22 January 2008

NC Blue Cross publishes prices

Medical News Today reports that Blue Cross Blue Shield of North Carolina is publishing online (for its members only) the prices it pays for thousands of procedures. Here's some examples:
  • Physician office visits, with separate categories of average costs for a variety of services for men, women and children. For example, the average cost BCBSNC pays statewide for an annual physical examination for a 35-year-old man is $279, including recommended lab work and immunizations. A child's doctor visit for a cold typically costs the company $75.
  • Diagnostic screenings and surgical procedures, with average costs broken out by place of service. For example, an MRI provided in an outpatient hospital setting costs BCBSNC $1,975 on average, while the same scan in a freestanding facility costs $933. Anterior cruciate ligament (ACL) surgery costs the company an average of $10,337 if done in an outpatient hospital setting, and $6,859 if done in an ambulatory surgical center. The average cost for an outpatient colonoscopy is $2,040 at a hospital, $1,203 at an ambulatory surgical center and $889 in a physician's office.
  • Total average costs for treatment of diseases and conditions. For example, the average total that BCBSNC would expect to pay for a member who requires heart bypass surgery is $57,280, including office visits, hospital costs, drugs, tests and other services. A typical course of breast cancer treatment, including surgery, costs $26,749.
  • The Health Cost Estimator includes prices BCBSNC pays for the most commonly used prescription medications. Members can learn, for example, that a brand name cholesterol-lowering drug can cost as much as $150 or more for a month's supply, while a generic drug can cost as low as $20 per month.

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