The study of autoworker health-plan spending across 18 cities in 2011 found huge price differences for tests and medical procedures like blood cholesterol level checks, colonoscopies and physical therapy.
Hospitals with more market clout may be using leverage to set higher prices. “We believe that a large part of the difference in the pricing is the fact that the hospitals can get away with charging higher prices,” said James Reschovsky, a senior fellow with Mathematica Policy Research and co-author of the study.
Community clinics and independent doctors often don't have as much (or any) leverage, so their prices vary less. “They are somewhat at the mercy of what the health plan is willing to pay,” Reschovsky said.
Hospital outpatient prices, on average, were 52% higher than community prices for knee MRIs and ranged from $1,518 at the top to $513 at the bottom.