In 2021, the federal Centers for Medicare and Medicaid Services (CMS) rolled out new rules requiring every licensed hospital to display costs for services. All hospitals have been required to list prices (whether that’s cash, gross charges, or negotiated) and display estimates in a consumer-friendly manner.
Unsurprisingly, many hospitals refused to comply throughout 2022. In response, CMS dramatically raised the fines that uncompliant hospitals would have to pay.
Naturally, more hospitals then released price information. To better understand how hospitals are meeting those requirements, I selected the three top-rated hospitals in Los Angeles to examine: Cedars-Sinai Medical Center, UCLA Medical Center, and Keck Medicine of USC.
Not only did I choose to focus on Los Angeles for practical cost comparison in a defined area but because these hospitals are some of the most highly rated on many variables in the country. The three hospitals have high visibility and may be setting an example for other hospitals.
Additionally, I searched for the costs of three common medical services: a MRI brain scan, colonoscopy, and cesarean section. These online cost estimates could change at any time, and nothing here is intended to serve as medical advice or as a recommendation for any service from any particular hospital.
On the billing section of each hospital’s website, I easily found price transparency sections or links that displayed the relevant information. This is a good sign.
Cedars-Sinai has a very user-friendly tool. Through the tool, you can input whether you will pay with cash, or you can specify your insurance carrier. Then, you can enter a keyword for the procedure you are looking for, or the specific billing code.
A MRI of the brain costs nearly $4k out-of-pocket, and an estimated $1k with my health insurance. A colonoscopy would be over $10k in cash, but my insurance brought that down to one-fifth the cost. Cedars-Sinai failed to disclose the price of an out-of-pocket C-section. But with insurance, the tool estimated $7k, noting that the estimate did not include prices for other relevant services such as anesthesia. One would hope anesthesia is a necessary element for every C-section.
Anesthetists are sometimes in-network or out-of-network so prices can be hard to estimate because it depends on who is working when a woman goes into labor. Regardless, the websites should include typical out-of-network prices for so mothers can prepare accordingly.
The cash pricing tool on UCLA’s Medical Center website is fun to use. It shows a featureless body where you can click where the procedure is needed.
The services actually included with the tool are limited, but it shows potential for consumer-friendly use. A cash-paid brain MRI came out to just $865 while if one were to use insurance, depending on one’s coverage, he or she would receive a bill over $5k for the same service. Colonoscopies came out to $3,200 in cash and I could not find the price the hospital typically charges the insurer. C-sections were unlisted in the cash prices.
Frustratingly, the labor and delivery section listed many billing codes, and it was unclear which would be included in the bill for a regular C-section. As someone who has given birth twice and who scrutinizes itemized charges on medical bills, even I found the labor and delivery list intimidating and difficult to understand.
Finally, I checked Keck Medicine of USC’s hospital pricing. One can only download a massive excel sheet. Each line displays a technical service name, a billing code, and what it charges insurance. It does not show cash prices.
Searching the sheet, I found that a brain MRI costs below $7k. A colonoscopy with a biopsy would be $4k. But when using keywords related to birth, I could find no results for a C-section (or vaginal birth, for that matter).
In short, the new transparency rules enabled me to learn that UCLA Medical Center is the most cost-effective place to get a brain MRI. Prices for colonoscopies are comparable at both UCLA and Keck. To be fair, Cedars-Sinai is rated as the second-best hospital, according to US News & World Report, in the nation and some consumers may choose to pay more for that care.
Mothers hoping to plan for future hospital maternity costs are incredibly short-changed. Hospitals might argue that it’s because births are highly variable and unpredictable. Birthing centers, on the other hand, standardize costs.
My search took me just a little over an hour. Luckily, searching for prices through several hospital websites may soon be unnecessary. Turquoise Health provides a service allowing consumers to search for a procedure’s price by zip code. As of January of this year, the CMS requires insurance companies to make price comparisons available for 500 medical services. By next year, price comparisons for all services must be made available by insurers to consumers upon request.
All consumers have the right to know the cost of any service at any hospital, so they can make the most informed decisions for themselves or their loved ones.
McKenzie Richards is a policy associate at the Pacific Research Institute.
