13,804 state average), schizophrenia ($18,932), cellulitis ($11,748), stroke, urinary tract infections ($11,438) and rehabilitation ($30,455). Data from first half of 2021. Hospital prices for the same procedure can vary widely. For example, inpatient hip replacement cost $35,199 on average at Johns Hopkins Bayview Medical Center, which had the largest program and an average length of stay of 4.3 days. Sinai Hospital, on the other hand had an average price over $52,000, which was the highest of any hospital that did at least 80 hip cases in six months. Sinai’s length of stay was 6.7 days. Mercy Medical Center had one of the shortest average stays – 1.8 days, and an average charge under $22,000. Easy to use website; easy to sort columns. Consumers can also view the average cost for commercial insurance patients compared to Medicare or Medicaid, for example. By MD Health Care Commission MHCC 2022.
Missouri hospital ER prices, inpatient cost and quality ratings. To compare hospital costs, click on Find a Hospital, then Pricing Data to find the average 2021 price (median charge) for common inpatient medical conditions and surgeries at Missouri (MO) hospitals. In addition, if you click on the arrow to expand, you will find a range of charges, average length of stay, and number of cases per year shown. Childbirth, maternity, mental health, hip and knee surgery, heart care, etc. Must know the general body system (such as musculoskeletal) in order to search inpatient prices.
Emergency department (ER Emergency Room) visit costs are shown separately by “level”. In Missouri, nearly 2/3 of the ER visits were at Levels 3 and 4. Median charge for Level 3 ER visit in 2021 (the most common, moderate severity & moderately complex case) was $1,746. This was 7.6% higher than last year. The second most common ER visit was Level 4 (high severity), had an average cost of $4,435, up almost 7% from 2020. The highest possible Level 5 visit cost $7,748 on average, up 9% from 2020. Just 11% of ER patients were classified as Level 1 or 2; the median prices for these low level visits were $541 and $880 respectively. Average prices shown for 2021. We assume these average costs reflect base price only, without “extra” test costs, and possibly without physician fees. Such information was not readily available at the site. The cost numbers are “sticker price”, not what insurance pays after discounts. Hospital “self-pay discounts” (e.g., 30% or 40% discount off the full charges) are listed at the site. Hospital Quality data also shown at this site. Compare hospitals on infections, readmissions, falls, and other patient safety results. Editor’s Pick for putting all of this information in one place and timely reporting on quality and costs. Published by the Missouri Hospital Association.
Compare inpatient prices at Montana hospitals. MHA PricePoint shows median and average charges for inpatient stays (2019-2020 prices), including newborns, deliveries, Cesarean section, knee or hip replacement, rehab, psychiatric hospitalization, back problems, heart failure, stent, chest pain, bowel surgery, more. Length of stay also shown. An admission for Psychoses (severe psychological disorders) in MT averaged 8.7 days with a median charge of $12,699 and average cost $18,085 in 2019-2020. Joint replacement was $40,885 average, 2.0 day stay. Uncomplicated maternity stay cost $11,051 in 2019-2020 (average charge). Average cost for a normal newborn stay was $3,231. Consumers may wish to add about 5.1% medical inflation to estimate 2021 prices. Discounts to insured patients are not shown. PricePoint site by MHA-Montana Hospital Association.
Nevada PricePoint Hospital Inpatient Charges for 2020-2021. Find average cost and typical prices for many types of inpatient hospitalizations in NV. Examples: childbirth prices, COPD, heart surgery, pacemaker, stents, hip & knee surgery, digestive problems, psychiatric hospitalization, rehab. Volume and average length of stay in the hospital also given. A normal newborn charge in 2020-2021 averaged $5,793. Most diagnosis types have 2020-2021 prices, but maternity stays were not populated. (Average price for vaginal delivery without complications in Nevada in 2018 [mom only] was a whopping $22,150, 1.9 days average length of stay. The median charge was about the same, for a cost of nearly $12,000 per day. Average c-section 2018 price was $37,000, without complications.) Physician fees are extra and not shown. A psychiatric stay for depression had an average charge of $22,220, average 5.2 days in hospital. Average hip or knee joint replacement had an average cost of $144,332 in Nevada in 2020-2021, with a 2.3 day stay. Comprehensive Query for prices on other conditions that are not on the Basic list, appears to be very limited. Get one hospital/one disease or condition at a time, then select other hospitals to compare; July 1, 2020 to June 30, 2021 charges shown. Sponsored by the Nevada Hospital Association.
