The Internet has turned us into experts when it comes to buying most products we want and need. We have instant access to price comparisons across most retailers, as well as quality scores from professional reviewers and previous customers.
That expertise does not extend to health care purchases.
A new study by a health care technology firm, Castlight Health, drives that point home.
The "Costliest Cities Index," culled from millions of medical claims, found wide disparities between prices for eight common in-network medical services across the nation's largest metro areas, as well as within those regions.
For instance, the average cost of a mammogram is $307 for a member of an employer-funded health care plan in Broward and Miami-Dade counties, making the region the ninth-most expensive for that procedure of the 30 largest cities identified in the study.
But within Broward and Miami-Dade, mammogram prices for insurance policyholders and their employers ranged from $96 to $510.
According to the study, "This happens because unlike virtually every other product and service, no one knows how much health care costs until days or weeks after they purchase it."
This is the second year Castlight has produced the comparison, based on millions of claims processed through a health benefits portal it manages for companies across the U.S., said Eric Mann, the company's vice president of product marketing.
Ranges were wide for other procedures as well, such as an MRI ($714 to $3,167) and an OBGYN visit ($55 to $89).
In Palm Beach County, which was not included in the study's comparison of prices across the Top 30 cities, the cost of a mammogram averaged $225 and ranged from $69 to $520, the study found. An MRI averaged $1,208 and ranged from $600 to $1,534.
Reasons for the wide ranges are complicated and are often a result of contracts between insurance companies and providers, Mann said. Unlike other consumer goods, prices for medical procedures charged to consumers have no relation to the quality of the procedures, Mann said.
Castlight conducts the study to teach consumers that they should compare prices and quality of health care services as they would compare other products.
"You can start by asking your doctor how much something is going to cost," Mann said. "And realize you can ask other doctors as well. You can call your insurance company and see what their agreement is with the doctor."
Mann also recommends asking a doctor or a clinic how many of a specific procedure they perform each year. "The reason is the more procedures are done, the more effective they can be at it."
"If the doctor says, 'Gee, I've only done two a year,' you might want to shop around."
Dr. Roderick King, CEO of the Florida Institute for Health Innovation and a faculty member at the University of Miami's Miller School of Medcine's Department of Public Health Services, said the Castlight Study is part of a national effort to encourage greater transparency regarding quality and cost of health care.
Ultimately, proponents want a system to rate "quality per unit cost." Right now, "the quality piece of the value equation is not well known. The price equation is even less known."
In the study's comparison of average costs across the nation's most populated cities, the Miami region, which includes Broward and Miami-Dade, was among the 10 most expensive for four of the eight procedures.
The four procedures are: CT scan of the head/brain without dye (third most expensive, average $1,225); lipid panel (eighth most expensive, average $72); MRI of the lower back without dye (seventh most expensive, average $1,750); mammogram (eighth most expensive, average $307).
But prices were in the middle of the pack for the four other procedures: OB/GYN follow-up visit (18th most expensive, average $75); preventive gynecological exam (15th most expensive, average $149); human papilloma virus (11th most expensive, average $66).
And the region was least expensive of the 30 cities for a preventative primary care visit with an average price of $96.
The most expensive cities for the study's basket of procedures included Indianapolis, with the highest average prices for MRIs, CT scans and lipid panels and the second-highest average prices for mammograms and HPV tests. San Francisco had the highest price for HPV tests and preventative gynecological exams. Minneapolis had the most expensive prices for OB/GYN follow-up visits and preventative primary care visits.
Phoenix was among the five top 30 cities with the lowest average prices for five of the eight services, including being the lowest-average-priced city for preventative and follow-up gynecological exams.
Although Palm Beach County was not included in the study's Top 30 comparison, the study data showed that average costs were lower there than in Miami-Fort Lauderdale for all eight procedures.
Eight medical services — average cost, low-to-high range
Mammogram — $307, $96 to $510
Human papillomavirus (HPV) test — $66, $32 to $494
Preventive gynecological exam — $149, $86 to $244
OB/GYN follow-up visit — $75, $55 to $89
Lipid panel — $72, $25 to $314
Preventive primary care visit — $96, $86 to $220
CT scan of head/brain — $1,225, $643 to $2,072
Magnetic resonance imaging (MRI) of lower back — $1,750, $714 to $3,164
Eight medical services — average cost, low-to-high range
West Palm Beach-Boca Raton
Mammogram – $226, $69 to $520
Human papillomavirus (HPV) test - $46, $32 to $220
Preventive gynecological exam - $145, $89 to $218
OB/GYN follow-up visit - $74, $61 to $88
Lipid panel - $57, $30 to $174
Preventive primary care visit - $95, $85 to $256
CT scan of head/brain - $727, $371 to $1,220