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"disqusTitle": "KQED’s #PriceCheck Project Shows Steep Variation in Prices Paid by Health Insurers",
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"content": "\u003cfigure id=\"attachment_19667\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/RS10943_Facebook_Final-hpf.jpg\">\u003cimg class=\"size-full wp-image-19667\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/RS10943_Facebook_Final-hpf.jpg\" alt=\"(Illustration: Andy Warner)\" width=\"640\" height=\"206\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/06/RS10943_Facebook_Final-hpf.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2014/06/RS10943_Facebook_Final-hpf-400x129.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/06/RS10943_Facebook_Final-hpf-320x103.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Illustration: Andy Warner)\u003c/figcaption>\u003c/figure>\n\u003cp>Since June, KQED has been crowdsourcing health care prices.\u003c/p>\n\u003caside class=\"pullquote alignleft\">For starters, insurers paid from $128 to $694 for a screening mammogram. \u003c/aside>\n\u003cp>Why turn to crowdsourcing? Because health care prices are notoriously opaque. Negotiated rates between insurance companies and providers, both doctors and hospitals, are sealed tight, by contract. We know there’s variation, but comparing what one insurance company pays with another is virtually impossible.\u003c/p>\n\u003cp>So \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/06/23/kqed-launches-project-to-help-make-health-costs-transparent/\" href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/kqed-launches-project-to-help-make-health-costs-transparent/\" target=\"_blank\">we asked you,\u003c/a> the members of our community, to share what you paid.\u003c/p>\n\u003cp>Together with our collaborators \u003ca title=\"http://www.scpr.org/price-check\" href=\"http://www.scpr.org/price-check\" target=\"_blank\">KPCC in Los Angeles\u003c/a> and \u003ca title=\"http://clearhealthcosts.com\" href=\"http://clearhealthcosts.com\" target=\"_blank\">ClearHealthCosts.com\u003c/a>, a New York City startup dedicated to health cost transparency, we created a form to make it easy for people to share what they paid — and easy for consumers to see apples-to-apples comparisons of prices.\u003c!--more-->\u003c/p>\n\u003cp>First off, thank you! Hundreds of you shared what you paid for common health care procedures, and thousands more have searched our database, looking for concrete prices they can count on.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Today, we are also proud to report recognition from the medical community: the journal \u003ca title=\"http://archinte.jamanetwork.com/article.aspx?doi=10.1001/jamainternmed.2014.6793\" href=\"http://archinte.jamanetwork.com/article.aspx?doi=10.1001/jamainternmed.2014.6793\" target=\"_blank\">JAMA Internal Medicine invited me to write\u003c/a> a Viewpoint to inform doctors about PriceCheck findings. It was published Monday.\u003c/p>\n\u003cp>\u003cstrong>How PriceCheck Works\u003c/strong>\u003c/p>\n\u003cp>In PriceCheck we asked people to share prices for four common medical procedures: mammograms, lower-back MRIs, IUDs and diabetes test strips -- although plenty of people shared prices for other procedures, too. Our form can take virtually any share.\u003c/p>\n\u003cp>I described in JAMA Internal Medicine what happens next:\u003c/p>\n\u003cblockquote>\u003cp>“First, people enter the ‘charged' price. Next, people who do not have insurance and pay out of pocket enter the self-pay price. People with insurance can submit both what the insurer paid and their copay amount, if any. All shared costs are automatically fed into the database, which we pre-populated with cash prices for 30 to 35 ‘shoppable’ medical tests and procedures; these prices were collected by ClearHealthCosts.com.\"\u003c/p>\u003c/blockquote>\n\u003cp>We started with mammograms, because this test is done \u003ca title=\"http://www.fda.gov/Radiation-EmittingProducts/MammographyQualityStandardsActandProgram/FacilityScorecard/ucm113858.htm\" href=\"http://www.fda.gov/Radiation-EmittingProducts/MammographyQualityStandardsActandProgram/FacilityScorecard/ucm113858.htm\" target=\"_blank\">more than 38 million times a year\u003c/a> across the country. Since screening mammograms are a test that can be scheduled, women can, in theory, call around and select a facility based on price.\u003c/p>\n\u003cp>We thought we would find variation, and indeed we did.\u003c/p>\n\u003cp>Looking just at the San Francisco and Los Angeles metropolitan areas, we found that the variation in what insurers paid for screening mammograms ranged from $128 to $694.\u003c/p>\n\u003cp>Specifically in Los Angeles, our KPCC co-conspirator Rebecca Plevin\u003ca title=\"http://www.scpr.org/blogs/health/2014/07/21/17024/next-up-for-pricecheck-back-mri-s/\" href=\"http://www.scpr.org/blogs/health/2014/07/21/17024/next-up-for-pricecheck-back-mri-s/\" target=\"_blank\"> found one woman\u003c/a> whose insurer paid $600 more than the lowest-cost screening mammogram in Los Angeles. “I’m sure every woman who’s had a mammogram had the exact same experience I did,” this woman told Plevin. \"It was a friendly technician, but I don’t think that’s worth maybe $600 extra dollars.”\u003c/p>\n\u003caside class=\"pullquote alignright\">Read the \u003ca title=\"http://archinte.jamanetwork.com/article.aspx?doi=10.1001/jamainternmed.2014.6793\" href=\"http://archinte.jamanetwork.com/article.aspx?doi=10.1001/jamainternmed.2014.6793\" target=\"_blank\">JAMA Internal Medicine Viewpoint\u003c/a> about PriceCheck. \u003c/aside>\n\u003cp>In lower-back MRIs, we found that for \u003ca title=\"http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/cpt.page\" href=\"http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/cpt.page\" target=\"_blank\">CPT\u003c/a> code 72148, insurers paid from $467 to $1,567. But when looking beyond commercial insurers, we found even greater variation — from a low of $255 to a self-pay price of $6,221 at an academic medical center.\u003c/p>\n\u003cp>That $255 MRI was paid by Medicare — and was just a fraction of the $2,450 price the facility charged.\u003c/p>\n\u003cp>But the variation doesn’t stop there, as I described in JAMA Internal Medicine. Yet another person went to the same facility and was charged $603 for the same procedure, same CPT code. This patient had commercial insurance, but paid the entire amount out of pocket, the patient said in comments on our form, since “I had not yet met my deductible.”\u003c/p>\n\u003cp>For IUDs, women reported that prices insurers paid ranged from $440 to $1,230 (for both the device and insertion.)\u003c/p>\n\u003cp>We received very few formal submissions for diabetes test strips. But people shared their prices in comments on Facebook or blog posts. Culling from these informal shares, we found that cash prices for a box of 50 strips ranged from $9 to $88.\u003c/p>\n\u003cp>In \u003ca title=\"http://archinte.jamanetwork.com/article.aspx?articleid=1935928\" href=\"http://archinte.jamanetwork.com/article.aspx?articleid=1935928\" target=\"_blank\">an editorial\u003c/a>, JAMA Internal Medicine editor Rita Redberg, a UC San Francisco cardiologist, called PriceCheck \"bold\" and said that PriceCheck is starting to supply \"essential information\" about price information for common health care tests and procedures.\u003c/p>\n\u003cp>\u003cstrong>Why Price Matters\u003c/strong>\u003c/p>\n\u003cp>Until recently, consumers didn’t have much incentive to shop on price in health care. They might have paid only a manageable copay; insurance picked up the rest.\u003c/p>\n\u003cp>But today, many people have high-deductible health plans. So it might matter to you if the price your insurer negotiated at Facility A is hundreds of dollars more than at Facility B.\u003c/p>\n\u003cp>People told us in comments on stories we wrote and on Facebook of their frustration (“fury” might be a better word):\u003c/p>\n\u003cul>\n\u003cli>“High deductible so paid the whole thing and then found out I could have had it done for *HALF* the price only blocks away. My first foray into individual insurance and it s***ed. Need to shop around assuming can even get a price quote.”\u003c/li>\n\u003cli>“I was told the procedure was $1850. I have a $7500 deductible. So I talked to (an employee) who said if I paid upfront and agreed not to report he procedure to Blue Cross, that it would be $580.”\u003c/li>\n\u003cli>“How’s a civilian supposed to make sense of this?”\u003c/li>\n\u003c/ul>\n\u003cp>\u003cstrong>What About Quality?\u003c/strong>\u003c/p>\n\u003cp>We’ve received thoughtful and pointed questions on two fronts. First, many people ask about quality. Should people be shopping for health care procedures in the same way they shop for a computer or look for the best price on canned goods?\u003c/p>\n\u003cp>This is a reasonable question, but the problem is that cost and quality are unfortunately not connected in health care. There’s no evidence that getting the most expensive treatment or procedure will yield a better outcome. People are starting to wonder why they're paying dramatically more if that extra money isn't buying better health.\u003c/p>\n\u003cp>At PriceCheck, we believe that driving cost transparency helps drive quality discussions, too. \u003ca title=\"But thanks to a law enacted in October, Massachusetts health insurers now have to make all their prices public — in advance.\" href=\"But%20thanks%20to%20a%20law%20enacted%20in%20October,%20Massachusetts%20health%20insurers%20now%20have%20to%20make%20all%20their%20prices%20public%20%E2%80%94%20in%20advance.\" target=\"_blank\">A new law in Massachusetts\u003c/a> requires insurers to make their prices public, in advance. Patients can look up their own costs, based on their plan. Advocates are encouraging people to shop on price.\u003c/p>\n\u003cp>We also hear skepticism about the reliability of crowdsourced data. While I noted this important caveat in JAMA Internal Medicine, we are also firmly behind our community and the prices they share with us. Yes, these data are crowdsourced and as such may contain errors, I wrote, then added:\u003c/p>\n\u003cblockquote>\u003cp>“Yet people should be able to understand their medical bills and explanation of benefits statements. Some people who shared their prices provided contact information; we reached some of them to discuss their bills more fully.”\u003c/p>\u003c/blockquote>\n\u003cp>The PriceCheck form and database are open to you. Please visit and search our database for prices — or share what you paid. Help us make health costs transparent!\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/177363983\"]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_19667\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/RS10943_Facebook_Final-hpf.jpg\">\u003cimg class=\"size-full wp-image-19667\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/RS10943_Facebook_Final-hpf.jpg\" alt=\"(Illustration: Andy Warner)\" width=\"640\" height=\"206\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/06/RS10943_Facebook_Final-hpf.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2014/06/RS10943_Facebook_Final-hpf-400x129.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/06/RS10943_Facebook_Final-hpf-320x103.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Illustration: Andy Warner)\u003c/figcaption>\u003c/figure>\n\u003cp>Since June, KQED has been crowdsourcing health care prices.\u003c/p>\n\u003caside class=\"pullquote alignleft\">For starters, insurers paid from $128 to $694 for a screening mammogram. \u003c/aside>\n\u003cp>Why turn to crowdsourcing? Because health care prices are notoriously opaque. Negotiated rates between insurance companies and providers, both doctors and hospitals, are sealed tight, by contract. We know there’s variation, but comparing what one insurance company pays with another is virtually impossible.\u003c/p>\n\u003cp>So \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/06/23/kqed-launches-project-to-help-make-health-costs-transparent/\" href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/kqed-launches-project-to-help-make-health-costs-transparent/\" target=\"_blank\">we asked you,\u003c/a> the members of our community, to share what you paid.\u003c/p>\n\u003cp>Together with our collaborators \u003ca title=\"http://www.scpr.org/price-check\" href=\"http://www.scpr.org/price-check\" target=\"_blank\">KPCC in Los Angeles\u003c/a> and \u003ca title=\"http://clearhealthcosts.com\" href=\"http://clearhealthcosts.com\" target=\"_blank\">ClearHealthCosts.com\u003c/a>, a New York City startup dedicated to health cost transparency, we created a form to make it easy for people to share what they paid — and easy for consumers to see apples-to-apples comparisons of prices.\u003c!--more-->\u003c/p>\n\u003cp>First off, thank you! Hundreds of you shared what you paid for common health care procedures, and thousands more have searched our database, looking for concrete prices they can count on.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Today, we are also proud to report recognition from the medical community: the journal \u003ca title=\"http://archinte.jamanetwork.com/article.aspx?doi=10.1001/jamainternmed.2014.6793\" href=\"http://archinte.jamanetwork.com/article.aspx?doi=10.1001/jamainternmed.2014.6793\" target=\"_blank\">JAMA Internal Medicine invited me to write\u003c/a> a Viewpoint to inform doctors about PriceCheck findings. It was published Monday.\u003c/p>\n\u003cp>\u003cstrong>How PriceCheck Works\u003c/strong>\u003c/p>\n\u003cp>In PriceCheck we asked people to share prices for four common medical procedures: mammograms, lower-back MRIs, IUDs and diabetes test strips -- although plenty of people shared prices for other procedures, too. Our form can take virtually any share.\u003c/p>\n\u003cp>I described in JAMA Internal Medicine what happens next:\u003c/p>\n\u003cblockquote>\u003cp>“First, people enter the ‘charged' price. Next, people who do not have insurance and pay out of pocket enter the self-pay price. People with insurance can submit both what the insurer paid and their copay amount, if any. All shared costs are automatically fed into the database, which we pre-populated with cash prices for 30 to 35 ‘shoppable’ medical tests and procedures; these prices were collected by ClearHealthCosts.com.\"\u003c/p>\u003c/blockquote>\n\u003cp>We started with mammograms, because this test is done \u003ca title=\"http://www.fda.gov/Radiation-EmittingProducts/MammographyQualityStandardsActandProgram/FacilityScorecard/ucm113858.htm\" href=\"http://www.fda.gov/Radiation-EmittingProducts/MammographyQualityStandardsActandProgram/FacilityScorecard/ucm113858.htm\" target=\"_blank\">more than 38 million times a year\u003c/a> across the country. Since screening mammograms are a test that can be scheduled, women can, in theory, call around and select a facility based on price.\u003c/p>\n\u003cp>We thought we would find variation, and indeed we did.\u003c/p>\n\u003cp>Looking just at the San Francisco and Los Angeles metropolitan areas, we found that the variation in what insurers paid for screening mammograms ranged from $128 to $694.\u003c/p>\n\u003cp>Specifically in Los Angeles, our KPCC co-conspirator Rebecca Plevin\u003ca title=\"http://www.scpr.org/blogs/health/2014/07/21/17024/next-up-for-pricecheck-back-mri-s/\" href=\"http://www.scpr.org/blogs/health/2014/07/21/17024/next-up-for-pricecheck-back-mri-s/\" target=\"_blank\"> found one woman\u003c/a> whose insurer paid $600 more than the lowest-cost screening mammogram in Los Angeles. “I’m sure every woman who’s had a mammogram had the exact same experience I did,” this woman told Plevin. \"It was a friendly technician, but I don’t think that’s worth maybe $600 extra dollars.”\u003c/p>\n\u003caside class=\"pullquote alignright\">Read the \u003ca title=\"http://archinte.jamanetwork.com/article.aspx?doi=10.1001/jamainternmed.2014.6793\" href=\"http://archinte.jamanetwork.com/article.aspx?doi=10.1001/jamainternmed.2014.6793\" target=\"_blank\">JAMA Internal Medicine Viewpoint\u003c/a> about PriceCheck. \u003c/aside>\n\u003cp>In lower-back MRIs, we found that for \u003ca title=\"http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/cpt.page\" href=\"http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/cpt.page\" target=\"_blank\">CPT\u003c/a> code 72148, insurers paid from $467 to $1,567. But when looking beyond commercial insurers, we found even greater variation — from a low of $255 to a self-pay price of $6,221 at an academic medical center.\u003c/p>\n\u003cp>That $255 MRI was paid by Medicare — and was just a fraction of the $2,450 price the facility charged.\u003c/p>\n\u003cp>But the variation doesn’t stop there, as I described in JAMA Internal Medicine. Yet another person went to the same facility and was charged $603 for the same procedure, same CPT code. This patient had commercial insurance, but paid the entire amount out of pocket, the patient said in comments on our form, since “I had not yet met my deductible.”\u003c/p>\n\u003cp>For IUDs, women reported that prices insurers paid ranged from $440 to $1,230 (for both the device and insertion.)\u003c/p>\n\u003cp>We received very few formal submissions for diabetes test strips. But people shared their prices in comments on Facebook or blog posts. Culling from these informal shares, we found that cash prices for a box of 50 strips ranged from $9 to $88.\u003c/p>\n\u003cp>In \u003ca title=\"http://archinte.jamanetwork.com/article.aspx?articleid=1935928\" href=\"http://archinte.jamanetwork.com/article.aspx?articleid=1935928\" target=\"_blank\">an editorial\u003c/a>, JAMA Internal Medicine editor Rita Redberg, a UC San Francisco cardiologist, called PriceCheck \"bold\" and said that PriceCheck is starting to supply \"essential information\" about price information for common health care tests and procedures.\u003c/p>\n\u003cp>\u003cstrong>Why Price Matters\u003c/strong>\u003c/p>\n\u003cp>Until recently, consumers didn’t have much incentive to shop on price in health care. They might have paid only a manageable copay; insurance picked up the rest.\u003c/p>\n\u003cp>But today, many people have high-deductible health plans. So it might matter to you if the price your insurer negotiated at Facility A is hundreds of dollars more than at Facility B.\u003c/p>\n\u003cp>People told us in comments on stories we wrote and on Facebook of their frustration (“fury” might be a better word):\u003c/p>\n\u003cul>\n\u003cli>“High deductible so paid the whole thing and then found out I could have had it done for *HALF* the price only blocks away. My first foray into individual insurance and it s***ed. Need to shop around assuming can even get a price quote.”\u003c/li>\n\u003cli>“I was told the procedure was $1850. I have a $7500 deductible. So I talked to (an employee) who said if I paid upfront and agreed not to report he procedure to Blue Cross, that it would be $580.”\u003c/li>\n\u003cli>“How’s a civilian supposed to make sense of this?”\u003c/li>\n\u003c/ul>\n\u003cp>\u003cstrong>What About Quality?\u003c/strong>\u003c/p>\n\u003cp>We’ve received thoughtful and pointed questions on two fronts. First, many people ask about quality. Should people be shopping for health care procedures in the same way they shop for a computer or look for the best price on canned goods?\u003c/p>\n\u003cp>This is a reasonable question, but the problem is that cost and quality are unfortunately not connected in health care. There’s no evidence that getting the most expensive treatment or procedure will yield a better outcome. People are starting to wonder why they're paying dramatically more if that extra money isn't buying better health.\u003c/p>\n\u003cp>At PriceCheck, we believe that driving cost transparency helps drive quality discussions, too. \u003ca title=\"But thanks to a law enacted in October, Massachusetts health insurers now have to make all their prices public — in advance.\" href=\"But%20thanks%20to%20a%20law%20enacted%20in%20October,%20Massachusetts%20health%20insurers%20now%20have%20to%20make%20all%20their%20prices%20public%20%E2%80%94%20in%20advance.\" target=\"_blank\">A new law in Massachusetts\u003c/a> requires insurers to make their prices public, in advance. Patients can look up their own costs, based on their plan. Advocates are encouraging people to shop on price.\u003c/p>\n\u003cp>We also hear skepticism about the reliability of crowdsourced data. While I noted this important caveat in JAMA Internal Medicine, we are also firmly behind our community and the prices they share with us. Yes, these data are crowdsourced and as such may contain errors, I wrote, then added:\u003c/p>\n\u003cblockquote>\u003cp>“Yet people should be able to understand their medical bills and explanation of benefits statements. Some people who shared their prices provided contact information; we reached some of them to discuss their bills more fully.”\u003c/p>\u003c/blockquote>\n\u003cp>The PriceCheck form and database are open to you. Please visit and search our database for prices — or share what you paid. Help us make health costs transparent!\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cfigure id=\"attachment_22493\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/iStock_000037081776_Large.jpg\">\u003cimg class=\"size-large wp-image-22493\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/iStock_000037081776_Large-640x424.