Due for a colonoscopy? Shopping for knee or hip replacement surgery? Or do you need a CT scan or MRI?
What Coloradans pay for these medical services depends widely on where they live and which service they seek. But the price is influenced by more than geography and how often the services are provided, according to a new analysis by the Center for Improving Value in Health Care (CIVHC), a Colorado Trust grantee.
Data in the analysis comes from the Colorado All Payer Claims Database, which contains prices paid by public and private insurance providers for a variety of medical claims. The analysis looked at claims paid by commercial insurance between 2010 and 2014 across Colorado.
You might think that prices for surgery and medical tests would be more expensive in rural or mountainous areas of Colorado, where fewer patients seek care compared to urban areas. That’s a common hypothesis, and to some extent it’s true—but not universally so.
Orthopedic surgery in northeast Colorado costs as much as $36,200 more for a hip joint replacement than the state median, for example. But colonoscopies in that region cost about as much as they do in other regions. Instead, the central mountain region had the most expensive colonoscopies, costing $1,200 to $2,300 more than the state median. By comparison, abdominal echo exams (or ultrasounds) in that region were $100 cheaper than the state median.
More analysis is needed to unpack the picture behind health care costs, said Cari Frank, director of communications and marketing at CIVHC.
A region’s cost of living, competition among providers, the extent of their network, and how much charity care they provide could all influence costs.
“People need to think very broadly about why prices are high,” she said. “There are a lot of factors that go into [pricing] and whether [high prices] are warranted or not.”