When I set out to comparison shop for a colonoscopy I expected the runaround.
This week I told you how hospitals and surgery centers consider their prices closely guarded secrets that they won't make accessible on a website the way you can shop for tires, hotel rooms or almost anything else.
What I didn't expect is the extreme difference in the prices.
After a few hours on the phone, I had prices for a colonoscopy performed on an uninsured patient at 11 places that ranged from $421 at a surgery center in Altamonte Springs to $3,249 at Orlando Health's Dr. P. Phillips Hospital. Two places I called refused to give a price.
That wasn't all. In some cases, the price varied even inside the same hospital system.
That price at Orlando Health's Dr. Phillips location dropped to $2,968 at its downtown Orlando Regional Medical Center.
Want to go to Villages Regional Hospital? That'll be $1,794. Or you could save $700 if you're willing to go to Leesburg Regional Medical Center, also owned by Central Florida Health Alliance.
So what gives?
The simple answer is that hospitals charge more than outpatient centers because they have more expensive operations to run (including 24-7 staffing and trauma centers) and more leverage over insurance companies to command high prices.
"There is nobody regulating what they charge — nobody in the state, nobody in the federal government," said Gerard Anderson, director of the Center for Hospital Finance and Management at Johns Hopkins. "There is no market forcing them to lower the price. They can charge whatever they want and until recently nobody's really been looking."
Such wild price variations are reason enough to comparison shop for our next non-emergency encounter with the medical industry.
But even that may not prevent sticker shock.
Becky Hatcher went in for a routine colonoscopy late last year. Her insurance company said the procedure would be free because of the new Affordable Care Act.
Her doctor said all was well, and she went home to sleep off the anesthesia.
Then, out of nowhere, she was hit with an $8,799 bill from Orlando Health, of which she owed $1,625 after insurance.
The hospital and insurance company apparently didn't consider her colonoscopy free because her doctor observed a minor abnormality.
"They should have told me that could happen from the beginning," said Hatcher, 58, who lives in Maitland. "I should have been able to plan my finances around this procedure."
Worse, Orlando Health charged three times what she paid five years earlier at a different facility. Same doctor, same procedure. The difference was that her doctor's practice was purchased by Orlando Health, and he now operated under its rates.
She is paying the bill, but has spent months disputing the charge.
"Nobody's looking out for the patients, so the patients have to start looking out for themselves," Hatcher said.
She said the experience will make her do things differently in the future.
She likes her doctor at Orlando Health and still considers a doctor's experience and bedside manner important.
But now she'll look for an independent doctor. They're harder to find nowadays, but the savings could be substantial.
She also said she plans to spend the extra time to get price estimates in writing, and the reasons the procedure is being prescribed. That's not possible for a heart attack or any other emergency, but typically folks can plan in advance for knee surgery or even certain tests such as ultrasounds.
Good advice. Colonoscopies are already unlikable enough without being blindsided with a big bill.