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"424\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Earlier this year, KQED launched \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">PriceCheck,\u003c/a> our crowdsourcing project on health costs. We’re working in collaboration with \u003ca style=\"font-weight: bold;color: #114999\" href=\"http://www.scpr.org/blogs/health/2014/07/21/17024/next-up-for-pricecheck-back-mri-s/\" target=\"_blank\">KPCC\u003c/a> public media in Los Angeles and \u003ca style=\"font-weight: bold;color: #114999\" href=\"http://clearhealthcosts.com/\" target=\"_blank\">ClearHealthCosts.com\u003c/a>, a New York City startup looking at health costs.\u003c/p>\n\u003cp>On PriceCheck we're shining a light on the opaque world of health care costs. We've asked what you, the members of our audience, have been charged for common medical tests and services, including \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/07/11/pricecheck-what-insurance-companies-are-paying-for-mammograms/\" href=\"http://ww2.kqed.org/stateofhealth/2014/07/11/pricecheck-what-insurance-companies-are-paying-for-mammograms/\" target=\"_blank\">mammograms\u003c/a> and \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/08/01/pricecheck-how-much-for-a-back-mri-in-the-bay-area-255-or-3700/\" href=\"http://ww2.kqed.org/stateofhealth/2014/08/01/pricecheck-how-much-for-a-back-mri-in-the-bay-area-255-or-3700/\" target=\"_blank\">lower-back MRIs\u003c/a>.\u003c/p>\n\u003cp>Now a PriceCheck update on IUDs, the long-acting contraceptive. (And \u003ca title=\"http://bedsider.org/features/243\" href=\"//bedsider.org/features/243\" target=\"_blank\">it's really long-acting\u003c/a> -- up to seven years for the hormonal type; up to 12 years for the copper IUD). You told us what you were charged and what your insurers paid for an IUD.\u003c/p>\n\u003cp>Like all FDA-approved methods of birth control, IUDs are supposed to be available at no co-pay to consumers under a\u003ca title=\"http://www.hrsa.gov/womensguidelines/\" href=\"http://www.hrsa.gov/womensguidelines/\" target=\"_blank\"> requirement of the Affordable Care Act\u003c/a>. Were they? The device alone generally costs several hundred dollars; a doctor's charge to insert the device can be hundreds more.\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>That's why the \"no co-pay\" mandate of the health law is so important. A\u003ca title=\"http://www.nejm.org/doi/full/10.1056/NEJMoa1400506?query=featured_home\" href=\"http://www.nejm.org/doi/full/10.1056/NEJMoa1400506?query=featured_home\" target=\"_blank\"> recent study\u003c/a> published in the New England Journal of Medicine found that teenagers who received counseling about long-acting birth control, and then were offered to choose an option at no cost, chose a long-acting method, like an IUD. Researchers then found they were much less likely to get pregnant, give birth or have an abortion.\u003c/p>\n\u003cp>\u003cstrong>What We Found: Prices Paid Ranged from $440 to $1,230\u003c/strong>\u003c/p>\n\u003cp>On PriceCheck, some women who shared their prices had gotten their IUD before the health law went into effect. Some of these women reported paying as much as $600 for their IUD. But none of the women in our group who got an IUD since the health law took effect reported paying a co-pay.\u003c/p>\n\u003caside class=\"pullquote alignright\">Learn more: \u003ca href=\"http://ww2.kqed.org/stateofhealth/series/price-check/\" target=\"_blank\">read all our PriceCheck coverage\u003c/a>. \u003c/aside>\n\u003cp>Of the submissions we received from women who got an IUD, overall prices charged ranged from about $650 to about $1,600.\u003c/p>\n\u003cp>But \"prices charged\" are considered \"retail\" prices. Insurance companies negotiate contracts with doctors, and the amount they pay is sometimes significantly less than what is charged. It's impossible for consumers to see this price range because those contracts are sealed.\u003c/p>\n\u003cp>We found that what insurers actually paid ranged from a low of $440, by Kaiser Sunset in Los Angeles, to $1,230 by Premera Blue Cross (an insurance company based in the state of Washington) to the Palo Alto Medical Foundation.\u003c/p>\n\u003cp>\u003cstrong>What Women Told Us\u003c/strong>\u003c/p>\n\u003cp>All the women in our database who got their IUD after the health law's requirement of no co-pay went into effect reported that they did not pay anything:\u003c/p>\n\u003cul>\n\u003cli>\"My insurance covered for me to get this free of charge.\"\u003c/li>\n\u003cli>\"I only paid my co pay for my first visit which was a pap and pregnancy test and consultation for the IUD. (After the appointment for the procedure and two follow ups) I didn't pay anything.\u003c/li>\n\u003c/ul>\n\u003cp>Another woman reported that she \u003cem>did\u003c/em> have to pay for a follow-up appointment. Anthem Blue Cross had covered the $1,149 cost of her IUD and doctors' fees, even though she had \"a few thousand dollar deductible … because it was considered preventative.\" Still, she had a six-week follow-up appointment and had to pay the full $197 cost.\u003c/p>\n\u003cp>Another woman said she was initially charged the full $1,200 cost, but called her insurer to challenge the charge. The insurer discovered the procedure had not been coded correctly. The error was fixed and her costs were \"completely covered … three months later.\"\u003c/p>\n\u003cp>In other words, it pays to review your bills and call to ask.\u003c/p>\n\u003cp>\u003cstrong>Are You Paying a Co-Pay for Your Birth Control?\u003c/strong>\u003c/p>\n\u003cp>Recent studies show that our survey sample is not representative of what's happening across the country. The Guttmacher Institute \u003ca title=\"http://www.contraceptionjournal.org/article/S0010-7824(14)00687-8/pdf\" href=\"http://www.contraceptionjournal.org/article/S0010-7824(14)00687-8/pdf\" target=\"_blank\">surveyed \u003c/a>privately insured women across the country. While the proportion of women obtaining IUDs at no cost rose from about 45 percent to just over 60 percent, you have to wonder why 40 percent of women are still having to pay.\u003c/p>\n\u003cp>“The biggest reason is probably the issue of \u003ca style=\"color: #003b79\" href=\"https://www.healthcare.gov/health-care-law-protections/grandfathered-plans/\" target=\"_blank\">grandfathered plans\u003c/a>,” Adam Sonfield, a senior public policy associate at the Guttmacher Institute and the study’s lead author, told \u003ca title=\"http://kaiserhealthnews.org/news/michelle-andrews-on-contraception-coverage/\" href=\"http://kaiserhealthnews.org/news/michelle-andrews-on-contraception-coverage/\" target=\"_blank\">Kaiser Health News\u003c/a>. Sonfield was referring to plans that were in effect when the Affordable Care Act was passed in March 2010 and haven’t changed substantially since. These grandfathered plans are not required to provide free contraceptive coverage.\u003c/p>\n\u003cp>Churches and other religious employers are also exempt from the requirement.\u003c/p>\n\u003cp>\u003cstrong>Share What You Paid!\u003c/strong>\u003c/p>\n\u003cp>We invite you, the members of our audience, \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/06/23/kqed-launches-project-to-help-make-health-costs-transparent/\" href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/kqed-launches-project-to-help-make-health-costs-transparent/\" target=\"_blank\">to share what you paid\u003c/a>. We're especially interested in IUDs, mammograms and lower-back MRIs, but our form is designed to accept virtually all health care tests, services and procedures. All you need is your insurance \"\u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/07/18/explaining-the-health-insurance-explanation-of-benefits/\" href=\"http://ww2.kqed.org/stateofhealth/2014/07/18/explaining-the-health-insurance-explanation-of-benefits/\" target=\"_blank\">explanation of benefits\u003c/a>\" and a visit to\u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/06/23/kqed-launches-project-to-help-make-health-costs-transparent/\" href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/kqed-launches-project-to-help-make-health-costs-transparent/\" target=\"_blank\"> KQED's PriceCheck\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This post has been updated to reflect a new lowest-cost IUD. \u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_22493\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/iStock_000037081776_Large.jpg\">\u003cimg class=\"size-large wp-image-22493\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/iStock_000037081776_Large-640x424.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"424\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Earlier this year, KQED launched \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">PriceCheck,\u003c/a> our crowdsourcing project on health costs. We’re working in collaboration with \u003ca style=\"font-weight: bold;color: #114999\" href=\"http://www.scpr.org/blogs/health/2014/07/21/17024/next-up-for-pricecheck-back-mri-s/\" target=\"_blank\">KPCC\u003c/a> public media in Los Angeles and \u003ca style=\"font-weight: bold;color: #114999\" href=\"http://clearhealthcosts.com/\" target=\"_blank\">ClearHealthCosts.com\u003c/a>, a New York City startup looking at health costs.\u003c/p>\n\u003cp>On PriceCheck we're shining a light on the opaque world of health care costs. We've asked what you, the members of our audience, have been charged for common medical tests and services, including \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/07/11/pricecheck-what-insurance-companies-are-paying-for-mammograms/\" href=\"http://ww2.kqed.org/stateofhealth/2014/07/11/pricecheck-what-insurance-companies-are-paying-for-mammograms/\" target=\"_blank\">mammograms\u003c/a> and \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/08/01/pricecheck-how-much-for-a-back-mri-in-the-bay-area-255-or-3700/\" href=\"http://ww2.kqed.org/stateofhealth/2014/08/01/pricecheck-how-much-for-a-back-mri-in-the-bay-area-255-or-3700/\" target=\"_blank\">lower-back MRIs\u003c/a>.\u003c/p>\n\u003cp>Now a PriceCheck update on IUDs, the long-acting contraceptive. (And \u003ca title=\"http://bedsider.org/features/243\" href=\"//bedsider.org/features/243\" target=\"_blank\">it's really long-acting\u003c/a> -- up to seven years for the hormonal type; up to 12 years for the copper IUD). You told us what you were charged and what your insurers paid for an IUD.\u003c/p>\n\u003cp>Like all FDA-approved methods of birth control, IUDs are supposed to be available at no co-pay to consumers under a\u003ca title=\"http://www.hrsa.gov/womensguidelines/\" href=\"http://www.hrsa.gov/womensguidelines/\" target=\"_blank\"> requirement of the Affordable Care Act\u003c/a>. Were they? The device alone generally costs several hundred dollars; a doctor's charge to insert the device can be hundreds more.\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>That's why the \"no co-pay\" mandate of the health law is so important. A\u003ca title=\"http://www.nejm.org/doi/full/10.1056/NEJMoa1400506?query=featured_home\" href=\"http://www.nejm.org/doi/full/10.1056/NEJMoa1400506?query=featured_home\" target=\"_blank\"> recent study\u003c/a> published in the New England Journal of Medicine found that teenagers who received counseling about long-acting birth control, and then were offered to choose an option at no cost, chose a long-acting method, like an IUD. Researchers then found they were much less likely to get pregnant, give birth or have an abortion.\u003c/p>\n\u003cp>\u003cstrong>What We Found: Prices Paid Ranged from $440 to $1,230\u003c/strong>\u003c/p>\n\u003cp>On PriceCheck, some women who shared their prices had gotten their IUD before the health law went into effect. Some of these women reported paying as much as $600 for their IUD. But none of the women in our group who got an IUD since the health law took effect reported paying a co-pay.\u003c/p>\n\u003caside class=\"pullquote alignright\">Learn more: \u003ca href=\"http://ww2.kqed.org/stateofhealth/series/price-check/\" target=\"_blank\">read all our PriceCheck coverage\u003c/a>. \u003c/aside>\n\u003cp>Of the submissions we received from women who got an IUD, overall prices charged ranged from about $650 to about $1,600.\u003c/p>\n\u003cp>But \"prices charged\" are considered \"retail\" prices. Insurance companies negotiate contracts with doctors, and the amount they pay is sometimes significantly less than what is charged. It's impossible for consumers to see this price range because those contracts are sealed.\u003c/p>\n\u003cp>We found that what insurers actually paid ranged from a low of $440, by Kaiser Sunset in Los Angeles, to $1,230 by Premera Blue Cross (an insurance company based in the state of Washington) to the Palo Alto Medical Foundation.\u003c/p>\n\u003cp>\u003cstrong>What Women Told Us\u003c/strong>\u003c/p>\n\u003cp>All the women in our database who got their IUD after the health law's requirement of no co-pay went into effect reported that they did not pay anything:\u003c/p>\n\u003cul>\n\u003cli>\"My insurance covered for me to get this free of charge.\"\u003c/li>\n\u003cli>\"I only paid my co pay for my first visit which was a pap and pregnancy test and consultation for the IUD. (After the appointment for the procedure and two follow ups) I didn't pay anything.\u003c/li>\n\u003c/ul>\n\u003cp>Another woman reported that she \u003cem>did\u003c/em> have to pay for a follow-up appointment. Anthem Blue Cross had covered the $1,149 cost of her IUD and doctors' fees, even though she had \"a few thousand dollar deductible … because it was considered preventative.\" Still, she had a six-week follow-up appointment and had to pay the full $197 cost.\u003c/p>\n\u003cp>Another woman said she was initially charged the full $1,200 cost, but called her insurer to challenge the charge. The insurer discovered the procedure had not been coded correctly. The error was fixed and her costs were \"completely covered … three months later.\"\u003c/p>\n\u003cp>In other words, it pays to review your bills and call to ask.\u003c/p>\n\u003cp>\u003cstrong>Are You Paying a Co-Pay for Your Birth Control?\u003c/strong>\u003c/p>\n\u003cp>Recent studies show that our survey sample is not representative of what's happening across the country. The Guttmacher Institute \u003ca title=\"http://www.contraceptionjournal.org/article/S0010-7824(14)00687-8/pdf\" href=\"http://www.contraceptionjournal.org/article/S0010-7824(14)00687-8/pdf\" target=\"_blank\">surveyed \u003c/a>privately insured women across the country. While the proportion of women obtaining IUDs at no cost rose from about 45 percent to just over 60 percent, you have to wonder why 40 percent of women are still having to pay.\u003c/p>\n\u003cp>“The biggest reason is probably the issue of \u003ca style=\"color: #003b79\" href=\"https://www.healthcare.gov/health-care-law-protections/grandfathered-plans/\" target=\"_blank\">grandfathered plans\u003c/a>,” Adam Sonfield, a senior public policy associate at the Guttmacher Institute and the study’s lead author, told \u003ca title=\"http://kaiserhealthnews.org/news/michelle-andrews-on-contraception-coverage/\" href=\"http://kaiserhealthnews.org/news/michelle-andrews-on-contraception-coverage/\" target=\"_blank\">Kaiser Health News\u003c/a>. Sonfield was referring to plans that were in effect when the Affordable Care Act was passed in March 2010 and haven’t changed substantially since. These grandfathered plans are not required to provide free contraceptive coverage.\u003c/p>\n\u003cp>Churches and other religious employers are also exempt from the requirement.\u003c/p>\n\u003cp>\u003cstrong>Share What You Paid!\u003c/strong>\u003c/p>\n\u003cp>We invite you, the members of our audience, \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/06/23/kqed-launches-project-to-help-make-health-costs-transparent/\" href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/kqed-launches-project-to-help-make-health-costs-transparent/\" target=\"_blank\">to share what you paid\u003c/a>. We're especially interested in IUDs, mammograms and lower-back MRIs, but our form is designed to accept virtually all health care tests, services and procedures. All you need is your insurance \"\u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/07/18/explaining-the-health-insurance-explanation-of-benefits/\" href=\"http://ww2.kqed.org/stateofhealth/2014/07/18/explaining-the-health-insurance-explanation-of-benefits/\" target=\"_blank\">explanation of benefits\u003c/a>\" and a visit to\u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/06/23/kqed-launches-project-to-help-make-health-costs-transparent/\" href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/kqed-launches-project-to-help-make-health-costs-transparent/\" target=\"_blank\"> KQED's PriceCheck\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This post has been updated to reflect a new lowest-cost IUD. \u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"headTitle": "Price Check | State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_21794\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://www.flickr.com/photos/v1ctor/10871254373/in/photolist-7xnQUz-4VVzWz-duRtoY-dteyRf-dtenzF-6onXMj-51knzJ-Q7qvr-51knpN-51gbqX-cBgG4U-53ybQU-CDq9F-hyE2be-25tH2r-6oiMk6-6oiM3g-6onXGL-5zr3ZY-6onXW9-9kVf2j-6oiMcc-53yc11-dHqMtG-cBgFKq-9kSbEZ-a3Qrfu-cBgFCW-cBgFyS-b8pMUx-aBgDAQ-53yc8S-EjCFC-7Vh97k-7Vhboa-7VkmkG-7VkjAo-6onY61-6onXyd-f1H9qJ-6onXuN-6oiLNF-25tDrw-L6Gwo-4bu3uW-4z8pLs-3mkAZ1-6DyhnP-5UDiQq-PiQgG\">\u003cimg class=\"size-large wp-image-21794\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/10871254373_07e4989b3c_k-640x424.jpg\" alt=\"(Victor/via Flickr)\" width=\"640\" height=\"424\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Test strips -- the white strip in the photo above -- vary dramatically both in cash price and in insurance coverage. (Victor/via Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Since early this summer, KQED and our partners, KPCC and ClearHealthCosts.com, have been crowdsourcing the costs of common health care procedures.\u003c/p>\n\u003caside class=\"pullquote alignleft\">'Every time someone moves to a new insurer, the pricing will be very different on test strips. Nobody is going to send you a breakdown.' \u003c/aside>\n\u003cp>If you're one of the 29 million people in America who has diabetes, we're turning now to you. We know that many people with diabetes must check their blood sugar, also called glucose, level several times a day.\u003c/p>\n\u003cp>For those of you who don't have diabetes, the reason for frequent checking is because in diabetes, sugar can build up in the bloodstream because the body is not able to process it. That can be dangerous. Depending on the severity of the disease, many people with diabetes must check their glucose level several times a day to make sure it is neither dangerously high nor dangerously low.\u003c/p>\n\u003cp>To \u003ca title=\"http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/checking-your-blood-glucose.html\" href=\"http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/checking-your-blood-glucose.html\" target=\"_blank\">check their blood sugar\u003c/a>, people with diabetes have a glucose meter. Each time they test their blood, a test strip is inserted into the meter. Then they use a special needle to prick a finger and place a drop of blood on a test strip. The meter displays the result.\u003c!--more-->\u003c/p>\n\u003cp>A single strip is not so much money, but testing day in, day out, the money adds up. In addition, like everything else in health care, different insurers cover different brands at different quantities and different co-pays or co-insurance.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"If you rely on our [health care] system,\" said Amy Tenderich, \u003ca title=\"http://www.diabetesmine.com/about\" href=\"http://www.diabetesmine.com/about\" target=\"_blank\">founder and editor of DiabetesMine.com,\u003c/a> a diabetes news, advocacy and community website, \"it's a major thorn in your side, because you have no way of knowing what the real costs are or how anything is calculated.\"\u003c/p>\n\u003cp>Tenderich knows the issue of test strips well. She was diagnosed with Type 1 diabetes in 2003.\u003c/p>\n\u003cp>Early last year, it looked like there was a glimmer of hope in the expense around test strips. Medicare instituted a \u003ca title=\"http://www.medicare.gov/coverage/blood-sugar-test-strips.html\" href=\"http://www.medicare.gov/coverage/blood-sugar-test-strips.html\" target=\"_blank\">competitive bidding process\u003c/a>. That brought the price of test strips down some, but may have created a ripple effect where other private insurers are clamping down on both quantity and variety of strips they cover. (Many in the diabetes community have also sharply criticized the move because they say the lower-cost strips are \u003ca title=\"http://asweetlife.org/riva/blogs/diabetes-management-blogs/the-diabetes-test-strips-crisis-how-cutting-costs-is-robbing-your-health/33603/\" href=\"http://asweetlife.org/riva/blogs/diabetes-management-blogs/the-diabetes-test-strips-crisis-how-cutting-costs-is-robbing-your-health/33603/\" target=\"_blank\">often less accurate\u003c/a>.)\u003c/p>\n\u003cp>Yes, you can\u003ca title=\"https://www.google.com/search?client=safari&rls=en&q=cost+of+diabetes+test+strips&ie=UTF-8&oe=UTF-8&gws_rd=ssl#q=cost+of+diabetes+test+strips&rls=en&tbm=shop\" href=\"https://www.google.com/search?client=safari&rls=en&q=cost+of+diabetes+test+strips&ie=UTF-8&oe=UTF-8&gws_rd=ssl#q=cost+of+diabetes+test+strips&rls=en&tbm=shop\" target=\"_blank\"> search online\u003c/a> and find the cash price for test strips pretty easily. But the variety can be confounding! First in quantity: boxes of 100, boxes of 50, a\u003ca title=\"http://www.totaldiabetessupply.com/glucose-test-strips/accu-chek-compact-glucose-test-strips-51.html?gdftrk=gdfV21446_a_7c1042_a_7c8455_a_7c7553747419&gclid=Cj0KEQjwnZShBRDfxqzr55rcyMEBEiQA1iRNPw_sUeHZuZeniGl06tQlgAqH5E0Y2yN4XctiOKSKV9YaAsZP8P8HAQ\" href=\"http://www.totaldiabetessupply.com/glucose-test-strips/accu-chek-compact-glucose-test-strips-51.html?gdftrk=gdfV21446_a_7c1042_a_7c8455_a_7c7553747419&gclid=Cj0KEQjwnZShBRDfxqzr55rcyMEBEiQA1iRNPw_sUeHZuZeniGl06tQlgAqH5E0Y2yN4XctiOKSKV9YaAsZP8P8HAQ\" target=\"_blank\"> box of 5\u003c/a>1.\u003c/p>\n\u003cp>Then there's price -- two brands I found were $17.17 for 100 count; another box of 50 was $33.79.\u003c/p>\n\u003cp>But cash prices found online are of little help to the millions of Americans who are insured and are restricted to what their insurer covers, both in brand and in quantity. The quantity is strips-per-some-arbitrary-unit-of-time. Maybe it's strips per day or per month, or 60 days, or 90 days.\u003c/p>\n\u003cp>It all depends on what contracts the insurance company has made with test strip manufacturers. Remember that those contracts are sealed; You can't compare insurer to insurer.\u003c/p>\n\u003cp>\"Every time someone moves to a new insurer,\" Tenderich says, \"the pricing will be very different on the drugs I'm taking and the test strips as well. Nobody is going to send you a breakdown. You have no way of knowing how they're calculated.\"\u003c/p>\n\u003cp>That's where PriceCheck comes in.\u003c/p>\n\u003cp>If you have diabetes and you test your blood sugar regularly, \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">please visit PriceCheck\u003c/a> and submit what you paid and what your insurer paid. In addition, please share the specifics of your own insurance -- how many strips a day (or month) your insurer covers and exactly what your co-pay or co-insurance is on test strips. We want to know the limitations of your insurance. Since people with Type 2 diabetes may face strict restrictions on the number of strips they can use, we're also asking people to let us know if they have Type 1 or Type 2 diabetes.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Help us make health costs transparent in California -- \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">visit PriceCheck\u003c/a> and share your costs!\u003c/p>\n\n",