Find the average charge (closest available to inpatient cost) for a Oklahoma hospital stay (compare OK hospital prices) by Principal Diagnosis (i.e., disease) or DRG. Example we found was the average price in Oklahoma for mental illness was $28,468 in 2019, with an average length of stay of 8.1 days. The mental health cost was up 20% over 3 years (vs. 7.5% general medical inflation). With additional medical inflation to 2022, the mental illness cost would be close to $31,000 in 2022 dollars. Statewide or county-specific statistics on volume and average length of stay also found in this dataset. May specify data for a certain age group and sex, but not specific procedures such as a knee replacement. Geared to researchers and health care professionals, rather than for consumers. If this website was meant for consumers, it would get the User-Unfriendly Award due to its complicated diagnosis choice sections. 2019 data are the most recent available as of April 2022, from OK2SHARE by the OK State Dept. of Health’s Health Care Information.
Find hospital performance reports in Pennsylvania for 2019, through PHC4. Compare PA hospitals on Mortality Rating (relative survival rate), Average Charge (price), and Readmission rates. Sixteen (16) conditions in the reports include heart failure, abnormal heartbeat, heart attack, angioplasty and stent, pneumonia, stroke, intestinal obstruction, COPD, diabetes, kidney failure, urinary tract infections, sepsis, chest pain, and respiratory failure. Grouped by region. As an example, there were 70,000 sepsis cases in Pennsylvania in 2018-2019, with an average mortality rate of 8.7% (a great improvement from 5 years earlier), and an average charge nearly $63,000; about 18% were readmitted. There were 26 hospitals that had worse mortality than expected for sepsis; and 18 hospitals that had significantly lower mortality than expected. Symbols for Mortality ratings can be confusing – a higher mortality rating means worse survival. Older reports may have laparoscopic gallbladder removal information. No orthopedic (hip or knee) surgery included. Data from Oct. 2018 to Sept. 2019, published by the Pennsylvania Health Care Cost Containment Council (PHC4), December 2020.
Find South Dakota hospital prices (2019 costs), by name of hospital. SD PricePoint shows average inpatient charges and typical (median) prices for 2019 at South Dakota hospitals. View one hospital at a time, or compare to hospitals for the same type of hospitalization. Select additional cities to add comparisons. Average hospital prices across the state are also listed. As an example, the average 2019 price for a vaginal delivery with no other procedures was $11,705 in SD hospitals; average healthy newborn stay was $5,661. Costs exclude doctor fees. All common hospitalizations shown, such as births and maternity delivery, knee replacement (average price about $50,400), heart failure, pneumonia, bowel procedures, COPD, angioplasty, kidney transplants (median $252,418), inpatient laparoscopic gallbladder removal (average price $54,200, but $62k average in Sioux Falls) and much more. Site shows number of cases and length of stay also. Site by SDAHO (South Dakota Association of Healthcare Organizations, the state’s hospital association. Last updated in 2020 (as of August 2021).
This file on Utah hospital charges, number of cases and severity mix is for administrators and financial analysts who are interested in UT hospital market share. Each hospital lists number of cases by APR-DRG, CMS DRG or MDC, total charges and length of stay, from 2018. Title: 2018 report, Utah Hospital Utilization and Charges Profile, Hospital Detail. Format is Excel file only; difficult for average consumers to find useful. Enable editing lets you open up the + sign to see the details. Must do your own calculations of average charge, or market share. Number of cases by hospital and county can be found under “Local Health District” category. Online file by UT Office of Health Care Statistics, UT Department of Health. No updates as of August 2021.
