The Cost Of A New Hip

Availability of Consumer Prices From US Hospitals for a Common Surgical Procedures

We randomly selected 2 hospitals from each state (plus Washington, DC) that perform THA (Hip Replacement), as well as the 20 top-ranked orthopedic hospitals according to US News and World Report rankings. We contacted each hospital by telephone between May 2011 and July 2012. Using a standardized script, we requested from each hospital the lowest complete “bundled price” (hospital plus physician fees) for an elective THA that was required by one of the author's 62-year-old grandmother. In our scenario, the grandmother did not have insurance but had the means to pay out of pocket. We explained that we were seeking the lowest complete price for the procedure. When we encountered hospitals that could provide the hospital fee only, we contacted a random hospital affiliated orthopedic surgery practice to obtain the physician fee. Each hospital was contacted up to 5 times in efforts to obtain pricing information.
Results  Nine top-ranked hospitals (45%) and 10 non–top-ranked hospitals (10%) were able to provide a complete bundled price. We were able to obtain a complete price estimate from an additional 3 top-ranked hospitals (15%) and 54 non–top-ranked hospitals (53%) by contacting the hospital and physician separately. The range of complete prices was wide for both top-ranked ($12 500-$105 000) and non–top-ranked hospitals ($11 100-$125 798).
Conclusions and Relevance  We found it difficult to obtain price information for THA and observed wide variation in the prices that were quoted. Many health care providers cannot provide reasonable price estimates. Patients seeking elective THA (Hip Replacement) may find considerable price savings through comparison shopping.

This is truly an amazing article from The Journal of the American Medical Association (JAMA) regarding how medical costs vary from hospital to hospital, and how difficult it is to get up front costs for procedures.
The bottom line, only 45% of the top-ranked hospitals and 10% of those randomly selected were able to provide such a price after five attempts each.
Worse, the range of the procedure in cost was from $11,100 to $125,798, with top-ranked hospitals neither being the low or high bids, but having representation near the endpoints of both (12,500 and 105,000.)
In any other sort of business this sort of price obfuscation and game-playing would either put the provider out of business or lead to criminal racketeering prosecution.  But it doesn't here, because we have all been "conditioned" to allow it.
I live in Durham, NC and Duke Medical Center has gone CAT Scan crazy; every doctor recommends one for the slightest ailment, and they are EXPENSIVE! Most people shrug when you bring the subject up, and they claim that "it's done to be on the safe side." I'm convinced that at worst it's a revenue generating tool, and at best a cost-shifting ruse.
Receiving a bill from any hospital these days is a nerve wracking experience because you have absolutely no idea as to what they billed you for or how much you have to pay.