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"excerpt": "KQED's PriceCheck project asks readers to share the price they've paid for diabetes test strips.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_21794\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://www.flickr.com/photos/v1ctor/10871254373/in/photolist-7xnQUz-4VVzWz-duRtoY-dteyRf-dtenzF-6onXMj-51knzJ-Q7qvr-51knpN-51gbqX-cBgG4U-53ybQU-CDq9F-hyE2be-25tH2r-6oiMk6-6oiM3g-6onXGL-5zr3ZY-6onXW9-9kVf2j-6oiMcc-53yc11-dHqMtG-cBgFKq-9kSbEZ-a3Qrfu-cBgFCW-cBgFyS-b8pMUx-aBgDAQ-53yc8S-EjCFC-7Vh97k-7Vhboa-7VkmkG-7VkjAo-6onY61-6onXyd-f1H9qJ-6onXuN-6oiLNF-25tDrw-L6Gwo-4bu3uW-4z8pLs-3mkAZ1-6DyhnP-5UDiQq-PiQgG\">\u003cimg class=\"size-large wp-image-21794\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/10871254373_07e4989b3c_k-640x424.jpg\" alt=\"(Victor/via Flickr)\" width=\"640\" height=\"424\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Test strips -- the white strip in the photo above -- vary dramatically both in cash price and in insurance coverage. (Victor/via Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Since early this summer, KQED and our partners, KPCC and ClearHealthCosts.com, have been crowdsourcing the costs of common health care procedures.\u003c/p>\n\u003caside class=\"pullquote alignleft\">'Every time someone moves to a new insurer, the pricing will be very different on test strips. Nobody is going to send you a breakdown.' \u003c/aside>\n\u003cp>If you're one of the 29 million people in America who has diabetes, we're turning now to you. We know that many people with diabetes must check their blood sugar, also called glucose, level several times a day.\u003c/p>\n\u003cp>For those of you who don't have diabetes, the reason for frequent checking is because in diabetes, sugar can build up in the bloodstream because the body is not able to process it. That can be dangerous. Depending on the severity of the disease, many people with diabetes must check their glucose level several times a day to make sure it is neither dangerously high nor dangerously low.\u003c/p>\n\u003cp>To \u003ca title=\"http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/checking-your-blood-glucose.html\" href=\"http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/checking-your-blood-glucose.html\" target=\"_blank\">check their blood sugar\u003c/a>, people with diabetes have a glucose meter. Each time they test their blood, a test strip is inserted into the meter. Then they use a special needle to prick a finger and place a drop of blood on a test strip. The meter displays the result.\u003c!--more-->\u003c/p>\n\u003cp>A single strip is not so much money, but testing day in, day out, the money adds up. In addition, like everything else in health care, different insurers cover different brands at different quantities and different co-pays or co-insurance.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"If you rely on our [health care] system,\" said Amy Tenderich, \u003ca title=\"http://www.diabetesmine.com/about\" href=\"http://www.diabetesmine.com/about\" target=\"_blank\">founder and editor of DiabetesMine.com,\u003c/a> a diabetes news, advocacy and community website, \"it's a major thorn in your side, because you have no way of knowing what the real costs are or how anything is calculated.\"\u003c/p>\n\u003cp>Tenderich knows the issue of test strips well. She was diagnosed with Type 1 diabetes in 2003.\u003c/p>\n\u003cp>Early last year, it looked like there was a glimmer of hope in the expense around test strips. Medicare instituted a \u003ca title=\"http://www.medicare.gov/coverage/blood-sugar-test-strips.html\" href=\"http://www.medicare.gov/coverage/blood-sugar-test-strips.html\" target=\"_blank\">competitive bidding process\u003c/a>. That brought the price of test strips down some, but may have created a ripple effect where other private insurers are clamping down on both quantity and variety of strips they cover. (Many in the diabetes community have also sharply criticized the move because they say the lower-cost strips are \u003ca title=\"http://asweetlife.org/riva/blogs/diabetes-management-blogs/the-diabetes-test-strips-crisis-how-cutting-costs-is-robbing-your-health/33603/\" href=\"http://asweetlife.org/riva/blogs/diabetes-management-blogs/the-diabetes-test-strips-crisis-how-cutting-costs-is-robbing-your-health/33603/\" target=\"_blank\">often less accurate\u003c/a>.)\u003c/p>\n\u003cp>Yes, you can\u003ca title=\"https://www.google.com/search?client=safari&rls=en&q=cost+of+diabetes+test+strips&ie=UTF-8&oe=UTF-8&gws_rd=ssl#q=cost+of+diabetes+test+strips&rls=en&tbm=shop\" href=\"https://www.google.com/search?client=safari&rls=en&q=cost+of+diabetes+test+strips&ie=UTF-8&oe=UTF-8&gws_rd=ssl#q=cost+of+diabetes+test+strips&rls=en&tbm=shop\" target=\"_blank\"> search online\u003c/a> and find the cash price for test strips pretty easily. But the variety can be confounding! First in quantity: boxes of 100, boxes of 50, a\u003ca title=\"http://www.totaldiabetessupply.com/glucose-test-strips/accu-chek-compact-glucose-test-strips-51.html?gdftrk=gdfV21446_a_7c1042_a_7c8455_a_7c7553747419&gclid=Cj0KEQjwnZShBRDfxqzr55rcyMEBEiQA1iRNPw_sUeHZuZeniGl06tQlgAqH5E0Y2yN4XctiOKSKV9YaAsZP8P8HAQ\" href=\"http://www.totaldiabetessupply.com/glucose-test-strips/accu-chek-compact-glucose-test-strips-51.html?gdftrk=gdfV21446_a_7c1042_a_7c8455_a_7c7553747419&gclid=Cj0KEQjwnZShBRDfxqzr55rcyMEBEiQA1iRNPw_sUeHZuZeniGl06tQlgAqH5E0Y2yN4XctiOKSKV9YaAsZP8P8HAQ\" target=\"_blank\"> box of 5\u003c/a>1.\u003c/p>\n\u003cp>Then there's price -- two brands I found were $17.17 for 100 count; another box of 50 was $33.79.\u003c/p>\n\u003cp>But cash prices found online are of little help to the millions of Americans who are insured and are restricted to what their insurer covers, both in brand and in quantity. The quantity is strips-per-some-arbitrary-unit-of-time. Maybe it's strips per day or per month, or 60 days, or 90 days.\u003c/p>\n\u003cp>It all depends on what contracts the insurance company has made with test strip manufacturers. Remember that those contracts are sealed; You can't compare insurer to insurer.\u003c/p>\n\u003cp>\"Every time someone moves to a new insurer,\" Tenderich says, \"the pricing will be very different on the drugs I'm taking and the test strips as well. Nobody is going to send you a breakdown. You have no way of knowing how they're calculated.\"\u003c/p>\n\u003cp>That's where PriceCheck comes in.\u003c/p>\n\u003cp>If you have diabetes and you test your blood sugar regularly, \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">please visit PriceCheck\u003c/a> and submit what you paid and what your insurer paid. In addition, please share the specifics of your own insurance -- how many strips a day (or month) your insurer covers and exactly what your co-pay or co-insurance is on test strips. We want to know the limitations of your insurance. Since people with Type 2 diabetes may face strict restrictions on the number of strips they can use, we're also asking people to let us know if they have Type 1 or Type 2 diabetes.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Help us make health costs transparent in California -- \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">visit PriceCheck\u003c/a> and share your costs!\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Stanford Health Care Terminates Anthem Blue Cross Contract",
"title": "Stanford Health Care Terminates Anthem Blue Cross Contract",
"headTitle": "Price Check | State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_21288\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://commons.wikimedia.org/wiki/File:Stanford_Medical_Center.JPG\">\u003cimg class=\"size-large wp-image-21288\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/Stanford_Medical_Center-640x470.jpg\" alt=\"As many as 10,000 patients may be affected by Stanford Health Care's termination of its contract with Anthem Blue Cross. (Robert Skolmen/Wikimedia Commons)\" width=\"640\" height=\"470\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">As many as 10,000 patients may be affected by Stanford Health Care's termination of its contract with Anthem Blue Cross. (Robert Skolmen/Wikimedia Commons)\u003c/figcaption>\u003c/figure>\n\u003cp>Stanford Hospital and Clinics -- now known as Stanford Health Care -- is ending its contract with Anthem Blue Cross effective Sunday night at midnight. The move could affect 10,000 patients.\u003c/p>\n\u003cp>According to both Stanford and Anthem spokespersons the two sides had reached agreement on a two-year contract. But Stanford seeks a third year; Anthem does not. The two parties could not come to terms as of Friday, so there is no new contract.\u003c/p>\n\u003cp>Stanford said the current contract ends Sunday, and since they do not have a deal for a new contract, they opted to terminate.\u003c/p>\n\u003cp>But, Anthem sees the termination of the contract as unnecessary. \"Nothing compels (Stanford) to terminate on Sunday night,\" said Anthem spokesman Darrel Ng.\u003c!--more-->\u003c/p>\n\u003cp>In a letter sent Friday to Stanford Health Care president Amir Dan Rubin, Anthem's president Mark Morgan wrote:\u003c/p>\n\u003cblockquote>\u003cp>\"I respectfully request that Stanford Health Care rescind its contract termination so that our members can have uninterrupted care. We have already agreed on terms for the next two years, and it would be unfortunate to subject our members to any disruption in their care during prolonged negotiations.\"\u003c/p>\u003c/blockquote>\n\u003cp>Morgan also wrote that if Stanford moves forward with termination of its contract, \"Anthem members will be liable for chargemaster rates.\" Chargemaster rates are essentially the list price, usually multiples higher than what insurers pay to providers.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Stanford spokesman James Larkin insisted there would \"be no impact on Anthem's patients\" treated at Stanford, and that Anthem patients would continue to pay in-network rates.\u003c/p>\n\u003cp>While Morgan acknowledged that Stanford \"does provide excellent care,\" he also noted that Stanford is \"one of the most expensive hospitals in the state.\"\u003c/p>\n\u003cp>In his letter, Morgan cited data from KQED's \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">PriceCheck project\u003c/a> where patients can share health care costs they have paid and that their insurers have paid. Morgan noted:\u003c/p>\n\u003cblockquote>\u003cp>According to KQED's Price Check tool, a lower back MRI (72158 MRI-Lower back/lumbar spine w/ and w/o contrast) cost $5,647 at Stanford, which is nearly eight times what an imaging center in nearby San Jose charges at $724.\u003c/p>\u003c/blockquote>\n\u003cp>Indeed, there is an entry in PriceCheck for a $5,647 lower back MRI at Stanford. This appears to be the chargemaster price, as the person who uploaded the information noted that the rate paid by the insurer (in this case, Aetna) was $2925.15. Here's a screenshot of the entry:\u003c/p>\n\u003cfigure id=\"attachment_21291\" class=\"wp-caption aligncenter\" style=\"max-width: 483px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/Screen-Shot-2014-09-05-at-11.36.52-PM.png\">\u003cimg class=\"size-full wp-image-21291\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/Screen-Shot-2014-09-05-at-11.36.52-PM.png\" alt=\"A screenshot of a consumer's price charged for a lower back MRI at Stanford, from KQED's PriceCheck project. \" width=\"483\" height=\"235\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/09/Screen-Shot-2014-09-05-at-11.36.52-PM.png 483w, https://ww2.kqed.org/app/uploads/sites/27/2014/09/Screen-Shot-2014-09-05-at-11.36.52-PM-400x195.png 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/09/Screen-Shot-2014-09-05-at-11.36.52-PM-320x156.png 320w\" sizes=\"(max-width: 483px) 100vw, 483px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A screenshot of a consumer's price charged for a lower back MRI at Stanford, from KQED's PriceCheck project.\u003c/figcaption>\u003c/figure>\n\u003cp>It's unclear if the termination will truly come to pass. \"This will almost certainly be resolved by Sunday,\" Larkin told the \u003ca href=\"http://www.mercurynews.com/health/ci_26477782/health-insurance-spat-surfaces-between-anthem-and-stanford\" target=\"_blank\">San Jose Mercury News\u003c/a>.\u003c/p>\n\u003cp>Long and fraught negotiations between major hospitals and giant insurance companies are common. Stanford terminated its contract with Anthem \u003ca href=\"http://www.paloaltoonline.com/news/2011/09/02/stanford-hospitals-terminate-blue-cross-coverage\" target=\"_blank\">in 2011\u003c/a>, and Larkin told State of Health that Stanford was \"three months out of contract\" with significant disruptions to patients at that time.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Lucille Packard Children's Hospital is not affected. Anthem and Stanford Health Care had previously reached agreement on a two-year deal.\u003c/p>\n\n",
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"excerpt": "The termination takes effect Sunday at midnight; 10,000 patients are potentially affected.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_21288\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://commons.wikimedia.org/wiki/File:Stanford_Medical_Center.JPG\">\u003cimg class=\"size-large wp-image-21288\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/Stanford_Medical_Center-640x470.jpg\" alt=\"As many as 10,000 patients may be affected by Stanford Health Care's termination of its contract with Anthem Blue Cross. (Robert Skolmen/Wikimedia Commons)\" width=\"640\" height=\"470\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">As many as 10,000 patients may be affected by Stanford Health Care's termination of its contract with Anthem Blue Cross. (Robert Skolmen/Wikimedia Commons)\u003c/figcaption>\u003c/figure>\n\u003cp>Stanford Hospital and Clinics -- now known as Stanford Health Care -- is ending its contract with Anthem Blue Cross effective Sunday night at midnight. The move could affect 10,000 patients.\u003c/p>\n\u003cp>According to both Stanford and Anthem spokespersons the two sides had reached agreement on a two-year contract. But Stanford seeks a third year; Anthem does not. The two parties could not come to terms as of Friday, so there is no new contract.\u003c/p>\n\u003cp>Stanford said the current contract ends Sunday, and since they do not have a deal for a new contract, they opted to terminate.\u003c/p>\n\u003cp>But, Anthem sees the termination of the contract as unnecessary. \"Nothing compels (Stanford) to terminate on Sunday night,\" said Anthem spokesman Darrel Ng.\u003c!--more-->\u003c/p>\n\u003cp>In a letter sent Friday to Stanford Health Care president Amir Dan Rubin, Anthem's president Mark Morgan wrote:\u003c/p>\n\u003cblockquote>\u003cp>\"I respectfully request that Stanford Health Care rescind its contract termination so that our members can have uninterrupted care. We have already agreed on terms for the next two years, and it would be unfortunate to subject our members to any disruption in their care during prolonged negotiations.\"\u003c/p>\u003c/blockquote>\n\u003cp>Morgan also wrote that if Stanford moves forward with termination of its contract, \"Anthem members will be liable for chargemaster rates.\" Chargemaster rates are essentially the list price, usually multiples higher than what insurers pay to providers.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Stanford spokesman James Larkin insisted there would \"be no impact on Anthem's patients\" treated at Stanford, and that Anthem patients would continue to pay in-network rates.\u003c/p>\n\u003cp>While Morgan acknowledged that Stanford \"does provide excellent care,\" he also noted that Stanford is \"one of the most expensive hospitals in the state.\"\u003c/p>\n\u003cp>In his letter, Morgan cited data from KQED's \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">PriceCheck project\u003c/a> where patients can share health care costs they have paid and that their insurers have paid. Morgan noted:\u003c/p>\n\u003cblockquote>\u003cp>According to KQED's Price Check tool, a lower back MRI (72158 MRI-Lower back/lumbar spine w/ and w/o contrast) cost $5,647 at Stanford, which is nearly eight times what an imaging center in nearby San Jose charges at $724.\u003c/p>\u003c/blockquote>\n\u003cp>Indeed, there is an entry in PriceCheck for a $5,647 lower back MRI at Stanford. This appears to be the chargemaster price, as the person who uploaded the information noted that the rate paid by the insurer (in this case, Aetna) was $2925.15. Here's a screenshot of the entry:\u003c/p>\n\u003cfigure id=\"attachment_21291\" class=\"wp-caption aligncenter\" style=\"max-width: 483px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/Screen-Shot-2014-09-05-at-11.36.52-PM.png\">\u003cimg class=\"size-full wp-image-21291\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/Screen-Shot-2014-09-05-at-11.36.52-PM.png\" alt=\"A screenshot of a consumer's price charged for a lower back MRI at Stanford, from KQED's PriceCheck project. \" width=\"483\" height=\"235\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/09/Screen-Shot-2014-09-05-at-11.36.52-PM.png 483w, https://ww2.kqed.org/app/uploads/sites/27/2014/09/Screen-Shot-2014-09-05-at-11.36.52-PM-400x195.png 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/09/Screen-Shot-2014-09-05-at-11.36.52-PM-320x156.png 320w\" sizes=\"(max-width: 483px) 100vw, 483px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A screenshot of a consumer's price charged for a lower back MRI at Stanford, from KQED's PriceCheck project.\u003c/figcaption>\u003c/figure>\n\u003cp>It's unclear if the termination will truly come to pass. \"This will almost certainly be resolved by Sunday,\" Larkin told the \u003ca href=\"http://www.mercurynews.com/health/ci_26477782/health-insurance-spat-surfaces-between-anthem-and-stanford\" target=\"_blank\">San Jose Mercury News\u003c/a>.\u003c/p>\n\u003cp>Long and fraught negotiations between major hospitals and giant insurance companies are common. Stanford terminated its contract with Anthem \u003ca href=\"http://www.paloaltoonline.com/news/2011/09/02/stanford-hospitals-terminate-blue-cross-coverage\" target=\"_blank\">in 2011\u003c/a>, and Larkin told State of Health that Stanford was \"three months out of contract\" with significant disruptions to patients at that time.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Lucille Packard Children's Hospital is not affected. Anthem and Stanford Health Care had previously reached agreement on a two-year deal.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "IUD Costs Vary by $600 in Bay Area; What Did You Pay?",
"title": "IUD Costs Vary by $600 in Bay Area; What Did You Pay?",