Which hospitals have the largest inpatient market share (counts) in Vermont for each major service line? The State of Vermont (Act 53 Hospital report cards) list volume of inpatient hospital admissions for each VT hospital, along with the statewide average price (charge) for the top 20 types of admission (by MS-DRG). See Table 1B – Counts. 2020 report cards show counts to calculate market share for year ending Sept. 30, 2018. Updated June 2020. The 2019 report cards do not yet appear to be published as of Sept. 2021.
Find Virginia Healthcare Prices for ER visits, ambulatory surgery, tests and hospital stays. This site shows average price ALLOWED (commercial insurance prices) in 2018 for almost 40 common healthcare services in VA. Includes a mix of outpatient, clinic, hospital stays and other services such as an ambulance (median $550) or an emergency helicopter ride ($19,466 which includes average base cost of $14,402 plus mileage). Examples: hospitalizations (maternity), outpatient xray/imaging, CT and MRI tests; colonoscopy, mammogram; inpatient or ambulatory surgery (e.g. hernia, gall bladder, knee replacement, tonsillectomy, kidney stones); and ER or well-child visits (median $126). Shows median and range of costs and provides a breakout by type of cost: facility, surgeon, anesthesiologist, etc. Also shows average price by setting: clinic vs. hospital vs. ambulatory surgical center; and region of Virginia. The median amount allowed for an ER visit (medium, code 99283) was $1,091. The 2020 report shows allowed amounts for each service that you or your insurance plan ACTUALLY PAID in 2018. More relevant than most pricing information, but lags in timeliness. Add at least 11% medical inflation rate to estimate 2022 costs. Virginia Healthcare Pricing Transparency, from Virginia Health Information (VHI), updated June 2020. No new updates as of May, 2022.
Find estimated hospital inpatient and outpatient charges in Virginia. Check prices for common hospital stays in VA. Topics for many hospitals include costs for childbirth delivery, newborn, C-Section; mental health, depression, psychiatric, alcohol rehab; hip or knee replacement surgery; cardiac cath, pacemaker, valve, stent; pneumonia, rehabilitation, digestive disorders, small or large bowel surgery, back and neck problems, spinal fusion, bone cancer. Use the price estimator tool to find average cost of doctor’s office visit, gall bladder surgery (cholecystectomy), CT or MRI test, psychotherapy visit and many other common outpatient services. Procedure list and hospitalizations may vary for each hospital. The price estimator tools and “standard charges” machine readable file replace the former PricePoint system. Quality scores are no longer linked. No side-by-side comparisons. Consumers may be required to provide their name and personal information for some hospitals. Provided by the VA Hospital & Healthcare Association (VHHA).
Find average facility charges and volumes for each Wisconsin hospital in 2020. Charges exclude physician and surgeon fees. Two-page summary for each WI hospital’s number of births, and other types of inpatient stays: Stroke, Knee replacement (APR-DRG 302), hip replacement (301), COPD, Pneumonia, Heart Failure, Bowel surgery, Septicemia, Psychoses, etc. Reports also show average length of stay and statewide average charges for the year 2020. Health Care Data Report 2020 released by WHA Information Center was updated August 2021.
Wisconsin PricePoint tool shows average hospital price, median charge and length of stay for common inpatient services. Full year 2021 prices are shown. Hospitalizations include maternity and newborn births, hip or knee replacement surgery, gallbladder removal, heart surgery, angioplasty, arrhythmia (irregular heartbeat), valves, cardiac cath, pacemaker, pneumonia, bipolar and other mental health, stroke, back care, asthma, COPD, rehab; kidney, heart, lung or other transplant; hysterectomy, prostate surgery, bowel surgery & more. Dates are not shown on the consumer version of the PricePoint tool. (See dates by going through the professional tool, from the Home page.) Also shows inpatient volumes if you click on more detail. Median price for a uncomplicated vaginal delivery in 2021, with normal newborn care was just over $16,000 total (about $12,000 for mom and $4,000 for baby). From WHA Information Center, part of the Wisconsin Hospital Association WHA Information Center. Updated Apr. 2022.
