Payer-Negotiated Prices for Cancer Services Across National Cancer Institute-Designated Cancer Centers

Abstract

INTRODUCTION: To promote price transparency and encourage insurer competition, recently implemented federal regulations require hospitals to publish payer-specific negotiated prices for all services. We sought to understand availability of payer-negotiated prices as well as how they vary within and across centers performing cancer operation. METHODS: We reviewed National Cancer Institute (NCI)-Designated Cancer Center (n = 64) websites to extract payer-negotiated prices and discounted cash prices for 131 services related to diagnosis and management of melanoma, colon, lung, pancreas, prostate, and rectal cancer. For each condition, we compared the highest and lowest payer-negotiated price within each center. We also compared centers with the highest median and lowest median payer-negotiated price for each condition. RESULTS: Of the 64 NCI-designated Cancer Centers, 34 (53.1%) had publicly available price data. Among these, there was wide variation in prices within and across centers and services. For example, median price for a pneumonectomy at 1 center demonstrated little variability ($7,423 to $9,000, median ratio 1.21) while another center for superficial axillary lymph node dissection demonstrated wide variation ($377 to $18,427, median ratio 31.7). Price variation also differed widely across different conditions with transanal excision demonstrating limited variability in median price across centers ($2,500.02 to $4,969.00, median ratio 1.99), while MLH1 gene analysis demonstrated wide variability in median price across centers ($2.80 to $2,631, median ratio 939.8) (Figure).FigureCONCLUSION: Adherence to federal regulations mandating hospital price transparency continues to be low. Significant variation in payer-negotiated prices exists both within and across hospitals for services related to diagnosis and treatment of the most common cancers.