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"content": "\u003cfigure id=\"attachment_15557\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/MD001975.jpg\">\u003cimg class=\"size-large wp-image-15557\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/MD001975-640x640.jpg\" alt=\"Intrauterine devices are one of the most effective forms of birth control, but are relatively underutilized, at least in the United States. (Spike Mafford/Getty Images)\" width=\"640\" height=\"640\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Intrauterine devices are one of the most effective forms of birth control. (Spike Mafford/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>If you're one of the 62 million American women of \u003ca href=\"www.guttmacher.org/pubs/fb_contr_use.html#9\" target=\"_blank\">childbearing age\u003c/a>, we have a question for you: How much do you pay for birth control? Did you know you might be able to save perhaps hundreds of dollars on your contraceptive method, just by asking? Let's back up. We've reached the halfway point in our PriceCheck project.\u003c/p>\n\u003cp>We're shining a light on notoriously opaque and highly variable health care costs. We're asking you, the members of our community, to share what you've paid for common procedures including \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/07/11/pricecheck-what-insurance-companies-are-paying-for-mammograms/\" target=\"_blank\">mammograms\u003c/a> and \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/07/24/pricecheck-how-much-does-a-back-mri-cost/\" target=\"_blank\">back MRIs\u003c/a>. We found that both screening mammograms and back MRIs could vary in price ten-fold. Now we're moving on to a new health care service: IUDs.\u003c/p>\n\u003cp>We're asking you to share what you paid for your IUD. The two most widely-used IUDs are Mirena (a hormonally-based IUD) and ParaGard (a non-hormonal product). Both are more than 99 percent effective in preventing pregnancy. Our PriceCheck partner, ClearHealthCosts.com, has surveyed health care providers and lists cash prices for these IUDs in our \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">PriceCheck database\u003c/a>.\u003c!--more--> [contextly_sidebar id=\"psJwnuCzaS7EPHqra7NYt7I2Omxunr8o\"]\u003c/p>\n\u003cp>We've already found that if you're not insured and are paying out-of-pocket for an IUD, these cash prices in the Bay Area range from about $600 to about $1,200. But we also know that what insurers pay for health care tests and treatments varies widely. We're asking you to share what your insurer paid -- and what your copay was.\u003c/p>\n\u003cp>Right about now you might be thinking that IUDs are supposed to be covered at no copay under rules established by the Affordable Care Act. Isn't that right?\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>That would be both yes -- and no.\u003c/p>\n\u003cp>Yes, the Affordable Care Act mandates coverage of birth contraceptive methods for all women. On \u003ca href=\"https://www.healthcare.gov/what-are-my-birth-control-benefits/\" target=\"_blank\">healthcare.gov\u003c/a>, it says that plans on the health insurance marketplace, which would include Covered California, \"must cover the services without charging a copayment, coinsurance, or deductible when they are provided by an in-network provider.\"\u003c/p>\n\u003cp>Yet, just 1.4 million of California's 38 million residents are insured through Covered California. While other people with private insurance should get the same benefit, it won't be true for everyone. That's because many people are in so-called \"grandfathered\" plans -- plans that have been around since before the ACA was signed into law in March, 2010, and so do not have to follow all the regulations required by the ACA. You've also probably heard of the \u003ca href=\"http://www.npr.org/blogs/health/2014/06/30/327065968/hobby-lobby-ruling-cuts-into-contraceptive-mandate\" target=\"_blank\">Hobby Lobby\u003c/a> case allowing some businesses to file a religious objection to providing contraceptives. Some religious nonprofits may also be exempt.\u003c/p>\n\u003caside class=\"pullquote alignright\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/series/price-check/\" target=\"_blank\">Read more stories \u003c/a>on health care cost variation from our PriceCheck project.\u003c/aside>\n\u003cp>In addition, \u003ca href=\"http://www.plannedparenthood.org/about-us/newsroom/the-affordable-care-act\" target=\"_blank\">some plans cover some, but not all\u003c/a>, of all the FDA-approved contraceptive services. If you want to know what specific methods are covered under your plan, you call call the member services number on the back of your insurance card.\u003c/p>\n\u003cp>The National Women's Law Center \u003ca href=\"http://www.nwlc.org/resource/how-find-out-if-your-health-plan-covering-women%E2%80%99s-preventive-services-no-co-pay-required-he\" target=\"_blank\">provides this extremely helpful phone guide\u003c/a> for you to use, to help make sure you're getting all the answers you need. ClearHealthCosts \u003ca href=\"http://clearhealthcosts.com/blog/2014/07/much-iud-cost-covered-one-patient-paid-2-24-another-730/\" target=\"_blank\">details some early submissions\u003c/a> we've already received from women who shared the cost of their IUD. Despite having insurance, one woman paid the entire $730 cost of her IUD because she had not yet met her deductible.Another woman was charged $2.24, but will also have to pay $197 for the six-week follow up appointment. A third woman says the entire cost of her IUD was paid by insurance.\u003c/p>\n\u003cp>The more women who shared what they paid, the more it helps other women be informed consumers. We invite you to share what you paid. It’s helpful if you have your “explanation of benefits” from your insurance company (\u003ca style=\"font-weight: bold;color: #114999\" href=\"http://ww2.kqed.org/stateofhealth/2014/07/18/explaining-the-health-insurance-explanation-of-benefits/\" target=\"_blank\">Find out more about EOBs here\u003c/a>.) Then \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">visit PriceCheck\u003c/a> and share.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Help us make health costs transparent in California!\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_15557\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/MD001975.jpg\">\u003cimg class=\"size-large wp-image-15557\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/MD001975-640x640.jpg\" alt=\"Intrauterine devices are one of the most effective forms of birth control, but are relatively underutilized, at least in the United States. (Spike Mafford/Getty Images)\" width=\"640\" height=\"640\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Intrauterine devices are one of the most effective forms of birth control. (Spike Mafford/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>If you're one of the 62 million American women of \u003ca href=\"www.guttmacher.org/pubs/fb_contr_use.html#9\" target=\"_blank\">childbearing age\u003c/a>, we have a question for you: How much do you pay for birth control? Did you know you might be able to save perhaps hundreds of dollars on your contraceptive method, just by asking? Let's back up. We've reached the halfway point in our PriceCheck project.\u003c/p>\n\u003cp>We're shining a light on notoriously opaque and highly variable health care costs. We're asking you, the members of our community, to share what you've paid for common procedures including \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/07/11/pricecheck-what-insurance-companies-are-paying-for-mammograms/\" target=\"_blank\">mammograms\u003c/a> and \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/07/24/pricecheck-how-much-does-a-back-mri-cost/\" target=\"_blank\">back MRIs\u003c/a>. We found that both screening mammograms and back MRIs could vary in price ten-fold. Now we're moving on to a new health care service: IUDs.\u003c/p>\n\u003cp>We're asking you to share what you paid for your IUD. The two most widely-used IUDs are Mirena (a hormonally-based IUD) and ParaGard (a non-hormonal product). Both are more than 99 percent effective in preventing pregnancy. Our PriceCheck partner, ClearHealthCosts.com, has surveyed health care providers and lists cash prices for these IUDs in our \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">PriceCheck database\u003c/a>.\u003c!--more--> \u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>We've already found that if you're not insured and are paying out-of-pocket for an IUD, these cash prices in the Bay Area range from about $600 to about $1,200. But we also know that what insurers pay for health care tests and treatments varies widely. We're asking you to share what your insurer paid -- and what your copay was.\u003c/p>\n\u003cp>Right about now you might be thinking that IUDs are supposed to be covered at no copay under rules established by the Affordable Care Act. Isn't that right?\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>That would be both yes -- and no.\u003c/p>\n\u003cp>Yes, the Affordable Care Act mandates coverage of birth contraceptive methods for all women. On \u003ca href=\"https://www.healthcare.gov/what-are-my-birth-control-benefits/\" target=\"_blank\">healthcare.gov\u003c/a>, it says that plans on the health insurance marketplace, which would include Covered California, \"must cover the services without charging a copayment, coinsurance, or deductible when they are provided by an in-network provider.\"\u003c/p>\n\u003cp>Yet, just 1.4 million of California's 38 million residents are insured through Covered California. While other people with private insurance should get the same benefit, it won't be true for everyone. That's because many people are in so-called \"grandfathered\" plans -- plans that have been around since before the ACA was signed into law in March, 2010, and so do not have to follow all the regulations required by the ACA. You've also probably heard of the \u003ca href=\"http://www.npr.org/blogs/health/2014/06/30/327065968/hobby-lobby-ruling-cuts-into-contraceptive-mandate\" target=\"_blank\">Hobby Lobby\u003c/a> case allowing some businesses to file a religious objection to providing contraceptives. Some religious nonprofits may also be exempt.\u003c/p>\n\u003caside class=\"pullquote alignright\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/series/price-check/\" target=\"_blank\">Read more stories \u003c/a>on health care cost variation from our PriceCheck project.\u003c/aside>\n\u003cp>In addition, \u003ca href=\"http://www.plannedparenthood.org/about-us/newsroom/the-affordable-care-act\" target=\"_blank\">some plans cover some, but not all\u003c/a>, of all the FDA-approved contraceptive services. If you want to know what specific methods are covered under your plan, you call call the member services number on the back of your insurance card.\u003c/p>\n\u003cp>The National Women's Law Center \u003ca href=\"http://www.nwlc.org/resource/how-find-out-if-your-health-plan-covering-women%E2%80%99s-preventive-services-no-co-pay-required-he\" target=\"_blank\">provides this extremely helpful phone guide\u003c/a> for you to use, to help make sure you're getting all the answers you need. ClearHealthCosts \u003ca href=\"http://clearhealthcosts.com/blog/2014/07/much-iud-cost-covered-one-patient-paid-2-24-another-730/\" target=\"_blank\">details some early submissions\u003c/a> we've already received from women who shared the cost of their IUD. Despite having insurance, one woman paid the entire $730 cost of her IUD because she had not yet met her deductible.Another woman was charged $2.24, but will also have to pay $197 for the six-week follow up appointment. A third woman says the entire cost of her IUD was paid by insurance.\u003c/p>\n\u003cp>The more women who shared what they paid, the more it helps other women be informed consumers. We invite you to share what you paid. It’s helpful if you have your “explanation of benefits” from your insurance company (\u003ca style=\"font-weight: bold;color: #114999\" href=\"http://ww2.kqed.org/stateofhealth/2014/07/18/explaining-the-health-insurance-explanation-of-benefits/\" target=\"_blank\">Find out more about EOBs here\u003c/a>.) Then \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">visit PriceCheck\u003c/a> and share.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Help us make health costs transparent in California!\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Here's a truism: Health care costs are wildly variable and utterly confusing. That's why KQED joined forces with \u003ca href=\"http://www.scpr.org/\" target=\"_blank\">KPCC\u003c/a> and \u003ca href=\"http://clearhealthcosts.com\" target=\"_blank\">ClearHealthCosts.com\u003c/a> to \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/kqed-launches-project-to-help-make-health-costs-transparent/\" target=\"_blank\">launch PriceCheck\u003c/a>. For the last six weeks we've asked you to submit your costs for common procedures. To compare apples-to-apples, we asked how much your provider charged, how much your insurer paid and how much you paid for common procedures. And you've responded! \u003c/p>\n\u003cp>You've showed us that \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/08/01/pricecheck-how-much-for-a-back-mri-in-the-bay-area-255-or-3700/\" target=\"_blank\">back MRIs can cost\u003c/a> anywhere between $255 and $3,700 in the Bay Area. And that \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/kqed-launches-project-to-help-make-health-costs-transparent/\" target=\"_blank\">screening mammograms range\u003c/a> from $125 to $801.\u003c/p>\n\u003cp>We've also surveyed hundreds of providers for cash prices — also known as self-pay — throughout California. Now you can sort through our data below as well as \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">search on our site\u003c/a>. Please help us build our database by \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">submitting your health care costs\u003c/a>.\u003c/p>\n\u003cp>\u003ciframe src=\"//kqednews.cartodb.com/viz/160ba4aa-1c29-11e4-bb6c-0e10bcd91c2b/embed_map?title=false&description=false&search=false&shareable=true&cartodb_logo=true&layer_selector=false&legends=true&scrollwheel=true&fullscreen=true&sublayer_options=1&sql=&sw_lat=32.75956202565003&sw_lon=-125.22216796875&ne_lat=39.8000959563483&ne_lon=-114.45556640625\" width=\"100%\" height=\"520\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\">\u003c/iframe>\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>To see more providers in your area, zoom in on the map using the arrows or your mouse wheel. Hover over each dot to see the provider name and procedure. Click to find out how much was charged. This map will update once a day with new information.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Here's a truism: Health care costs are wildly variable and utterly confusing. That's why KQED joined forces with \u003ca href=\"http://www.scpr.org/\" target=\"_blank\">KPCC\u003c/a> and \u003ca href=\"http://clearhealthcosts.com\" target=\"_blank\">ClearHealthCosts.com\u003c/a> to \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/kqed-launches-project-to-help-make-health-costs-transparent/\" target=\"_blank\">launch PriceCheck\u003c/a>. For the last six weeks we've asked you to submit your costs for common procedures. To compare apples-to-apples, we asked how much your provider charged, how much your insurer paid and how much you paid for common procedures. And you've responded! \u003c/p>\n\u003cp>You've showed us that \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/08/01/pricecheck-how-much-for-a-back-mri-in-the-bay-area-255-or-3700/\" target=\"_blank\">back MRIs can cost\u003c/a> anywhere between $255 and $3,700 in the Bay Area. And that \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/kqed-launches-project-to-help-make-health-costs-transparent/\" target=\"_blank\">screening mammograms range\u003c/a> from $125 to $801.\u003c/p>\n\u003cp>We've also surveyed hundreds of providers for cash prices — also known as self-pay — throughout California. Now you can sort through our data below as well as \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">search on our site\u003c/a>. Please help us build our database by \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">submitting your health care costs\u003c/a>.\u003c/p>\n\u003cp>\u003ciframe src=\"//kqednews.cartodb.com/viz/160ba4aa-1c29-11e4-bb6c-0e10bcd91c2b/embed_map?title=false&description=false&search=false&shareable=true&cartodb_logo=true&layer_selector=false&legends=true&scrollwheel=true&fullscreen=true&sublayer_options=1&sql=&sw_lat=32.75956202565003&sw_lon=-125.22216796875&ne_lat=39.8000959563483&ne_lon=-114.45556640625\" width=\"100%\" height=\"520\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\">\u003c/iframe>\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cfigure id=\"attachment_20483\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/168732667.jpg\">\u003cimg class=\"size-large wp-image-20483\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/168732667-640x426.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">People can easily save $1,000 or more just by going to another facility, sometimes only a few minutes drive away. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cem>Editor's note: In June, KQED launched \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">PriceCheck\u003c/a>, a crowdsourcing project on health costs. We’re working in collaboration with \u003ca style=\"font-weight: bold;color: #114999\" href=\"http://www.scpr.org/blogs/health/2014/07/21/17024/next-up-for-pricecheck-back-mri-s/\" target=\"_blank\">KPCC\u003c/a>, public media in Los Angeles, and \u003ca style=\"font-weight: bold;color: #114999\" href=\"http://clearhealthcosts.com/\" target=\"_blank\">ClearHealthCosts.com\u003c/a>, a New York City startup looking at health costs.\u003c/em>\u003c/p>\n\u003cp>Last week in our PriceCheck project, we turned to MRIs. We asked you, the members of our audience, to share what you have paid for a back MRI. The goal is to shine a light on the notoriously opaque world of health care costs.\u003c/p>\n\u003caside class=\"pullquote alignleft\">One person saved $1,270 on a back MRI, just by asking.\u003c/aside>\n\u003cp>What we've found is even more startling than the prices we already collected on \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/07/11/pricecheck-what-insurance-companies-are-paying-for-mammograms/\" target=\"_blank\">screening mammograms\u003c/a>. Most of our results so far are from the Bay Area, so I'm focusing on that variation. For a comparison looking at the entire state, check out \u003ca href=\"http://clearhealthcosts.com/blog/2014/07/much-pay-mri-california-255-973-25-2294/#more-14818\" target=\"_blank\">this post\u003c/a> from our ClearHealthCosts.com partner.\u003c!--more-->\u003c/p>\n\u003cp>\u003cstrong>One Facility, At Least 3 Prices for a Back MRI\u003c/strong>\u003c/p>\n\u003cp>The lowest rate paid by any insurer in our data set so far is Medicare. One contributor went to Health Diagnostics in San Francisco's Financial District and was charged $2,450. Medicare paid \u003cstrong>$255\u003c/strong>. The person did not indicate having to pay any additional money.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Curiously, another person went to the same facility but was charged $602.85 for the same procedure. We know it's the same because the procedure code both patients entered was identical -- CPT code 72148 \"lower back MRI without contrast.\"\u003c/p>\n\u003cp>How can one facility charge two radically different rates -- \u003cstrong>$2,450 and $602.85\u003c/strong> -- for the exact same thing? It turns out the second patient was insured through Blue Shield. This person told us in comments on the form that s/he had to pay the entire amount, \"since I had not yet met my deductible.\"\u003c/p>\n\u003caside class=\"pullquote alignright\">Another person could have saved $1,085 by going to another facility an 11-minute drive down the road.\u003c/aside>\n\u003cp>What this tells us is that Blue Shield has negotiated a rate with Health Diagnostics -- a rate of $602.85 for an MRI. The patient gets this rate, even though insurance covers none of it, because the person has not yet met the deductible.\u003c/p>\n\u003cp>We launched PriceCheck because these contractually agreed upon rates between insurers and providers are generally sealed. WIth help from our community, we can see what these prices are.\u003c/p>\n\u003cp>What's even more curious is that the self-pay price for a back MRI at Health Diagnostics is \u003cstrong>$575.\u003c/strong> In other words, if you walk in the door, want an MRI and are uninsured or otherwise agree to pay out of your own pocket, you'll pay $575.\u003c/p>\n\u003cp>\u003cstrong>Other Back MRI Prices from around the Bay Area\u003c/strong>\u003c/p>\n\u003cp>This cash price/insured price differential played out to the benefit of one of our contributors who went to Vallejo MRI, north of San Francisco. This person was charged \u003cstrong>$580\u003c/strong> and paid $580 out of pocket. Here's why, according to the comment: \"I was told the procedure was \u003cstrong>$1,850.\u003c/strong> I have a $7,500 deductible. So I talked to (an employee) who said if I paid upfront and agreed not to report the procedure to Blue Cross, that it would be $580.