Variation of Chargemaster Price Listings for Hysterectomy Procedures across Five States

Abstract

<h3>Study Objective</h3> A 2018 Executive Order calling for price transparency required hospitals to provide their chargemaster (list of prices) on their public websites in order to drive competition and lower prices. Our goal was to compare chargemaster prices listed for hysterectomy procedures from hospitals in five states. <h3>Design</h3> Hospital chargemasters were obtained between February to April 2020, across 5 states chosen to represent a range of demographics and health systems. Current Procedural Terminology (CPT) codes for abdominal hysterectomy (58150, 58152, 58180), vaginal hysterectomy (58260, 58262, 58290, 58291, 58263, 58267, 58270, 58292, 58293, 58294), and laparoscopic hysterectomy (58541, 58542, 58543, 58544, 58550, 58552, 58553, 58554, 58570, 58571, 58572, 58573) as well as procedure names were searched and pricing extracted. <h3>Setting</h3> N/A. <h3>Patients or Participants</h3> N/A. <h3>Interventions</h3> N/A. <h3>Measurements and Main Results</h3> 837 hospitals in 5 states were included. 105 chargemasters (12.5%) listed prices for abdominal, 106 (12.7%) vaginal, and 114 (13.6%) laparoscopic hysterectomies. Mean prices listed were significantly different for all types of hysterectomy across states (Table 1). Each type of hysterectomy had a wide range of prices listed (laparoscopic $49.00-$43,491.00, abdominal $61.45-$34,849.20, vaginal $6.00-$22,651.00). <h3>Conclusion</h3> Overall, few hospitals made price listings available for abdominal, vaginal, or laparoscopic hysterectomies and price listings varied widely for these procedures across states. Despite previous literature reporting vaginal hysterectomy to have the lowest direct cost and abdominal hysterectomy the highest (Kaaki et al 2020), this is not what these public chargemasters reflect to patients. Currently, chargemasters do not seem to be a reliable option for patients to shop for healthcare. Further investigation of chargemaster prices with hospital characteristics and quality metrics is imperative.