The wild price variation for women's health services

Studies have shown that irrational prices exist in a variety of healthcare procedures—from MRIs and cholesterol tests to knee replacement surgeries and angioplasties. Now, we can add an array of women's health services to the list.

Women with employer-sponsored health insurance living in Dallas pay from $50 to $1,045 for a mammogram, according to an analysis from Castlight Health, a publicly traded company that helps employers manage health benefits and examine healthcare prices. Dallas has the largest variation of the 179 metropolitan markets studied.

New York City is close behind. Women pay between $130 and $1,898 for a mammogram in the Big Apple. The price of a mammogram for privately insured women in Los Angeles varies from $86 to $954. Castlight defined prices as the amount the employer paid and what the employee paid in cost-sharing, such as their copay or deductible.

“The healthcare system in America today just does not have transparency,” said Eric Mann, vice president of product marketing at Castlight. “It does not have transparency for price. As or more importantly, it doesn't have transparency for quality.”

Mammograms and three other women's health services—a human papillomavirus, or HPV, test; a preventive gynecological exam; and a follow-up visit with an OB-GYN doctor—are new to the study. Castlight previously looked at lipid tests, primary-care visits, brain imaging scans and lower-back MRIs, which continue to have pronounced variations in pricing.

The price of HPV tests varies by at least 10 times in 47 metro markets. The largest variation is in Philadelphia, where women pay from $32 to $626 for an HPV test.

Prices are more standard for OB-GYN follow-up visits, with employers and employees paying no more than roughly two times the lowest amount. But compared with more typical consumer products, such as TVs or refrigerators, even paying twice as much for the same services isn't really the norm.

“There's a huge variation in cost for women's health services,” Mann said. “It has implications for women's health because they don't end up getting the services they need if they can't afford them.”