\"\u003c/p>\n\u003cp>In other words this person saved $1,270, just by asking.\u003c/p>\n\u003cp>Back in San Francisco, another of our contributors went to Radnet Medical Imaging on California Street in the Laurel Village area. (This is where the California Pacific Medical Center is located.) This person was charged \u003cstrong>$1,660\u003c/strong> and paid $1,660 out of \u003ca href=\"http://www.treasury.gov/resource-center/faqs/taxes/pages/health-savings-accounts.aspx\" target=\"_blank\">Health Savings Account\u003c/a> funds.\u003c/p>\n\u003cp>I wonder if the person who went to Radnet and paid $1,660 knows that Health Diagnostics and its $575 rate was an 11-minute drive away?\u003c/p>\n\u003cp>Probably not. We know from this project that consumers do not have a history of shopping on price for health care tests and services -- but people are starting to. One of the most frequent questions we get is from people wondering if it makes sense to shop on price for health care -- do you really want a bargain MRI?\u003c/p>\n\u003caside class=\"pullquote alignright\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/series/price-check/\" target=\"_blank\">Read more stories \u003c/a>on health care cost variation from our PriceCheck project.\u003c/aside>\n\u003cp>There's not a correlation between cost and quality in health care. So it really becomes how much you want to save money. These are personal decisions, but we believe consumers can make informed decisions only when they have all the facts.\u003c/p>\n\u003cp>Here are a couple more submitted prices:\u003c/p>\n\u003cp>Palo Alto Medical Foundation: A member of our audience received a lower back MRI and submitted a charged price of \u003cstrong>$2,650\u003c/strong>, said insurance paid $0 -- and this person paid the full cost. There was no additional comment.\u003c/p>\n\u003cp>Kaiser Antioch Medical Center: A member of our audience received a lower back MRI and was charged \u003cstrong>$973.25\u003c/strong> and paid $973.25. Comment: \"This price was the contracted amount through my insurance. Deductible had not been met so I was responsible for all charges. This does not include the two office visits required to obtain and analyze the results.\"\u003c/p>\n\u003cp>The $3,700 price referred to in the headline of this post -- technically \u003cstrong>$3,732.60\u003c/strong> -- comes from UC San Francisco. It's the self-pay price as long as you pay on the day of service. If you don't pay on the day of service, it might run you $6,221.\u003c/p>\n\u003cp>\u003cstrong>A Couple Prices for a Different MRI\u003c/strong>\u003c/p>\n\u003cp>This next story from a contributor hits close to home -- literally -- because I live just blocks away from Magnetic Imaging Affiliates on Telegraph Avenue in Oakland, where this person went.\u003c/p>\n\u003cp>The charge for a chest MRI with dye (CPT code 72147) was \u003cstrong>$3,163\u003c/strong> -- and insurance covered nothing. Comment: “High deductible so paid the whole thing and then found out I could have had it done for *HALF* the price only blocks away. My first foray into individual insurance and it s***ed. Need to shop around assuming can even get a price quote.”\u003c/p>\n\u003cp>Yes, you can get a price quote. You may need to be persistent. Ask for the billing office. They may send you around, but try.\u003c/p>\n\u003cp>Just from this handful of prices, we can see a stunning variation. With more data, we can tell more stories. We invite you to share what you paid. It's helpful if you have your \"explanation of benefits\" from your insurance company (\u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/07/18/explaining-the-health-insurance-explanation-of-benefits/\" target=\"_blank\">Find out more about EOBs here\u003c/a>.)\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Then vi\u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">sit PriceCheck\u003c/a> and share. Help us make health costs transparent in California!\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_20483\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/168732667.jpg\">\u003cimg class=\"size-large wp-image-20483\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/168732667-640x426.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">People can easily save $1,000 or more just by going to another facility, sometimes only a few minutes drive away. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cem>Editor's note: In June, KQED launched \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">PriceCheck\u003c/a>, a crowdsourcing project on health costs. We’re working in collaboration with \u003ca style=\"font-weight: bold;color: #114999\" href=\"http://www.scpr.org/blogs/health/2014/07/21/17024/next-up-for-pricecheck-back-mri-s/\" target=\"_blank\">KPCC\u003c/a>, public media in Los Angeles, and \u003ca style=\"font-weight: bold;color: #114999\" href=\"http://clearhealthcosts.com/\" target=\"_blank\">ClearHealthCosts.com\u003c/a>, a New York City startup looking at health costs.\u003c/em>\u003c/p>\n\u003cp>Last week in our PriceCheck project, we turned to MRIs. We asked you, the members of our audience, to share what you have paid for a back MRI. The goal is to shine a light on the notoriously opaque world of health care costs.\u003c/p>\n\u003caside class=\"pullquote alignleft\">One person saved $1,270 on a back MRI, just by asking.\u003c/aside>\n\u003cp>What we've found is even more startling than the prices we already collected on \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/07/11/pricecheck-what-insurance-companies-are-paying-for-mammograms/\" target=\"_blank\">screening mammograms\u003c/a>. Most of our results so far are from the Bay Area, so I'm focusing on that variation. For a comparison looking at the entire state, check out \u003ca href=\"http://clearhealthcosts.com/blog/2014/07/much-pay-mri-california-255-973-25-2294/#more-14818\" target=\"_blank\">this post\u003c/a> from our ClearHealthCosts.com partner.\u003c!--more-->\u003c/p>\n\u003cp>\u003cstrong>One Facility, At Least 3 Prices for a Back MRI\u003c/strong>\u003c/p>\n\u003cp>The lowest rate paid by any insurer in our data set so far is Medicare. One contributor went to Health Diagnostics in San Francisco's Financial District and was charged $2,450. Medicare paid \u003cstrong>$255\u003c/strong>. The person did not indicate having to pay any additional money.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Curiously, another person went to the same facility but was charged $602.85 for the same procedure. We know it's the same because the procedure code both patients entered was identical -- CPT code 72148 \"lower back MRI without contrast.\"\u003c/p>\n\u003cp>How can one facility charge two radically different rates -- \u003cstrong>$2,450 and $602.85\u003c/strong> -- for the exact same thing? It turns out the second patient was insured through Blue Shield. This person told us in comments on the form that s/he had to pay the entire amount, \"since I had not yet met my deductible.\"\u003c/p>\n\u003caside class=\"pullquote alignright\">Another person could have saved $1,085 by going to another facility an 11-minute drive down the road.\u003c/aside>\n\u003cp>What this tells us is that Blue Shield has negotiated a rate with Health Diagnostics -- a rate of $602.85 for an MRI. The patient gets this rate, even though insurance covers none of it, because the person has not yet met the deductible.\u003c/p>\n\u003cp>We launched PriceCheck because these contractually agreed upon rates between insurers and providers are generally sealed. WIth help from our community, we can see what these prices are.\u003c/p>\n\u003cp>What's even more curious is that the self-pay price for a back MRI at Health Diagnostics is \u003cstrong>$575.\u003c/strong> In other words, if you walk in the door, want an MRI and are uninsured or otherwise agree to pay out of your own pocket, you'll pay $575.\u003c/p>\n\u003cp>\u003cstrong>Other Back MRI Prices from around the Bay Area\u003c/strong>\u003c/p>\n\u003cp>This cash price/insured price differential played out to the benefit of one of our contributors who went to Vallejo MRI, north of San Francisco. This person was charged \u003cstrong>$580\u003c/strong> and paid $580 out of pocket. Here's why, according to the comment: \"I was told the procedure was \u003cstrong>$1,850.\u003c/strong> I have a $7,500 deductible. So I talked to (an employee) who said if I paid upfront and agreed not to report the procedure to Blue Cross, that it would be $580.\"\u003c/p>\n\u003cp>In other words this person saved $1,270, just by asking.\u003c/p>\n\u003cp>Back in San Francisco, another of our contributors went to Radnet Medical Imaging on California Street in the Laurel Village area. (This is where the California Pacific Medical Center is located.) This person was charged \u003cstrong>$1,660\u003c/strong> and paid $1,660 out of \u003ca href=\"http://www.treasury.gov/resource-center/faqs/taxes/pages/health-savings-accounts.aspx\" target=\"_blank\">Health Savings Account\u003c/a> funds.\u003c/p>\n\u003cp>I wonder if the person who went to Radnet and paid $1,660 knows that Health Diagnostics and its $575 rate was an 11-minute drive away?\u003c/p>\n\u003cp>Probably not. We know from this project that consumers do not have a history of shopping on price for health care tests and services -- but people are starting to. One of the most frequent questions we get is from people wondering if it makes sense to shop on price for health care -- do you really want a bargain MRI?\u003c/p>\n\u003caside class=\"pullquote alignright\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/series/price-check/\" target=\"_blank\">Read more stories \u003c/a>on health care cost variation from our PriceCheck project.\u003c/aside>\n\u003cp>There's not a correlation between cost and quality in health care. So it really becomes how much you want to save money. These are personal decisions, but we believe consumers can make informed decisions only when they have all the facts.\u003c/p>\n\u003cp>Here are a couple more submitted prices:\u003c/p>\n\u003cp>Palo Alto Medical Foundation: A member of our audience received a lower back MRI and submitted a charged price of \u003cstrong>$2,650\u003c/strong>, said insurance paid $0 -- and this person paid the full cost. There was no additional comment.\u003c/p>\n\u003cp>Kaiser Antioch Medical Center: A member of our audience received a lower back MRI and was charged \u003cstrong>$973.25\u003c/strong> and paid $973.25. Comment: \"This price was the contracted amount through my insurance. Deductible had not been met so I was responsible for all charges. This does not include the two office visits required to obtain and analyze the results.\"\u003c/p>\n\u003cp>The $3,700 price referred to in the headline of this post -- technically \u003cstrong>$3,732.60\u003c/strong> -- comes from UC San Francisco. It's the self-pay price as long as you pay on the day of service. If you don't pay on the day of service, it might run you $6,221.\u003c/p>\n\u003cp>\u003cstrong>A Couple Prices for a Different MRI\u003c/strong>\u003c/p>\n\u003cp>This next story from a contributor hits close to home -- literally -- because I live just blocks away from Magnetic Imaging Affiliates on Telegraph Avenue in Oakland, where this person went.\u003c/p>\n\u003cp>The charge for a chest MRI with dye (CPT code 72147) was \u003cstrong>$3,163\u003c/strong> -- and insurance covered nothing. Comment: “High deductible so paid the whole thing and then found out I could have had it done for *HALF* the price only blocks away. My first foray into individual insurance and it s***ed. Need to shop around assuming can even get a price quote.”\u003c/p>\n\u003cp>Yes, you can get a price quote. You may need to be persistent. Ask for the billing office. They may send you around, but try.\u003c/p>\n\u003cp>Just from this handful of prices, we can see a stunning variation. With more data, we can tell more stories. We invite you to share what you paid. It's helpful if you have your \"explanation of benefits\" from your insurance company (\u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/07/18/explaining-the-health-insurance-explanation-of-benefits/\" target=\"_blank\">Find out more about EOBs here\u003c/a>.)\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Then vi\u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">sit PriceCheck\u003c/a> and share. Help us make health costs transparent in California!\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_20331\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://www.flickr.com/photos/doctorow/4751523473/in/photolist-8eSNov-mEwTy8-6JTraD-APuDh-bBZBFE-7i2KDw-mjwKtu-hsLC1-56pdoq-4EuwaZ-D7GFQ-5eDg7f-mxWSn-asuNsS-6qLs2L-8pmybr-fC72FA-7r62wP-6JNkTW-4Rfdog-9ptXra-5p8yAG-56pdiC-dLzvc-58x2wS-79HPBT-pCtxt-4baKok-4beLFS-aBDC1M-6QXKL6-6R2AJb-6R2AKN-6R2ej7-7A9mik-aqUL8N-6QXu82-7Hd2Zu-6R2x1y-6R2x4m-7oNFfu-mExNwk-5aG9mV-2D8Czi-hsKK8-7S9qAu-vtX2T-79MH7C-6QXu7k-a41Hz\">\u003cimg class=\"size-large wp-image-20331\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/BackMRI-640x467.jpg\" alt=\"Back MRI costs vary widely, even within the same city. (Cory Doctorow/Flickr)\" width=\"640\" height=\"467\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Back MRI costs vary widely, even within the same city. (Cory Doctorow/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>In June, KQED launched PriceCheck, our crowdsourcing project on health costs. We're working in collaboration with \u003ca href=\"http://www.scpr.org/blogs/health/2014/07/21/17024/next-up-for-pricecheck-back-mri-s/\" target=\"_blank\">KPCC\u003c/a>, public media in Los Angeles, and \u003ca href=\"http://clearhealthcosts.com\" target=\"_blank\">ClearHealthCosts.com\u003c/a>, a New York City startup looking at health costs.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Just in San Francisco, back MRIs range in price from $575 to $6,221. \u003c/aside>\n\u003cp>We're asking you, the members of our community, to share what you've paid. We started with mammograms. We have both cash or \"self-pay\" prices in our database. We also have crowdsourced prices. The range we've found, even in close geographic areas, is startling.\u003c/p>\n\u003cp>Here's one example: ClearHealthCosts collected self-pay prices at various centers in the Bay Area and Southern California. If a woman walks into the NorCal Imaging Center in Walnut Creek, a screening mammogram will cost her $125, if she pays out of pocket.\u003c!--more-->\u003c/p>\n\u003cp>Meanwhile, the same mammogram will cost you $173 at NorCal Imaging in Oakland, $48 more, a 38 percent increase.\u003c/p>\n\u003cp>Across the bay in San Francisco, UCSF charges $801 for a screening mammogram -- but offers a 40 percent discount if a woman is paying out of pocket and pays at the time of service. This brings the cost paid down to $480.60.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Which would you rather pay -- $480.60 or $125?\u003c/p>\n\u003cp>Then we heard from a member of our community who has Blue Shield and had her screening mammogram at UCSF. She said UCSF had listed its charged price as $801, but Blue Shield paid $283.55.\u003c/p>\n\u003cp>In other words, those without insurance are paying nearly $200 more for a mammogram than the women with this type of insurance if they get a screening mammogram at UCSF.\u003c/p>\n\u003cp>In Los Angeles, our co-conspirators at \u003ca href=\"http://www.scpr.org/blogs/health/2014/07/21/17024/next-up-for-pricecheck-back-mri-s/\" target=\"_blank\">KPCC's Impatient blog described a woman\u003c/a> whose insurer paid $649 for her mammogram at Glendale Adventist Medical Center. Compare that price with the lowest in our database statewide -- $60 for a mammogram at the H. Claude Hudson Comprehensive Cancer Center.\u003c/p>\n\u003cp>\u003cstrong>Share Your Back MRI Prices\u003c/strong>\u003c/p>\n\u003cp>We're moving on now to back MRIs. (Don't worry, we'll happily accept your mammogram prices if you still want to share those!)\u003c/p>\n\u003caside class=\"pullquote alignright\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/series/price-check/\" target=\"_blank\">Learn more: read all our PriceCheck coverage.\u003c/a> \u003c/aside>\n\u003cp>We're interested in comparing MRIs of the lower back or upper back, either with or without contrast.\u003c/p>\n\u003cp>We're already astonished by what we've found.\u003c/p>\n\u003cp>Folks, the range just in the city of San Francisco is $575 to $6,221. Yes, more than a 10-fold difference. That $6,221 MRI of the lower back, without contrast, is done at UCSF. To be fair, it comes with the same 40 percent discount for self-pay that UCSF offers for mammograms as well.\u003c/p>\n\u003cp>The discounted price is $3,732.60, still significantly more expensive than the next one down the list, $2,607 at California Pacific Medical Center.\u003c/p>\n\u003cp>You can search for yourself by \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">visiting PriceCheck\u003c/a>, entering any zip code in the Bay Area for MRI lower back, without contrast, and search in a 100-mile range.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The $575 MRI is offered at Health Diagnostics. You can get the price down to $500 by heading to San Jose's PremiereScan. You can get it for $300 at Universal MRI & CT Inc. on Wilshire Boulevard in Los Angeles.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_20331\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://www.flickr.com/photos/doctorow/4751523473/in/photolist-8eSNov-mEwTy8-6JTraD-APuDh-bBZBFE-7i2KDw-mjwKtu-hsLC1-56pdoq-4EuwaZ-D7GFQ-5eDg7f-mxWSn-asuNsS-6qLs2L-8pmybr-fC72FA-7r62wP-6JNkTW-4Rfdog-9ptXra-5p8yAG-56pdiC-dLzvc-58x2wS-79HPBT-pCtxt-4baKok-4beLFS-aBDC1M-6QXKL6-6R2AJb-6R2AKN-6R2ej7-7A9mik-aqUL8N-6QXu82-7Hd2Zu-6R2x1y-6R2x4m-7oNFfu-mExNwk-5aG9mV-2D8Czi-hsKK8-7S9qAu-vtX2T-79MH7C-6QXu7k-a41Hz\">\u003cimg class=\"size-large wp-image-20331\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/BackMRI-640x467.jpg\" alt=\"Back MRI costs vary widely, even within the same city. (Cory Doctorow/Flickr)\" width=\"640\" height=\"467\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Back MRI costs vary widely, even within the same city. (Cory Doctorow/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>In June, KQED launched PriceCheck, our crowdsourcing project on health costs. We're working in collaboration with \u003ca href=\"http://www.scpr.org/blogs/health/2014/07/21/17024/next-up-for-pricecheck-back-mri-s/\" target=\"_blank\">KPCC\u003c/a>, public media in Los Angeles, and \u003ca href=\"http://clearhealthcosts.com\" target=\"_blank\">ClearHealthCosts.com\u003c/a>, a New York City startup looking at health costs.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Just in San Francisco, back MRIs range in price from $575 to $6,221. \u003c/aside>\n\u003cp>We're asking you, the members of our community, to share what you've paid. We started with mammograms. We have both cash or \"self-pay\" prices in our database. We also have crowdsourced prices. The range we've found, even in close geographic areas, is startling.\u003c/p>\n\u003cp>Here's one example: ClearHealthCosts collected self-pay prices at various centers in the Bay Area and Southern California. If a woman walks into the NorCal Imaging Center in Walnut Creek, a screening mammogram will cost her $125, if she pays out of pocket.\u003c!--more-->\u003c/p>\n\u003cp>Meanwhile, the same mammogram will cost you $173 at NorCal Imaging in Oakland, $48 more, a 38 percent increase.\u003c/p>\n\u003cp>Across the bay in San Francisco, UCSF charges $801 for a screening mammogram -- but offers a 40 percent discount if a woman is paying out of pocket and pays at the time of service. This brings the cost paid down to $480.60.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Which would you rather pay -- $480.60 or $125?\u003c/p>\n\u003cp>Then we heard from a member of our community who has Blue Shield and had her screening mammogram at UCSF. She said UCSF had listed its charged price as $801, but Blue Shield paid $283.55.\u003c/p>\n\u003cp>In other words, those without insurance are paying nearly $200 more for a mammogram than the women with this type of insurance if they get a screening mammogram at UCSF.\u003c/p>\n\u003cp>In Los Angeles, our co-conspirators at \u003ca href=\"http://www.scpr.org/blogs/health/2014/07/21/17024/next-up-for-pricecheck-back-mri-s/\" target=\"_blank\">KPCC's Impatient blog described a woman\u003c/a> whose insurer paid $649 for her mammogram at Glendale Adventist Medical Center. Compare that price with the lowest in our database statewide -- $60 for a mammogram at the H. Claude Hudson Comprehensive Cancer Center.\u003c/p>\n\u003cp>\u003cstrong>Share Your Back MRI Prices\u003c/strong>\u003c/p>\n\u003cp>We're moving on now to back MRIs. (Don't worry, we'll happily accept your mammogram prices if you still want to share those!)\u003c/p>\n\u003caside class=\"pullquote alignright\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/series/price-check/\" target=\"_blank\">Learn more: read all our PriceCheck coverage.\u003c/a> \u003c/aside>\n\u003cp>We're interested in comparing MRIs of the lower back or upper back, either with or without contrast.\u003c/p>\n\u003cp>We're already astonished by what we've found.\u003c/p>\n\u003cp>Folks, the range just in the city of San Francisco is $575 to $6,221. Yes, more than a 10-fold difference. That $6,221 MRI of the lower back, without contrast, is done at UCSF. To be fair, it comes with the same 40 percent discount for self-pay that UCSF offers for mammograms as well.