Price Comparison for Gastroenterology Tests and Procedures in the US

Introduction: After The Hospital Price Transparency Final Rule, hospitals were required to post prices for all services with the goal of increasing transparency and clarity for patients undergoing medical tests and evaluations. This data presents the opportunity to analyze variation in prices for commonly performed tests and procedures. We aimed to assess availability of price information and differences in reported costs per procedure of the most common gastroenterology and hepatology tests and procedures. Methods: Hospital chargemasters were analyzed for the top 20 rated hospitals and top 20 rated gastroenterology and gastrointestinal surgery hospitals according to US News Report Weekly12. Twenty-five hospitals were included in total. Median self-pay price was obtained for the following procedures: ultrasound abdomen, computed tomography abdomen with contrast, magnetic resonance imaging abdomen with contrast, liver elastography, esophagogastroduodenoscopy, colonoscopy, liver biopsy, as well as pathology fees for specimens from EGD, colonoscopy, and liver biopsy. Results: All hospitals included in the study reported service costs online. However, only 8% of these hospitals reported the cost of all procedures investigated. Significant cost variation was seen in all procedures. An esophagogastroduodenoscopy had a 51-fold difference in cost in reported price between hospitals, and a colonoscopy similarly was found to have greater than an 80-fold difference (Figure 1). Conclusion: Despite The Hospital Price Transparency Final Rule, the availability of costs for gastroenterology medical tests and procedures are not readily accessible or transparent. Of these reported costs, we found notable price discrepancies, and further studies are needed to investigate similar patterns across different insurance payers.Figure 1.: A) is a box plot of procedure vs the cost of gastroenterology and hepatology procedures at the top 20 gastroenterology hospitals. B) shows the cost of esophagogastroduodenoscopy with a vertical line representative of the mean cost. C) shows the cost of colonoscopy with a vertical line representative of the mean cost. D) shows the cost of percutaneous liver biopsy with a vertical line representative of the mean cost.