Surgeon and other physician fees NOT included. Wisc. Hospital Assn. created the PricePoint System now used in other states. This version of Pricepoint has been modified to be payer-specific, so consumers can get a better idea of average cost. Gross charges (sticker price) should be the same for all patients who have identical care. Must watch a video before proceeding to see the prices; you may also need specific medical information about the procedure in order to select the price you are interested in.
Find the average cost (payment) for healthcare services to Medicaid patients in South Carolina. SC Department of Health & Human Services shows how much the state paid for Medicaid costs, by type of service. It appears that the average amount paid per visit was about $38 (physician) and $88 (clinic); about $150 for a dental visit; $5,256 for a hospital inpatient stay, and $31,658 for a nursing facility resident in 2012. Consumers can also compare what each provider was paid by downloading the full datasheet (Excel file). Full charges (prices) are NOT shown. Medicaid Transparency Reporting project, FY 2012 data is latest available; very old.
Washington State Hospital Association (WSHA) has discontinued its inpatient price comparison site. Another disappointment for consumers who used to be able to compare hospital inpatient prices in the state of Washington. The old site also helped consumers estimate the average cost of about 60 types of hospital surgery or medical problems, including maternity care, newborn cost, psychiatric hospitalization, knee joint replacement, and digestive problems. 2021 note. Each hospital is required to post standard charges for certain procedures. Not all hospitals comply.
Compare costs at Wyoming hospitals through the Hospital PricePoint website. Inpatient charges in WY are shown for 60 common types of hospital admissions. Average statewide cost in WY is also shown, like childbirth (average price for uncomplicated vaginal delivery in state was $9,323, which would be more than $10,500 in 2021 dollars), newborn, hip or knee joint replacement surgery (average charge $54,605 without complications), heart valves or stents, pneumonia, psychiatric admission ($19,055 average price for severe psychological disorders including schizophrenia, with average 9 day stay in hospital), rehab, and many more. Site shows one hospital at a time. Unfortunately, the charges are quite old, showing 2016-2017 prices; add at least 13% medical inflation for 2021. (Better yet, call the hospital for current information.) WyoPricePoint is by the Wyoming Hospital Association.
Compare hospital and outpatient surgery costs in Oregon. The most recent data are from 2019 costs. However, only the difficult-to-use Excel files full of data are available from the government OHA – Oregon Health Authority. In the past, a set of reports (instead of just the data file) showed the median amount PAID by commercial insurance companies. Costs paid, are after any discounts off charges (prices) have been taken. The data file was updated June 30, 2021.
If you choose the older Reports (2017 or 2018), select OUTPATIENT SURGERIES Report for same-day procedures such as breast biopsy ($3,302 median paid in 2017), carpal tunnel ($4.313), colonoscopy ($2,383), ambulatory gallbladder surgery ($11,697), hernia repair ($8,605 median paid), knee or shoulder arthroscopy, tonsillectomy ($6,380), tympanostomy (ear tubes $4,680), upper endoscopy, and more. Select INPATIENT Procedures Report to compare hospitals on costs for appendectomy, coronary bypass, kidney removal, inpatient gallbladder surgery or hernia repair, inpatient hip replacement, hysterectomy, angioplasty and more. Select PREGNANCY report to find 2017 maternity costs paid (about $8,400 for normal delivery, $14,838 for uncomplicated c-section and $2,200 for newborns). Compare hospital payments for IMAGING such as CT, MRI, Nuclear Medicine tests, ECG, x-ray, bone density studies. Compare amounts paid for RADIATION AND (outpatient) CHEMOTHERAPY infusions or injections. The reports are easier to read, cover a large set of services, and show each hospital’s payment, along with what was paid the year before. Unfortunately, the information in the reports is 4 to 5 years old. When estimating, consider medical inflation which has been about 13% from 2017 to 2022.