\u003c/p>\n\u003cp>The discounted price is $3,732.60, still significantly more expensive than the next one down the list, $2,607 at California Pacific Medical Center.\u003c/p>\n\u003cp>You can search for yourself by \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">visiting PriceCheck\u003c/a>, entering any zip code in the Bay Area for MRI lower back, without contrast, and search in a 100-mile range.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The $575 MRI is offered at Health Diagnostics. You can get the price down to $500 by heading to San Jose's PremiereScan. You can get it for $300 at Universal MRI & CT Inc. on Wilshire Boulevard in Los Angeles.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003cstrong>By Lynne Shallcross\u003c/strong>\u003c/p>\n\u003cp>We are wrapping up the first phase of our PriceCheck project. The goal is to \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/kqed-launches-project-to-help-make-health-costs-transparent/\" target=\"_blank\">shine a light \u003c/a>on costs of common health care procedures in California. We're starting with screening mammograms, and already we've found that the cash price (for people who are uninsured or have gone out of network) varies from a low of $60 at the H. Claude Hudson Comprehensive Health Center in Los Angeles, a county-run clinic, to $801 at U.C. San Francisco on the high end.\u003c/p>\n\u003cp>Together with\u003ca href=\"http://www.scpr.org/blogs/health\" target=\"_blank\"> KPCC\u003c/a> in Los Angeles and \u003ca href=\"http://clearhealthcosts.com\" target=\"_blank\">ClearHealthCosts.com\u003c/a>, we're also asking you, the members of our community, to \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">share what you've been charged\u003c/a> -- and what your provider has been paid -- for common health procedures.\u003c/p>\n\u003cp>In order to do that, you need to get familiar with your insurance company's \"explanation of benefits\" or EOB. That's the form your insurer sends to explain what was paid, to whom, at what level and why.\u003c/p>\n\u003cp>Here's a typical EOB, that we've marked with some explanations below:\u003c/p>\n\u003cfigure id=\"attachment_20256\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/EOB_2.jpg\">\u003cimg class=\"size-large wp-image-20256\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/EOB_2-640x800.jpg\" alt=\"An explanation of benefits from Anthem Blue Cross. \" width=\"640\" height=\"800\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">An explanation of benefits from Anthem Blue Cross.\u003c/figcaption>\u003c/figure>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>For help in decoding the EOB, we talked to Pat Palmer, founder and CEO of \u003ca href=\"http://billadvocates.com\" target=\"_blank\">Medical Billing Advocates of America\u003c/a>.\u003c/p>\n\u003cp>The information included on an EOB isn’t consistent from one health care insurance company to the next, Palmer says, and they often include abbreviations and other language difficult for the average consumer to understand.\u003c/p>\n\u003cp>We've numbered items above and here are the descriptions of each:\u003c/p>\n\u003cp>1. \"Paid Amount.\" This is the total amount of money that the insurance company has paid directly to the provider, Palmer says. Or, in an out-of-network situation, it may be paid to the member. If you scan farther across that line to the right, you’ll see who the insurance company paid; in this case, it’s Mills Hospital.\u003c/p>\n\u003cp>2. \"Total Billed.\" These are the amounts being billed to the insurance company by the provider for each service — in this case, $51.50 for mammography (likely what the physician was paid to interpret the mammogram, although it does not say) and $365.12 for the screening mammogram (likely the facility fee for the patient to have the mammogram done, although it does not say). The charges are then totaled below the line.\u003c/p>\n\u003cp>In addition to an EOB, individuals will usually receive an itemized bill from their provider(s). Palmer says it’s important to be sure the total billed amount on the EOB — in this case, $416.62 — matches the total billed amount on the itemized bill from the provider.\u003c/p>\n\u003cp>3. \"Patient Savings.\" This is the difference between what the provider charged for this service and the amount they agreed to accept as a participating provider of your health insurance plan. That's because when a doctor or other provider agrees to contract with an insurer, they agree to accept reimbursement at a lower price than the charged price. In American medicine, the amounts charged by providers generally bear little relation to what they are ultimately paid.\u003c/p>\n\u003cp>There should always be a code that identifies the reason for the savings, Palmer says. And although it’s a little hard to see, there is a “01” that follows each charge in this column — that “01” corresponds to the “detail message” in the box below. “It’s usually clearer than that,” Palmer says, adding that consumers reading this EOB may miss that little “01” mark after the charge. “It’s usually a separate column that says ‘remark’ or ‘reason,’ and they’ll put the ‘01’ in there.”\u003c/p>\n\u003cp>In this case, Palmer says the “01” remark indicates that the provider billed more than was allowed under their agreement with the insurer, and the individual is not responsible for the difference.\u003c/p>\n\u003cp>4. \"Applied to Deductible.\" Many health plans require members to pay out a certain amount of money, a “deductible,” before the insurance will begin paying, Palmer says. If the individual has not met the deductible and has to pay for these medical services, the amount that is being applied toward his or her deductible would be in this column. But the Affordable Care Act mandates that some services are provided outside the deductible, at no cost to patients. These services include some cancer screening tests, such as a mammogram. In this EOB, we see that the patient has no amount applied to deductible.\u003c/p>\n\u003cp>But even if the service is being applied to the deductible, Palmer says that the amount that goes in the “applied to deductible” column will be the lesser, agreed-upon amount — not the higher, original amount that the provider billed.\u003c/p>\n\u003cp>5. \"Coinsurance, Copayment Amount.\" This may vary depending on what health insurance you have. Sometimes, members must make a copay for an office visit, for example. That is a flat fee. Other services may require coinsurance, a percentage of the cost of the service. If the member on this EOB had been required to pay a copay or a coinsurance for the service, the amount would be listed here.\u003c/p>\n\u003cp>6.\"Claims Payment.\" The amounts in this column break down what the insurance company paid to the provider for each service, with a total at the bottom.\u003c/p>\n\u003cp>7. Palmer says this is an important part of this EOB. In this case, it’s the insurance company telling the member that it is not his or her responsibility to pay the difference in price between the agreed-upon charges for these services and the amount the provider billed. “It’s very easy to read this [as], ‘It is your responsibility to pay $104’ — somebody could misread it and think they owe $104.15,” Palmer says. “That word ‘not’ should be bold or stand out a lot more.” On some EOBs, Palmer says there is an additional line that says what the patient’s payment responsibility is; in this case, it would list it as $0.\u003c/p>\n\u003cp>But your EOB might look different from the example above. Or a mailed EOB may look different from what you see online. The above example is a mailed EOB from Anthem Blue Cross, a major health insurer in California. Below is an online EOB, which is also from Anthem Blue Cross, yet it looks quite different. (The numbers in the EOB below line up with the explanations we've provided.)\u003c/p>\n\u003cp>Numbers 1, 2, 4 and 5 line up with explanations we have provided. But there are no terms on this EOB that line up with 3, 6 and 7 above. Yes, we know this is confusing.\u003c/p>\n\u003cfigure id=\"attachment_20262\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/OnlineEOBrevised.jpg\">\u003cimg class=\"size-large wp-image-20262\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/OnlineEOBrevised-640x639.jpg\" alt=\"An Explanation of Benefits from Anthem Blue Cross, retrieved online.\" width=\"640\" height=\"639\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">An Explanation of Benefits from Anthem Blue Cross, retrieved online.\u003c/figcaption>\u003c/figure>\n\u003cp>Other things Palmer suggests paying attention to on an EOB:\u003c/p>\n\u003cp>• Look at the “provider of services” and “place of service,” listed on the first EOB in this post as “Mills Hospital” and “outpatient.” Palmer says insurance companies often pay a different rate depending on whether the service was provided in an inpatient setting, outpatient setting or a doctor’s office. “The insurance company is the one that wrote this up, and they may have miscoded the place of service,” Palmer says. “When they do, it will vary on how much your plan pays and how much you’re responsible for.”\u003c/p>\n\u003cp>• Look for a \u003ca href=\"http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/cpt.page\" target=\"_blank\">CPT code\u003c/a> (Current Procedural Terminology). CPT codes were developed by the American Medical Association and identify the health care service provided. Palmer says that most times, insurance companies print either a “type of service” (as is listed on the first EOB) or a CPT code. And Palmer says having one, but not both, makes it a bit more difficult to determine if the provider is billing for the right services. Note that the online EOB above does list both a CPT code and a procedure code.\u003c/p>\n\u003cp>Palmer gives the example of a chest x-ray. If “type of service” is listed as chest x-ray, the individual can’t tell if the charge is for one view or three views, and the price will differ depending. Palmer says it’s often a good idea to call the insurance company to get the CPT code. If the CPT code is written on your EOB, instead of a description of service, Palmer says it’s easy to Google that code and see if it matches up with the service you received.\u003c/p>\n\u003caside class=\"pullquote alignright\">Learn more: \u003ca href=\"http://ww2.kqed.org/stateofhealth/series/price-check/\" target=\"_blank\">read all our PriceCheck coverage\u003c/a>. \u003c/aside>\n\u003cp>• Pay close attention to the message or comment box, Palmer says, and be sure you understand why a certain amount is not payable. If an insurance company says something is not payable, it could be a non-covered service that the individual is responsible for. Or, it could be a charge above what the provider and insurer agreed upon, meaning the individual does not have to pay. “Knowing that reason tells you whether you are responsible or not responsible for it,” Palmer says.\u003c/p>\n\u003cp>• Double-check the calculations on the EOB. Know the benefits that are part of your plan, Palmer says, and keep track of any payments you’ve made toward a deductible. Know where you are in your progress of meeting your deductible and when the insurance company is supposed to start paying.\u003c/p>\n\u003cp>If you scour your EOB and you do find an error, Palmer says you should determine who made the error -- the provider or the insurer -- and then follow up with them to correct the error.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Finding and correcting an error on an EOB may mean that you, as the individual member, aren’t overcharged, Palmer says. But it also may mean that the insurance company isn’t overcharged by the provider. While our natural instinct may not be to save a health insurance company some money, Palmer says that insurance companies will make profits regardless — so expensive errors only translate to higher premiums passed on to members down the road.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>By Lynne Shallcross\u003c/strong>\u003c/p>\n\u003cp>We are wrapping up the first phase of our PriceCheck project. The goal is to \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/kqed-launches-project-to-help-make-health-costs-transparent/\" target=\"_blank\">shine a light \u003c/a>on costs of common health care procedures in California. We're starting with screening mammograms, and already we've found that the cash price (for people who are uninsured or have gone out of network) varies from a low of $60 at the H. Claude Hudson Comprehensive Health Center in Los Angeles, a county-run clinic, to $801 at U.C. San Francisco on the high end.\u003c/p>\n\u003cp>Together with\u003ca href=\"http://www.scpr.org/blogs/health\" target=\"_blank\"> KPCC\u003c/a> in Los Angeles and \u003ca href=\"http://clearhealthcosts.com\" target=\"_blank\">ClearHealthCosts.com\u003c/a>, we're also asking you, the members of our community, to \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">share what you've been charged\u003c/a> -- and what your provider has been paid -- for common health procedures.\u003c/p>\n\u003cp>In order to do that, you need to get familiar with your insurance company's \"explanation of benefits\" or EOB. That's the form your insurer sends to explain what was paid, to whom, at what level and why.\u003c/p>\n\u003cp>Here's a typical EOB, that we've marked with some explanations below:\u003c/p>\n\u003cfigure id=\"attachment_20256\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/EOB_2.jpg\">\u003cimg class=\"size-large wp-image-20256\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/EOB_2-640x800.jpg\" alt=\"An explanation of benefits from Anthem Blue Cross. \" width=\"640\" height=\"800\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">An explanation of benefits from Anthem Blue Cross.\u003c/figcaption>\u003c/figure>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>For help in decoding the EOB, we talked to Pat Palmer, founder and CEO of \u003ca href=\"http://billadvocates.com\" target=\"_blank\">Medical Billing Advocates of America\u003c/a>.\u003c/p>\n\u003cp>The information included on an EOB isn’t consistent from one health care insurance company to the next, Palmer says, and they often include abbreviations and other language difficult for the average consumer to understand.\u003c/p>\n\u003cp>We've numbered items above and here are the descriptions of each:\u003c/p>\n\u003cp>1. \"Paid Amount.\" This is the total amount of money that the insurance company has paid directly to the provider, Palmer says. Or, in an out-of-network situation, it may be paid to the member. If you scan farther across that line to the right, you’ll see who the insurance company paid; in this case, it’s Mills Hospital.\u003c/p>\n\u003cp>2. \"Total Billed.\" These are the amounts being billed to the insurance company by the provider for each service — in this case, $51.50 for mammography (likely what the physician was paid to interpret the mammogram, although it does not say) and $365.12 for the screening mammogram (likely the facility fee for the patient to have the mammogram done, although it does not say). The charges are then totaled below the line.\u003c/p>\n\u003cp>In addition to an EOB, individuals will usually receive an itemized bill from their provider(s). Palmer says it’s important to be sure the total billed amount on the EOB — in this case, $416.62 — matches the total billed amount on the itemized bill from the provider.\u003c/p>\n\u003cp>3. \"Patient Savings.\" This is the difference between what the provider charged for this service and the amount they agreed to accept as a participating provider of your health insurance plan. That's because when a doctor or other provider agrees to contract with an insurer, they agree to accept reimbursement at a lower price than the charged price. In American medicine, the amounts charged by providers generally bear little relation to what they are ultimately paid.\u003c/p>\n\u003cp>There should always be a code that identifies the reason for the savings, Palmer says. And although it’s a little hard to see, there is a “01” that follows each charge in this column — that “01” corresponds to the “detail message” in the box below. “It’s usually clearer than that,” Palmer says, adding that consumers reading this EOB may miss that little “01” mark after the charge. “It’s usually a separate column that says ‘remark’ or ‘reason,’ and they’ll put the ‘01’ in there.”\u003c/p>\n\u003cp>In this case, Palmer says the “01” remark indicates that the provider billed more than was allowed under their agreement with the insurer, and the individual is not responsible for the difference.\u003c/p>\n\u003cp>4. \"Applied to Deductible.\" Many health plans require members to pay out a certain amount of money, a “deductible,” before the insurance will begin paying, Palmer says. If the individual has not met the deductible and has to pay for these medical services, the amount that is being applied toward his or her deductible would be in this column. But the Affordable Care Act mandates that some services are provided outside the deductible, at no cost to patients. These services include some cancer screening tests, such as a mammogram. In this EOB, we see that the patient has no amount applied to deductible.\u003c/p>\n\u003cp>But even if the service is being applied to the deductible, Palmer says that the amount that goes in the “applied to deductible” column will be the lesser, agreed-upon amount — not the higher, original amount that the provider billed.\u003c/p>\n\u003cp>5. \"Coinsurance, Copayment Amount.\" This may vary depending on what health insurance you have. Sometimes, members must make a copay for an office visit, for example. That is a flat fee. Other services may require coinsurance, a percentage of the cost of the service. If the member on this EOB had been required to pay a copay or a coinsurance for the service, the amount would be listed here.\u003c/p>\n\u003cp>6.\"Claims Payment.\" The amounts in this column break down what the insurance company paid to the provider for each service, with a total at the bottom.\u003c/p>\n\u003cp>7. Palmer says this is an important part of this EOB. In this case, it’s the insurance company telling the member that it is not his or her responsibility to pay the difference in price between the agreed-upon charges for these services and the amount the provider billed. “It’s very easy to read this [as], ‘It is your responsibility to pay $104’ — somebody could misread it and think they owe $104.15,” Palmer says. “That word ‘not’ should be bold or stand out a lot more.” On some EOBs, Palmer says there is an additional line that says what the patient’s payment responsibility is; in this case, it would list it as $0.\u003c/p>\n\u003cp>But your EOB might look different from the example above. Or a mailed EOB may look different from what you see online. The above example is a mailed EOB from Anthem Blue Cross, a major health insurer in California. Below is an online EOB, which is also from Anthem Blue Cross, yet it looks quite different. (The numbers in the EOB below line up with the explanations we've provided.)\u003c/p>\n\u003cp>Numbers 1, 2, 4 and 5 line up with explanations we have provided. But there are no terms on this EOB that line up with 3, 6 and 7 above. Yes, we know this is confusing.\u003c/p>\n\u003cfigure id=\"attachment_20262\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/OnlineEOBrevised.jpg\">\u003cimg class=\"size-large wp-image-20262\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/OnlineEOBrevised-640x639.jpg\" alt=\"An Explanation of Benefits from Anthem Blue Cross, retrieved online.\" width=\"640\" height=\"639\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">An Explanation of Benefits from Anthem Blue Cross, retrieved online.\u003c/figcaption>\u003c/figure>\n\u003cp>Other things Palmer suggests paying attention to on an EOB:\u003c/p>\n\u003cp>• Look at the “provider of services” and “place of service,” listed on the first EOB in this post as “Mills Hospital” and “outpatient.” Palmer says insurance companies often pay a different rate depending on whether the service was provided in an inpatient setting, outpatient setting or a doctor’s office. “The insurance company is the one that wrote this up, and they may have miscoded the place of service,” Palmer says. “When they do, it will vary on how much your plan pays and how much you’re responsible for.”\u003c/p>\n\u003cp>• Look for a \u003ca href=\"http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/cpt.page\" target=\"_blank\">CPT code\u003c/a> (Current Procedural Terminology). CPT codes were developed by the American Medical Association and identify the health care service provided. Palmer says that most times, insurance companies print either a “type of service” (as is listed on the first EOB) or a CPT code. And Palmer says having one, but not both, makes it a bit more difficult to determine if the provider is billing for the right services. Note that the online EOB above does list both a CPT code and a procedure code.\u003c/p>\n\u003cp>Palmer gives the example of a chest x-ray. If “type of service” is listed as chest x-ray, the individual can’t tell if the charge is for one view or three views, and the price will differ depending. Palmer says it’s often a good idea to call the insurance company to get the CPT code. If the CPT code is written on your EOB, instead of a description of service, Palmer says it’s easy to Google that code and see if it matches up with the service you received.\u003c/p>\n\u003caside class=\"pullquote alignright\">Learn more: \u003ca href=\"http://ww2.kqed.org/stateofhealth/series/price-check/\" target=\"_blank\">read all our PriceCheck coverage\u003c/a>. \u003c/aside>\n\u003cp>• Pay close attention to the message or comment box, Palmer says, and be sure you understand why a certain amount is not payable. If an insurance company says something is not payable, it could be a non-covered service that the individual is responsible for. Or, it could be a charge above what the provider and insurer agreed upon, meaning the individual does not have to pay. “Knowing that reason tells you whether you are responsible or not responsible for it,” Palmer says.\u003c/p>\n\u003cp>• Double-check the calculations on the EOB. Know the benefits that are part of your plan, Palmer says, and keep track of any payments you’ve made toward a deductible. Know where you are in your progress of meeting your deductible and when the insurance company is supposed to start paying.\u003c/p>\n\u003cp>If you scour your EOB and you do find an error, Palmer says you should determine who made the error -- the provider or the insurer -- and then follow up with them to correct the error.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Finding and correcting an error on an EOB may mean that you, as the individual member, aren’t overcharged, Palmer says. But it also may mean that the insurance company isn’t overcharged by the provider. While our natural instinct may not be to save a health insurance company some money, Palmer says that insurance companies will make profits regardless — so expensive errors only translate to higher premiums passed on to members down the road.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "PriceCheck: What Insurance Companies Are Paying for Mammograms",
