Coronary bypass surgery would cost $72,000 at a Richmond, Va., hospital but $15,600 at a Norfolk, Va., hospital.
A chest X-ray at one Richmond-area hospital would cost $131; at another, the bill would be $31. The charge for an electrocardiogram is $110 at one hospital, but $43 at another in central Virginia.
Such wide variations in charges once again showed up in the annual survey of hospital charges issued Sept. 1 by the Virginia Health Services Cost Review Council. The survey was conducted in February among the state's 93 acute-care hospitals, as well as its ambulatory surgery, psychiatric and rehabilitation hospitals, and nursing homes.
The charges do not reflect discounts that insurance companies and other health coverage plans negotiate with hospitals; they reflect what a patient would be billed if he or she were paying the tab.
Surveyed were 10 hospital charges, including room, intensive care and laboratory charges; charges for 15 common conditions that result in people being hospitalized; and charges for 15 commonly performed outpatient procedures.
"This type of information gives consumers a basis for asking questions about why charges are set at particular levels," said the Cost Review Council's executive director, Ann Y. McGee.
"The limitation (of the report) is that this is only a one-month sample," said Kim Barnes, executive director of the Richmond Area Business Group on Health. That may mean only a few cases of a specific disorder were handled in a particular hospital that month.
One of the largest variations was in coronary bypass surgery, which is among the most commonly performed operations in the United States.
The charges ranged from $72,165 at Henrico Doctor's Hospital in Richmond to $15,567 at Sentara Norfolk General Hospital. The Henrico Doctor's figure is an average gross charge for the 19 cases performed during February. Sentara Norfolk General's figure is the average gross charge for 82 cases that month. The statewide median was $41,084.
John Mitchell, spokesman for Henrico Doctor's, said the survey figures do not reflect degrees of illnesses among a hospital's patients. "We're getting sicker patients and patients from all over the state," he said.
Mr. Mitchell also said that Henrico Doctor's has the highest Medicare severity of illness index in the Richmond area and the second highest in the state.
"Experienced physicians who do a high volume of procedures and a qualified staff" help make Sentara Norfolk General's program the lowest priced in the state, said Pam Robertson, director of cardiac services.
The report said charges vary due to the severity of patients' illnesses, the range of services offered, wages, interest on financing for construction and renovation, and the cost of care for the indigent and underinsured.