By Sarah Kliff March 2, 2013
Steve Brill's recent Time cover story. for me, drove home one key point: Prices in our health-care system are absurd. They range dramatically depending on where you seek treatment and what type of health insurance coverage you have.
Brill examined seven medical bills in his story to make this point. A new, NIH-funded study takes the idea even further: A team of four researchers looked at medical expenditure bills that represented more than 8,303 emergency room visits.
They found, essentially, two things. First, huge variation in prices: Bills sent out for sprained ankles ranged from $4 to $24,110. Second, overall, really high prices: The average emergency room visit now costs 40 percent more than a month's rent.
Researchers used data from the Medical Expenditures Panel Survey, which looks at how much American families spend on, well, medical expenditures. They looked just at what they found to be the 10 most common reasons listed for trips to the emergency room — designated by billing codes — and how much each one cost. The chart below shows a huge amount of variation.
A headache could cost $15 —
or $17,797. There was a difference of more than $70,000 between the most and least costly treatments for a urinary tract infection.
Pulling all that data together, researchers found that the average charge for an emergency room trip for all these conditions came out to $1,233, which is 40 percent higher than the average American rent right now, $871 per month.
These costs could go down for an individual with insurance; as lead author Renee Hsia explained to me over e-mail. "We looked at charges, meaning what patients were billed. We did not look at the amounts insurers paid, or what individuals paid," Hsia said.
It's possible that after this point, insurance companies negotiated down rates — and they most likely paid some part of the bill for the patients they covered.
Stil, Hsia wanted to show the sticker price for the emergency services.
"We feel that while charges are usually much higher than what insurers pay, for uninsured patients, or for patients who receive care in an out-of-network hospital (like one of my friends, which really started my whole interest in this area a few years ago!)," Hsia wrote, "they actually are faced with the sticker prices."