"headTitle": "Price Check | State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_18497\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/154216755_2-e1396421050813.jpg\">\u003cimg class=\"size-large wp-image-18497\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/154216755_2-640x424.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"424\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>It's been almost three weeks since we launched our PriceCheck project, and women statewide are continuing to share what they -- or their insurance companies -- have paid for a mammogram.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Is your insurer paying $134 or $1,200? \u003c/aside>\n\u003cp>I talked about PriceCheck and our most recent data with \u003ca href=\"http://www.californiareport.org/archive/R201407100850/c\" target=\"_blank\">Rachael Myrow on The California Report\u003c/a> Thursday morning.\u003c/p>\n\u003cp>It's been fun to see people's mouths fall open when I tell them the range we're seeing that insurers pay for mammograms across California: $134 on the low end to $1,200 on the high end.\u003c!--more-->\u003c/p>\n\u003cp>To back up a minute, in PriceCheck, KQED has partnered with our sister station in Los Angeles, \u003ca href=\"http://www.scpr.org/blogs/health/2014/07/02/16943/in-la-one-mammogram-is-60-another-is-254-why/\" target=\"_blank\">KPCC\u003c/a>, and \u003ca href=\"http://clearhealthcosts.com\" target=\"_blank\">ClearHealthCosts.com\u003c/a>, a New York health costs transparency startup. We're gathering two kinds of prices for common health care procedures.\u003c/p>\n\u003cp>First, there's the \"self-pay\" or cash price. That's for people who do not have insurance or are out of network and do not receive coverage from their insurer. ClearHealthCosts.com has gathered \u003ca href=\"http://clearhealthcosts.com\" target=\"_blank\">these prices for two dozen procedures\u003c/a> in some major cities around the country.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Then there's the \"insurance paid\" price. These prices are quite interesting because they differ dramatically, according to what insurers have negotiated with providers. It's virtually impossible for people to know what they are because, as I told Myrow, \"those payments are not public; they are sealed in contract negotiations.\"\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/158156162&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false&visual=true\" width=\"100%\" height=\"450\" frameborder=\"no\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cp>Myrow asked the question that practically everyone asks when you start discussing specific costs of health care procedures. \"I'm used to bargain hunting for toilet paper,\" she said, \"but is it a good thing to bargain hunt in health care?\"\u003c/p>\n\u003cp>Yes, it can be, I told her. \"There's no correlation between cost and quality in health care, so it's entirely possible that the place down the street, that's a lot cheaper, will be just as good on quality.\"\u003c/p>\n\u003cp>Rebecca Plevin at our partner KPCC talked to Annie Brown of Toluca Lake, \u003ca href=\"http://www.scpr.org/programs/airtalk/2014/07/09/38288/checking-in-on-pricecheck-mammograms/\" target=\"_blank\">whose insurer appeared to pay 10 times more for her mammogram\u003c/a> than the least expensive location in Los Angeles. It was Brown's first mammogram, so she could not compare it with others, but, she noted, \"It was a friendly technician, but I don't know if it was worth maybe $600 extra.\"\u003c/p>\n\u003caside class=\"pullquote alignright\">Learn more: \u003ca href=\"http://ww2.kqed.org/stateofhealth/series/price-check/\" target=\"_blank\">read all our PriceCheck coverage\u003c/a>. \u003c/aside>\n\u003cp>Even if you have employer-provided health insurance, those 600 extra dollars are coming out of your pocket, just indirectly. To your employer, your health insurance premium is part of your \u003ca href=\"http://www.theatlantic.com/business/archive/2012/10/where-did-your-raise-go-it-went-to-health-care/263879/\" target=\"_blank\">total compensation\u003c/a>. So, as health costs rise — which they are — your employer's ability to offer you a raise goes down.\u003c/p>\n\u003cp>Then there are the taxes you pay. Nearly \u003ca href=\"http://blogs.census.gov/2013/09/17/medicare-and-medicaid-age-and-income-2/\" target=\"_blank\">one-third of Americans\u003c/a> are covered by the government-sponsored Medicare and Medicaid. Costs are rising fast for these programs too, paid for by tax dollars.\u003c/p>\n\u003cp>Many people have asked us why we're sampling prices on mammograms, since the Affordable Care Act mandates that this (and some other) screening tests must be covered at no cost to consumers. We picked mammograms because we wanted a procedure that lots of people have (37 million every year) and we wanted a procedure that could be scheduled. We recognize that someone is not going to shop on price after he or she has been in a car accident or is suffering some other life-threatening condition.\u003c/p>\n\u003cp>I invite you to share what you paid. \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/?__utma=34673459.1803067961.1357800400.1404922916.1405105833.11&__utmb=34673459.0.10.1405106305&__utmc=34673459&__utmx=-&__utmz=34673459.1394593792.6.2.utmcsr=google%7Cutmccn=(organic)%7Cutmcmd=organic%7Cutmctr=(not%20provided)&__utmv=-&__utmk=185180715\" target=\"_blank\">Get a bill or your insurance \"explanation of benefits\" — and visit PriceCheck\u003c/a>. The more prices shared that we have, the more we can help to make health costs more transparent in California.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>KQED's Newsroom also featured PriceCheck in a recent program. Below host Scott Shafer interviews me about health costs broadly and PriceCheck specifically. Please watch!\u003c/p>\n\u003cdiv>\u003ca class=\"embedly-card\" href=\"https://www.youtube.com/watch?v=Xhm_BykQBwU&feature=youtu.be\">KQED Newsroom Segment: Price Check sheds light on health care costs, July 11, 2014\u003c/a>\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_18497\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/154216755_2-e1396421050813.jpg\">\u003cimg class=\"size-large wp-image-18497\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/154216755_2-640x424.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"424\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>It's been almost three weeks since we launched our PriceCheck project, and women statewide are continuing to share what they -- or their insurance companies -- have paid for a mammogram.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Is your insurer paying $134 or $1,200? \u003c/aside>\n\u003cp>I talked about PriceCheck and our most recent data with \u003ca href=\"http://www.californiareport.org/archive/R201407100850/c\" target=\"_blank\">Rachael Myrow on The California Report\u003c/a> Thursday morning.\u003c/p>\n\u003cp>It's been fun to see people's mouths fall open when I tell them the range we're seeing that insurers pay for mammograms across California: $134 on the low end to $1,200 on the high end.\u003c!--more-->\u003c/p>\n\u003cp>To back up a minute, in PriceCheck, KQED has partnered with our sister station in Los Angeles, \u003ca href=\"http://www.scpr.org/blogs/health/2014/07/02/16943/in-la-one-mammogram-is-60-another-is-254-why/\" target=\"_blank\">KPCC\u003c/a>, and \u003ca href=\"http://clearhealthcosts.com\" target=\"_blank\">ClearHealthCosts.com\u003c/a>, a New York health costs transparency startup. We're gathering two kinds of prices for common health care procedures.\u003c/p>\n\u003cp>First, there's the \"self-pay\" or cash price. That's for people who do not have insurance or are out of network and do not receive coverage from their insurer. ClearHealthCosts.com has gathered \u003ca href=\"http://clearhealthcosts.com\" target=\"_blank\">these prices for two dozen procedures\u003c/a> in some major cities around the country.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Then there's the \"insurance paid\" price. These prices are quite interesting because they differ dramatically, according to what insurers have negotiated with providers. It's virtually impossible for people to know what they are because, as I told Myrow, \"those payments are not public; they are sealed in contract negotiations.\"\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/158156162&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false&visual=true\" width=\"100%\" height=\"450\" frameborder=\"no\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cp>Myrow asked the question that practically everyone asks when you start discussing specific costs of health care procedures. \"I'm used to bargain hunting for toilet paper,\" she said, \"but is it a good thing to bargain hunt in health care?\"\u003c/p>\n\u003cp>Yes, it can be, I told her. \"There's no correlation between cost and quality in health care, so it's entirely possible that the place down the street, that's a lot cheaper, will be just as good on quality.\"\u003c/p>\n\u003cp>Rebecca Plevin at our partner KPCC talked to Annie Brown of Toluca Lake, \u003ca href=\"http://www.scpr.org/programs/airtalk/2014/07/09/38288/checking-in-on-pricecheck-mammograms/\" target=\"_blank\">whose insurer appeared to pay 10 times more for her mammogram\u003c/a> than the least expensive location in Los Angeles. It was Brown's first mammogram, so she could not compare it with others, but, she noted, \"It was a friendly technician, but I don't know if it was worth maybe $600 extra.\"\u003c/p>\n\u003caside class=\"pullquote alignright\">Learn more: \u003ca href=\"http://ww2.kqed.org/stateofhealth/series/price-check/\" target=\"_blank\">read all our PriceCheck coverage\u003c/a>. \u003c/aside>\n\u003cp>Even if you have employer-provided health insurance, those 600 extra dollars are coming out of your pocket, just indirectly. To your employer, your health insurance premium is part of your \u003ca href=\"http://www.theatlantic.com/business/archive/2012/10/where-did-your-raise-go-it-went-to-health-care/263879/\" target=\"_blank\">total compensation\u003c/a>. So, as health costs rise — which they are — your employer's ability to offer you a raise goes down.\u003c/p>\n\u003cp>Then there are the taxes you pay. Nearly \u003ca href=\"http://blogs.census.gov/2013/09/17/medicare-and-medicaid-age-and-income-2/\" target=\"_blank\">one-third of Americans\u003c/a> are covered by the government-sponsored Medicare and Medicaid. Costs are rising fast for these programs too, paid for by tax dollars.\u003c/p>\n\u003cp>Many people have asked us why we're sampling prices on mammograms, since the Affordable Care Act mandates that this (and some other) screening tests must be covered at no cost to consumers. We picked mammograms because we wanted a procedure that lots of people have (37 million every year) and we wanted a procedure that could be scheduled. We recognize that someone is not going to shop on price after he or she has been in a car accident or is suffering some other life-threatening condition.\u003c/p>\n\u003cp>I invite you to share what you paid. \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/?__utma=34673459.1803067961.1357800400.1404922916.1405105833.11&__utmb=34673459.0.10.1405106305&__utmc=34673459&__utmx=-&__utmz=34673459.1394593792.6.2.utmcsr=google%7Cutmccn=(organic)%7Cutmcmd=organic%7Cutmctr=(not%20provided)&__utmv=-&__utmk=185180715\" target=\"_blank\">Get a bill or your insurance \"explanation of benefits\" — and visit PriceCheck\u003c/a>. The more prices shared that we have, the more we can help to make health costs more transparent in California.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>KQED's Newsroom also featured PriceCheck in a recent program. Below host Scott Shafer interviews me about health costs broadly and PriceCheck specifically. Please watch!\u003c/p>\n\u003cdiv>\u003ca class=\"embedly-card\" href=\"https://www.youtube.com/watch?v=Xhm_BykQBwU&feature=youtu.be\">KQED Newsroom Segment: Price Check sheds light on health care costs, July 11, 2014\u003c/a>\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Initial Mammogram Cost Comparisons in KQED's PriceCheck Project",
"title": "Initial Mammogram Cost Comparisons in KQED's PriceCheck Project",
"headTitle": "Price Check | State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_19667\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/RS10943_Facebook_Final-hpf.jpg\">\u003cimg class=\"size-full wp-image-19667\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/RS10943_Facebook_Final-hpf.jpg\" alt=\"(Illustration: Andy Warner)\" width=\"640\" height=\"206\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/06/RS10943_Facebook_Final-hpf.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2014/06/RS10943_Facebook_Final-hpf-400x129.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/06/RS10943_Facebook_Final-hpf-320x103.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Illustration: Andy Warner)\u003c/figcaption>\u003c/figure>\n\u003cp>Last Monday, \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">KQED\u003c/a>, \u003ca href=\"http://www.scpr.org/blogs/health/2014/06/23/16873/join-pricecheck-help-make-health-care-costs-more-t/\" target=\"_blank\">KPCC\u003c/a> and \u003ca href=\"http://clearhealthcosts.com\" target=\"_blank\">ClearHealthCosts.com\u003c/a> launched our community-created guide to health costs.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Share what you paid for a mammogram. \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">Visit KQED's PriceCheck\u003c/a>. \u003c/aside>\n\u003cp>As\u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/kqed-launches-project-to-help-make-health-costs-transparent/\" target=\"_blank\"> I outlined last week\u003c/a>, health care costs lack transparency, and it's virtually impossible for consumers to shop around. We're asking you, members of our KQED community, to share what you've paid for common health care procedures. Your responses feed directly into a database so others can look up how much mammograms cost in their area.\u003c/p>\n\u003cp>So far, we've received a handful of submitted prices. Our partner, ClearHealthCosts, had previously collected a range of \"self-pay\" prices -- that's the price people are charged if they do not have insurance or have decided to go out of their insurance network and are paying out of their own pocket.\u003c!--more-->\u003c/p>\n\u003cp>Those self-pay prices for a screening mammogram in the Bay Area range from $125 at the low end -- from NorCal Imaging in Walnut Creek -- to $801 at the other end at UCSF.\u003c/p>\n\u003cp>Here's a screen shot of some places in the middle:\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/Screen-Shot-2014-06-29-at-2.33.24-PM.png\">\u003cimg class=\"aligncenter wp-image-19813 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/Screen-Shot-2014-06-29-at-2.33.24-PM.png\" alt=\"Screen Shot 2014-06-29 at 2.33.24 PM\" width=\"462\" height=\"614\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/06/Screen-Shot-2014-06-29-at-2.33.24-PM.png 462w, https://ww2.kqed.org/app/uploads/sites/27/2014/06/Screen-Shot-2014-06-29-at-2.33.24-PM-400x532.png 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/06/Screen-Shot-2014-06-29-at-2.33.24-PM-320x425.png 320w\" sizes=\"(max-width: 462px) 100vw, 462px\">\u003c/a>\u003c/p>\n\u003cp>Then there are the submitted prices. Here's a screenshot of two prices shared by women in the Bay Area (and thank you to them!). Remember, this is all anonymous:\u003c/p>\n\u003cfigure id=\"attachment_19814\" class=\"wp-caption aligncenter\" style=\"max-width: 465px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\">\u003cimg class=\"size-full wp-image-19814\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/Screen-Shot-2014-06-29-at-2.40.20-PM.png\" alt=\"(screenshot of mammogram prices submitted by KQED audience members from our PriceCheck project)\" width=\"465\" height=\"441\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/06/Screen-Shot-2014-06-29-at-2.40.20-PM.png 465w, https://ww2.kqed.org/app/uploads/sites/27/2014/06/Screen-Shot-2014-06-29-at-2.40.20-PM-400x379.png 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/06/Screen-Shot-2014-06-29-at-2.40.20-PM-320x303.png 320w\" sizes=\"(max-width: 465px) 100vw, 465px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Screenshot of mammogram prices submitted by KQED audience members from our \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">PriceCheck project\u003c/a>.\u003c/figcaption>\u003c/figure>\n\u003cp>(As an aside, please bear with us as we refine this tool. We've just discovered that even though the two people above both are insured, the tool lists their insurer as \"Self-pay.\" We are fixing this!)\u003c/p>\n\u003cp>Screening mammograms are supposed to be covered at no co-pay or other costs to patients. This patient appeared to pay $300, but her comments detail that she also got an ultrasound.\u003c/p>\n\u003cfigure id=\"attachment_19815\" class=\"wp-caption aligncenter\" style=\"max-width: 459px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\">\u003cimg class=\"size-full wp-image-19815\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/Screen-Shot-2014-06-29-at-3.04.43-PM.png\" alt=\"Screenshot from PRice Check.\" width=\"459\" height=\"240\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/06/Screen-Shot-2014-06-29-at-3.04.43-PM.png 459w, https://ww2.kqed.org/app/uploads/sites/27/2014/06/Screen-Shot-2014-06-29-at-3.04.43-PM-400x209.png 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/06/Screen-Shot-2014-06-29-at-3.04.43-PM-320x167.png 320w\" sizes=\"(max-width: 459px) 100vw, 459px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Screenshot from PRice Check.\u003c/figcaption>\u003c/figure>\n\u003cp>So what do these early data tell us? Starting with the final submission above, the apparent $300 co-pay, it's clear that consumers need to be careful about what procedures they're getting. While screening mammograms are supposed to be a zero-cost item for patients, diagnostic procedures are different. They are possibly subject to co-pays, depending on your insurance.\u003c/p>\n\u003caside class=\"pullquote alignright\">Learn more: \u003ca href=\"http://ww2.kqed.org/stateofhealth/series/price-check/\" target=\"_blank\">read all our PriceCheck coverage\u003c/a>. \u003c/aside>\n\u003cp>These early data demonstrate that there's tremendous cost variation -- especially on self-pay prices -- on screening mammograms in the Bay Area. While cost variation is well known in American medicine, there aren't a lot of places consumers can go to see prices laid out in front of them. If you're not insured or if you want to go out-of-network for a screening mammogram, these data, though not comprehensive, at least give you a starting point on price.\u003c/p>\n\u003cp>Finally, in addition to the handful of prices people have submitted to us, we've also been gratified that doctors have reached out to talk to us, too.