How much does that knee MRI cost across town? Across the country?

Researchers studying variations in cost for outpatient knee MRI examinations found dramatic differences in price on both national and local levels, with reduced prices in areas with a higher populations. The results of the study were published in the May issue of the Journal of the American College of Radiology.

With health spending in the U.S. rising at what many believe to be unsustainable rates, price transparency initiatives are helping patients—who now bear more responsibilities for up-front costs in health insurance marketplace—determine what treatments and providers to invest in. Though imaging is often implicated in creating excessive costs, research into the actual price of outpatient radiology services is lacking, according to lead author Dario Pasalic, and colleagues at the Mayo Clinic in Rochester, Minn. “Given the rapid increases in the proportion of the insured population being covered by high-deductible insurance plans, out-of-pocket expense information will gain substantially greater relevance,” they wrote.

Pasalic and his team set out to assess the cost variations of outpatient non-contrast knee MRI according to geographic- and population-based factors. To do so, they conducted a study using 122 randomly selected nonhospital outpatient radiology facilities in 43 cities across the country. The facilities were contacted via telephone to ascertain the lowest possible out-of-pocket cost for non-contrast knee MRI. Median costs were calculated and compared within each locality selected, as well as across four distinct national regions.

Their results showed that costs associated with the procedure varied widely within localities and nationwide, with prices ranging from $259 to $2,049 across all radiology facilities contacted. For radiology facilities within the same locality, costs varied from $1,592 to $0, while median cost varied between localities from $1,488 to $325. Median costs for national regions were $690 in the West, $500 in the Northeast, $550 in the Midwest and $550 in the South.

“One trend to note was the inverse relationship between population density and cost, as centers located in highly populated areas were more likely to have lower costs compared with lower-population areas,” wrote Pasalic et al. “Collectively, these findings indicate that competition for patients in highly populated areas may be a consideration when centers determine price points.”

The researchers also found significant savings available to patients who took the initiative to price shop among various local radiology facilities. “In particular, our study indicates that a potential savings of $200 [or more] can be obtained by calling multiple centers to compare prices,” they wrote.

Pasalic and his team caution that cost alone should not be the only variable at play in patient decision-making regarding radiology services. “Future work should be aimed at obtaining pricing and quality information, hand-in-hand, to offer the most balanced perspective when choosing providers,” the authors concluded. “In addition, future investigations should focus on including more outpatient center characteristics, such as the level of technology available, training level of radiologists, turnaround time for reads, and patient convenience factors.”