It’s opaque and messy alright.

A few months ago I tried to lookup costs and prices for a particular surgery at a particular hospital. I found the price list, and it lists what the surgeons and the anesthesiologists would charge, but not what the hospital will charge for the use of the facility (and presumably the supplies and the support staff).

And those are “lost prices.” No one could tell me what the insurance adjusted prices will be. I called the insurance company and asked, even the insurance company could not tell me what the insurance adjusted costs will be. Best they could do was looking at my out-of-pocket maximum and telling me my out-of-pocket cap for that surgery.

Later I learnt that even if I could get the line item insurance adjusted costs, it would not have been accurate because, depending on what procedures were done on the same day or on different days, the insurance company may waive the costs for certain line items if they are done with some other line item on the same day.

We still have a long way to go to reach “price transparency.”

the hospital my surgeons use has complete price transparency. well before your surgery date, they send you a detailed and complete invoice in the mail, tell you what your out of pocket will be after insurance, and give you the option of getting a discount if you pay in full in advance.

great hospital. a non-profit and rated best in the state.