\u003c/p>\n\u003cp>This week, Dr. Eli Chen in Morgan Hill emailed us that he'd had a patient come in with a flier of self-pay prices. Chen had a second price list as well. Here's one of them, from Valley Radiology Imaging. which lists several locations in the South Bay. Its cash price for a screening mammogram is $125, and it appears to offer an additional discount if a patient is uninsured and pays in full at time of service:\u003c/p>\n\u003cfigure id=\"attachment_19817\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/Screen-Shot-2014-06-29-at-3.22.34-PM.png\">\u003cimg class=\"size-large wp-image-19817\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/Screen-Shot-2014-06-29-at-3.22.34-PM-640x503.png\" alt=\"Excerpt of flyer of self-pay prices from Valley Radiology Imaging. \" width=\"640\" height=\"503\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Excerpt of flyer of self-pay prices from Valley Radiology Imaging.\u003c/figcaption>\u003c/figure>\n\u003cp>If you have a price to share, please do so. If you see an advertised list of cash or self-pay prices, please send us those, too! Our centralized email address is info@clearhealthcosts.com.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This post has been updated to clarify the lowest cost self-pay mammogram in our PriceCheck database for the Bay Area.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_19667\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/RS10943_Facebook_Final-hpf.jpg\">\u003cimg class=\"size-full wp-image-19667\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/RS10943_Facebook_Final-hpf.jpg\" alt=\"(Illustration: Andy Warner)\" width=\"640\" height=\"206\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/06/RS10943_Facebook_Final-hpf.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2014/06/RS10943_Facebook_Final-hpf-400x129.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/06/RS10943_Facebook_Final-hpf-320x103.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Illustration: Andy Warner)\u003c/figcaption>\u003c/figure>\n\u003cp>Last Monday, \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">KQED\u003c/a>, \u003ca href=\"http://www.scpr.org/blogs/health/2014/06/23/16873/join-pricecheck-help-make-health-care-costs-more-t/\" target=\"_blank\">KPCC\u003c/a> and \u003ca href=\"http://clearhealthcosts.com\" target=\"_blank\">ClearHealthCosts.com\u003c/a> launched our community-created guide to health costs.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Share what you paid for a mammogram. \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">Visit KQED's PriceCheck\u003c/a>. \u003c/aside>\n\u003cp>As\u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/kqed-launches-project-to-help-make-health-costs-transparent/\" target=\"_blank\"> I outlined last week\u003c/a>, health care costs lack transparency, and it's virtually impossible for consumers to shop around. We're asking you, members of our KQED community, to share what you've paid for common health care procedures. Your responses feed directly into a database so others can look up how much mammograms cost in their area.\u003c/p>\n\u003cp>So far, we've received a handful of submitted prices. Our partner, ClearHealthCosts, had previously collected a range of \"self-pay\" prices -- that's the price people are charged if they do not have insurance or have decided to go out of their insurance network and are paying out of their own pocket.\u003c!--more-->\u003c/p>\n\u003cp>Those self-pay prices for a screening mammogram in the Bay Area range from $125 at the low end -- from NorCal Imaging in Walnut Creek -- to $801 at the other end at UCSF.\u003c/p>\n\u003cp>Here's a screen shot of some places in the middle:\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/Screen-Shot-2014-06-29-at-2.33.24-PM.png\">\u003cimg class=\"aligncenter wp-image-19813 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/Screen-Shot-2014-06-29-at-2.33.24-PM.png\" alt=\"Screen Shot 2014-06-29 at 2.33.24 PM\" width=\"462\" height=\"614\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/06/Screen-Shot-2014-06-29-at-2.33.24-PM.png 462w, https://ww2.kqed.org/app/uploads/sites/27/2014/06/Screen-Shot-2014-06-29-at-2.33.24-PM-400x532.png 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/06/Screen-Shot-2014-06-29-at-2.33.24-PM-320x425.png 320w\" sizes=\"(max-width: 462px) 100vw, 462px\">\u003c/a>\u003c/p>\n\u003cp>Then there are the submitted prices. Here's a screenshot of two prices shared by women in the Bay Area (and thank you to them!). Remember, this is all anonymous:\u003c/p>\n\u003cfigure id=\"attachment_19814\" class=\"wp-caption aligncenter\" style=\"max-width: 465px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\">\u003cimg class=\"size-full wp-image-19814\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/Screen-Shot-2014-06-29-at-2.40.20-PM.png\" alt=\"(screenshot of mammogram prices submitted by KQED audience members from our PriceCheck project)\" width=\"465\" height=\"441\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/06/Screen-Shot-2014-06-29-at-2.40.20-PM.png 465w, https://ww2.kqed.org/app/uploads/sites/27/2014/06/Screen-Shot-2014-06-29-at-2.40.20-PM-400x379.png 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/06/Screen-Shot-2014-06-29-at-2.40.20-PM-320x303.png 320w\" sizes=\"(max-width: 465px) 100vw, 465px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Screenshot of mammogram prices submitted by KQED audience members from our \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">PriceCheck project\u003c/a>.\u003c/figcaption>\u003c/figure>\n\u003cp>(As an aside, please bear with us as we refine this tool. We've just discovered that even though the two people above both are insured, the tool lists their insurer as \"Self-pay.\" We are fixing this!)\u003c/p>\n\u003cp>Screening mammograms are supposed to be covered at no co-pay or other costs to patients. This patient appeared to pay $300, but her comments detail that she also got an ultrasound.\u003c/p>\n\u003cfigure id=\"attachment_19815\" class=\"wp-caption aligncenter\" style=\"max-width: 459px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\">\u003cimg class=\"size-full wp-image-19815\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/Screen-Shot-2014-06-29-at-3.04.43-PM.png\" alt=\"Screenshot from PRice Check.\" width=\"459\" height=\"240\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/06/Screen-Shot-2014-06-29-at-3.04.43-PM.png 459w, https://ww2.kqed.org/app/uploads/sites/27/2014/06/Screen-Shot-2014-06-29-at-3.04.43-PM-400x209.png 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/06/Screen-Shot-2014-06-29-at-3.04.43-PM-320x167.png 320w\" sizes=\"(max-width: 459px) 100vw, 459px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Screenshot from PRice Check.\u003c/figcaption>\u003c/figure>\n\u003cp>So what do these early data tell us? Starting with the final submission above, the apparent $300 co-pay, it's clear that consumers need to be careful about what procedures they're getting. While screening mammograms are supposed to be a zero-cost item for patients, diagnostic procedures are different. They are possibly subject to co-pays, depending on your insurance.\u003c/p>\n\u003caside class=\"pullquote alignright\">Learn more: \u003ca href=\"http://ww2.kqed.org/stateofhealth/series/price-check/\" target=\"_blank\">read all our PriceCheck coverage\u003c/a>. \u003c/aside>\n\u003cp>These early data demonstrate that there's tremendous cost variation -- especially on self-pay prices -- on screening mammograms in the Bay Area. While cost variation is well known in American medicine, there aren't a lot of places consumers can go to see prices laid out in front of them. If you're not insured or if you want to go out-of-network for a screening mammogram, these data, though not comprehensive, at least give you a starting point on price.\u003c/p>\n\u003cp>Finally, in addition to the handful of prices people have submitted to us, we've also been gratified that doctors have reached out to talk to us, too.\u003c/p>\n\u003cp>This week, Dr. Eli Chen in Morgan Hill emailed us that he'd had a patient come in with a flier of self-pay prices. Chen had a second price list as well. Here's one of them, from Valley Radiology Imaging. which lists several locations in the South Bay. Its cash price for a screening mammogram is $125, and it appears to offer an additional discount if a patient is uninsured and pays in full at time of service:\u003c/p>\n\u003cfigure id=\"attachment_19817\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/Screen-Shot-2014-06-29-at-3.22.34-PM.png\">\u003cimg class=\"size-large wp-image-19817\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/Screen-Shot-2014-06-29-at-3.22.34-PM-640x503.png\" alt=\"Excerpt of flyer of self-pay prices from Valley Radiology Imaging. \" width=\"640\" height=\"503\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Excerpt of flyer of self-pay prices from Valley Radiology Imaging.\u003c/figcaption>\u003c/figure>\n\u003cp>If you have a price to share, please do so. If you see an advertised list of cash or self-pay prices, please send us those, too! Our centralized email address is info@clearhealthcosts.com.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This post has been updated to clarify the lowest cost self-pay mammogram in our PriceCheck database for the Bay Area.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp> \u003cscript>var chc_widget_hash = \"TRHMKJCB\";\u003c/script>\u003cbr>\n \u003cscript src=\"http://widgets.clearhealthcosts.com/assets/widgets/widget.js\">\u003c/script>\u003c!--more-->\u003cbr>\nRight now, buying health care is like going to the grocery store and finding all the price tags removed. Even worse, bananas might cost you $4 and another shopper $400, and you wouldn’t know which until you handed over your debit card. By collecting information from you and others like you, we can help change that.\u003c/p>\n\u003cp>Check out the form below and share what you paid. If you have insurance, you’ll need your \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/07/18/explaining-the-health-insurance-explanation-of-benefits/\" target=\"_blank\">explanation of benefits\u003c/a>.\u003c/p>\n\u003cp>We’re focusing now on \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/05/27/pricecheck-how-much-does-a-colonoscopy-cost/\" target=\"_blank\">colonoscopies\u003c/a>, a screening test for colon cancer. \u003cem>When\u003c/em>\u003cem> you share your price, please indicate in comments if you had anesthesia as part of the procedure and if any polyps were removed.\u003c/em>\u003c/p>\n\u003cp>Our form is designed to accept many kinds of medical tests and procedures. Please check out \u003ca title=\"PriceCheck\" href=\"http://ww2.kqed.org/stateofhealth/series/price-check/\" target=\"_blank\">all of our PriceCheck coverage\u003c/a>.\u003c/p>\n\u003cdiv id=\"chc_widget\">\u003c/div>\n\u003cp> \u003cscript>var chc_widget_hash = \"TRHMKJCB\"\u003c/script>\u003cbr>\n \u003cscript src=\"https://widgets.clearhealthcosts.com/assets/widgets/widget.js\">\u003c/script>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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},
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},
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"id": "bbc-world-service",
"title": "BBC World Service",
"info": "The day's top stories from BBC News compiled twice daily in the week, once at weekends.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/BBC-World-Service-Podcast-Tile-360x360-1.jpg",
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},
"link": "/radio/program/bbc-world-service",
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"rss": "https://podcasts.files.bbci.co.uk/p02nq0gn.rss"
}
},
"californiareport": {
"id": "californiareport",
"title": "The California Report",
"tagline": "California, day by day",
"info": "KQED’s statewide radio news program providing daily coverage of issues, trends and public policy decisions.",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-California-Report-Podcast-Tile-703x703-1.jpg",
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"officialWebsiteLink": "/californiareport",
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"source": "kqed",
"order": 8
},
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}
},
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"title": "The California Report Magazine",
"tagline": "Your state, your stories",
"info": "Every week, The California Report Magazine takes you on a road trip for the ears: to visit the places and meet the people who make California unique. The in-depth storytelling podcast from the California Report.",
"airtime": "FRI 4:30pm-5pm, 6:30pm-7pm, 11pm-11:30pm",
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"order": 10
},
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM3NjkwNjk1OTAz",
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},
"city-arts": {
"id": "city-arts",
"title": "City Arts & Lectures",
"info": "A one-hour radio program to hear celebrated writers, artists and thinkers address contemporary ideas and values, often discussing the creative process. Please note: tapes or transcripts are not available",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/05/cityartsandlecture-300x300.jpg",
"officialWebsiteLink": "https://www.cityarts.net/",
"airtime": "SUN 1pm-2pm, TUE 10pm, WED 1am",
"meta": {
"site": "news",
"source": "City Arts & Lectures"
},
"link": "https://www.cityarts.net",
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"tuneIn": "https://tunein.com/radio/City-Arts-and-Lectures-p692/",
"rss": "https://www.cityarts.net/feed/"
}
},
"closealltabs": {
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"info": "Close All Tabs breaks down how digital culture shapes our world through thoughtful insights and irreverent humor.",
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"officialWebsiteLink": "/podcasts/closealltabs",
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"order": 1
},
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"title": "Code Switch / Life Kit",
"info": "\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />",
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"meta": {
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"id": "commonwealth-club",
"title": "Commonwealth Club of California Podcast",
"info": "The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.",
"airtime": "THU 10pm, FRI 1am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg",
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"meta": {
"site": "news",
"source": "Commonwealth Club of California"
},
"link": "/radio/program/commonwealth-club",
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"google": "https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw",
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"id": "forum",
"title": "Forum",
"tagline": "The conversation starts here",
"info": "KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.",
"airtime": "MON-FRI 9am-11am, 10pm-11pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Forum with Mina Kim and Alexis Madrigal",
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"source": "kqed",
"order": 9
},
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM5NTU3MzgxNjMz",
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"id": "freakonomics-radio",
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"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/freakonomicsRadio.png",
"officialWebsiteLink": "http://freakonomics.com/",
"airtime": "SUN 1am-2am, SAT 3pm-4pm",
"meta": {
"site": "radio",
"source": "WNYC"
},
"link": "/radio/program/freakonomics-radio",
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"apple": "https://itunes.apple.com/us/podcast/freakonomics-radio/id354668519",
"tuneIn": "https://tunein.com/podcasts/WNYC-Podcasts/Freakonomics-Radio-p272293/",
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},
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"id": "fresh-air",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=214089682&at=11l79Y&ct=nprdirectory",
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"info": "A live production of NPR and WBUR Boston, in collaboration with stations across the country, Here & Now reflects the fluid world of news as it's happening in the middle of the day, with timely, in-depth news, interviews and conversation. Hosted by Robin Young, Jeremy Hobson and Tonya Mosley.",
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},
"hidden-brain": {
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"info": "Shankar Vedantam uses science and storytelling to reveal the unconscious patterns that drive human behavior, shape our choices and direct our relationships.",
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"airtime": "SUN 7pm-8pm",
"meta": {
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"source": "NPR"
},
"link": "/radio/program/hidden-brain",
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},
"how-i-built-this": {
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"title": "How I Built This with Guy Raz",
"info": "Guy Raz dives into the stories behind some of the world's best known companies. How I Built This weaves a narrative journey about innovators, entrepreneurs and idealists—and the movements they built.",
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"officialWebsiteLink": "https://www.npr.org/podcasts/510313/how-i-built-this",
"airtime": "SUN 7:30pm-8pm",
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},
"link": "/radio/program/how-i-built-this",
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"apple": "https://itunes.apple.com/us/podcast/how-i-built-this-with-guy-raz/id1150510297?mt=2",
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},
"hyphenacion": {
"id": "hyphenacion",
"title": "Hyphenación",
"tagline": "Where conversation and cultura meet",
"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/03/Hyphenacion_FinalAssets_PodcastTile.png",
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"officialWebsiteLink": "/podcasts/hyphenacion",
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"order": 15
},
"link": "/podcasts/hyphenacion",
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},
"jerrybrown": {
"id": "jerrybrown",
"title": "The Political Mind of Jerry Brown",
"tagline": "Lessons from a lifetime in politics",
"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-Political-Mind-of-Jerry-Brown-Podcast-Tile-703x703-1.jpg",
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"officialWebsiteLink": "/podcasts/jerrybrown",
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"order": 18
},
"link": "/podcasts/jerrybrown",
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},
"latino-usa": {
"id": "latino-usa",
"title": "Latino USA",
"airtime": "MON 1am-2am, SUN 6pm-7pm",
"info": "Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/latinoUsa.jpg",
"officialWebsiteLink": "http://latinousa.org/",
"meta": {
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"source": "npr"
},
"link": "/radio/program/latino-usa",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=79681317&at=11l79Y&ct=nprdirectory",
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"rss": "https://feeds.npr.org/510016/podcast.xml"
}
},
"marketplace": {
"id": "marketplace",
"title": "Marketplace",
"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Marketplace-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.marketplace.org/",
"meta": {
"site": "news",
"source": "American Public Media"
},
"link": "/radio/program/marketplace",
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"rss": "https://feeds.publicradio.org/public_feeds/marketplace-pm/rss/rss"
}
},
"masters-of-scale": {
"id": "masters-of-scale",
"title": "Masters of Scale",
"info": "Masters of Scale is an original podcast in which LinkedIn co-founder and Greylock Partner Reid Hoffman sets out to describe and prove theories that explain how great entrepreneurs take their companies from zero to a gazillion in ingenious fashion.",
"airtime": "Every other Wednesday June 12 through October 16 at 8pm (repeats Thursdays at 2am)",
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"officialWebsiteLink": "https://mastersofscale.com/",
"meta": {
"site": "radio",
"source": "WaitWhat"
},
"link": "/radio/program/masters-of-scale",
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"apple": "http://mastersofscale.app.link/",
"rss": "https://rss.art19.com/masters-of-scale"
}
},
"mindshift": {
"id": "mindshift",
"title": "MindShift",
"tagline": "A podcast about the future of learning and how we raise our kids",
"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED MindShift: How We Will Learn",
"officialWebsiteLink": "/mindshift/",
"meta": {
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"source": "kqed",
"order": 12
},
"link": "/podcasts/mindshift",
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
"npr": "https://www.npr.org/podcasts/464615685/mind-shift-podcast",
"stitcher": "https://www.stitcher.com/podcast/kqed/stories-teachers-share",
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}
},
"morning-edition": {
"id": "morning-edition",
"title": "Morning Edition",
"info": "\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. Hosts Steve Inskeep, David Greene and Rachel Martin bring you the latest breaking news and features to prepare you for the day.",
"airtime": "MON-FRI 3am-9am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Morning-Edition-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.npr.org/programs/morning-edition/",
"meta": {
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"source": "npr"
},
"link": "/radio/program/morning-edition"
},
"onourwatch": {
"id": "onourwatch",
"title": "On Our Watch",
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