The kids are asleep, and I鈥檝e settled into a comfy armchair in the corner of my New England living room, one of my favorite spots for shopping online. I鈥檝e got my laptop open and I鈥檓 ready to search for a bone density test.
Hmmm 鈥� looks like the price that my insurer pays for that test varies from $190 at Harvard Vanguard to $445 at Brigham and Women鈥檚 Hospital.
Really? I鈥檓 calm, but this is a seismic moment. In most of the country, it is still nearly impossible to compare the price and quality of anything in health care. Ten years ago, I tried filing Freedom of Information Act requests to get this information and got nothing. Occasionally, sources would leak me spread sheets from one hospital or another.
Websites that mine such data are to fill the void, revealing price tags on everything from an office visit to a cesarean section. But thanks to a law enacted in October, Massachusetts health insurers now have to make all their prices public 鈥� in advance.
鈥淭his is a very big deal,鈥� says , undersecretary for consumer affairs in Massachusetts. 鈥�We鈥檙e letting the light shine in.鈥�
The online tools also calculate your cost, based on your plan. Anthony鈥檚 office has launched an ad campaign, urging patients to shop around. She says doctors and hospitals are becoming frequent users of the online cost tools, too.
鈥淭hey鈥檙e already saying, 鈥業 don鈥檛 want to be the highest priced provider on your website 鈥� I thought I was lower than my competitors.鈥� That鈥檚 exactly the kind of reaction we want to see,鈥� she says.
It鈥檚 key to getting at why one hospital charges three, four or five times more than its competitors, she says, and to seeing if exposing these differences will drive down prices.
鈥淚鈥檓 just talking about sensible, rational pricing,鈥� Anthony says, 鈥渁nd right now, health prices are anything but that.鈥�
Take, for example, the cost in Boston of an MRI of the upper back, which, the numbers show can range from $614 to $1,800.
鈥淭hat to me is a very big range,鈥� says Sue Amsel, who oversees the shopping at the insurer, .
In this case, the most expensive MRI is at Boston Children鈥檚 Hospital 鈥� and the option of lowest cost is at New England Baptist, a hospital that specializes in orthopedics. The total cost of most surgeries is not yet available, but Amsel says you can now search for hundreds of tests, procedures and office visits.
鈥淚t鈥檚 eye opening,鈥� she says. 鈥淚鈥檓 always surprised at the difference between providers.鈥�
Now, most of us don鈥檛 have a strong incentive to shop. We pay the same $25 or $30 co-pay, no matter where we get an MRI. But more and more people have high-deductible plans, says Amsel, where patients pay the full cost of an office visit or test, up to the amount of their deductible.
The benefit鈥檚 not just in getting to choose, Amsel says. 鈥淚t鈥檚 primarily for getting you the information about whatever you鈥檙e having done, so you can plan for it.鈥�
After spending a lot of time window shopping for common tests, I have some tips: There are no uniform prices; they vary from one insurer to the next. And you have to read the fine print on these sites to know what is and is not included in the dollar figure you鈥檒l see online.
This story is part of a partnership that includes , and Kaiser Health News.