Ultrasound Costs
This blog post is part of our ongoing insights series from our data team exploring various trends within our business and healthcare more broadly
Healthcare costs have tremendous variability even if the services are the same. Healthcare prices can vary based on the provider that performs the services, the setting of the care (whether it took place in an office, hospital, or other facility), or other co-occurring services. Medical billing is complex and subjective, prices are negotiated in very different contexts, and patients don’t always have the same needs (or receive the same care when they do have the same needs!).
As an example of how much the prices can vary, below are the probability distributions for the total costs of visits where the primary service that took place is an ultrasound of a pregnant uterus — the first graph showing what percentage of visits fall in a specific price range, the second what percentage are at least (or at most) a given amount.
We chose ultrasounds received during pregnancy because these are common, low-acuity services that are often stand-alone services done in an office setting.
To understand this distribution, we can look at typical cost percentiles:
- 25th percentile: $125
- 50th percentile: $200
- 75th percentile: $325
- 90th percentile: $550
(The Xth percentile means that X% of all ultrasounds cost less than that amount; so in this case, a quarter of ultrasounds are $125 or less, and half are $200 or less.)
This means that 1 in 10 members will pay roughly 3 times more than a typical member. Yikes!
That “yikes” is why it’s important for us to help pick cheaper providers for our members, and be able to tell members precisely how much their services will cost. That cost transparency is something we accomplish through a blend of predictive analytics and our innovative pricing engine that lets us price claims before they happen and surface those prices to our members via our app, our website, or our concierge teams. In this case, that means our members can get cost estimates for ultrasounds before they go to the office, and we’re working to make this information available in more detail in our care router.
Want to talk more tech? Send our CEO, Mario, a tweet @mariots
