Researcher Is Surprised by Wild Disparity in Cost for Simple Blood Test

File this under “irrational”: At one hospital, a blood cholesterol test cost $10, while another in the same state charged $10,169. That’s a multiple of more than 1,000.

Wildly divergent costs for similar lab tests was the subject of a recent report in the journal BMJ Open, which looked at charges for routine blood tests at California hospitals that were performed in 2011.

The researchers, as noted on, (KHN) found no rational explanation for the dramatic different in listed prices, although they did recognize that teaching hospitals and government hospitals generally charged less than other facilities.

Here’s another blow-you-away comparison: for a basic metabolic panel, another common blood test, the average hospital charged $371, but some charged as little as $35 to as much as $7,303, more than 200 times more.

Dr. Renee Hsia, lead author of the study, and a professor of emergency medicine at University of California, San Francisco, told KHN, “When people try to understand why prices are the way they are, we have no ability to explain it. That is the take-home message. That is what is so disturbing.”

Almost as disturbing, in our opinion, is the response of the California Hospital Association, which dismissed the report as irrelevant and said most patients pay discounted rates because of their insurance coverage. “Charges are meaningless data – virtually no one pays charges,” said Jan Emerson-Shea, the association’s vice president for external affairs.

How arrogant. How clueless. How unhelpful in addressing America’s out of control health-care price management.

Hsia is familiar with the “say-what?” aspect of medical pricing. She once studied listed charges for labor and deliveries, and for appendectomies in California, and found that the former varyied by as much as 11 times, and that charges for a routine appendectomy ranged from $1,500 to $182,955.

Earlier studies by Hsia identified variations in listed charges for labor and deliveries and for appendectomies in California, with labor and delivery charges varying eight to 11-fold between hospitals, and charges for a routine appendectomy ranging from $1,500 to $182,955.

But even she was surprised by the variation in cost for a single line item like a blood test.

“There is always some variation in patients, even among young healthy adults, and there are variations in physician practice,” she told KHN. “But these are very basic, standard blood tests. It doesn’t matter if you’re sick or not, a complete blood count is a complete blood count. You draw the blood, send it to the lab and put it in a machine.”

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