Atlanta hospital price comparison shows wide medical fee disparity

Everyone knows healthcare costs are rising, but it's useful to drill down into the hospital price data to see the true variability in hospital fees. We recently looked at prices for 10 hospitals in and around Atlanta, measuring negotiated rates from Aetna, UnitedHealthcare and Blue Cross for a diagnostic colonoscopy (CPT 45378). 

Inside the city, Aetna rates ranged from $2,891 at Northside Hospital and Grady Health Systems to $4,353 at Emory St. Joseph’s Hospital and $4,126 at Emory University Hospital Midtown. Outside Atlanta proper, Aetna negotiated rates ranged from $2,704 at Piedmont Fayette to $4,353 at Northside Hospital Gwinnett. 

On the whole, Aetna rates are lower than UnitedHealthcare, which ranged from $2,880 at Grady in the city to $5,272 for the procedure at Wellstar Cobb Medical Center in Austell. UnitedHealthcare returned the most consistent rates: Of the 10 hospitals surveyed, 4 came out to $3,792, with 4 more at $3,425.    

Six of those hospitals returned rates from Blue Cross Blue Shield ranging from $3,136 (Grady) to $3,933 (Northside).

We can see the same general trends by examining the rates at a few key hospitals for a total knee replacement (CPT 27447). At Northside Atlanta, Aetna returns a rate of $17,805, whereas the Aetna rate for Emory University Hospital Midtown is $20,951 (Emory Saint Joseph’s rate is even higher: $22,447). Negotiated rates for the procedure outside the city are much lower: between $13,777 and $15,523 at Piedmont-affiliated hospitals in Stockbridge, Newnan and Snelville.

UnitedHealthcare rates range from $19,918 at Northside and Emory University Hospital Midtown to $21,741 at Piedmont hospitals outside Atlanta. The lowest Blue Cross price is $13,912 at Grady Health Systems. 

Negotiated rates at hospitals vary widely even when using the same insurance carrier. For brokers, this means it’s more important than ever to run detailed network analyses and create health plans that effectively steer patients toward high-value providers.

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