Variations in the open market costs for prostate cancer surgery: a survey of US hospitals.
OBJECTIVE
To examine variation in the open market cost of a radical prostatectomy (RP) procedure in the US hospitals for an uninsured patient, as many proposals for health care reform highlight the importance of individuals actively participating in selecting care. However, reports suggest that obtaining procedure prices remains challenging and highly variable.


METHODS
We used 2011-2012 US News and World Report rankings to identify a cohort of 100 hospitals making an effort to include an equal distribution of both academic and private centers, city size, and geographic region. Each hospital was called and the essence of the script included a caller stating he was a healthy, uninsured 55-year-old man recently diagnosed with Gleason 3 + 4 prostatic adenocarcinoma with no metastases. Facility, surgeon, and anesthesia fees were solicited.


RESULTS
Seventy hospitals provided facility prices. Facility estimates averaged $34,720 (±20,335; range, $10,100-$135,000), which was statistically higher at academics centers. No significant differences were seen by region, population, or hospital ranking. Surgeon and anesthesia fees were provided by 10%, averaging $8280 (±$4282; range, $4028-$18,720). Thirty-three hospitals provided discounted fees for prompt payment averaging 34% (±16%; range, 10%-80%).


CONCLUSIONS
There is wide variation in pricing for RP, with higher rates found in academic centers. Wide variation in facility costs were observed, and nearly all were unable to provide surgeon and/or anesthesia fees. Currently, it appears to be unacceptably difficult for men with prostate cancer without insurance to obtain prices for an RP procedure.
Department of Urology, University of Iowa Carver College of Medicine, Iowa City, IA.
Scott C
SC
Pate
Department of Urology, University of Iowa Carver College of Medicine, Iowa City, IA.
Matthew A
MA
Uhlman
Division of General Internal Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA.
Jaime A
JA
Rosenthal
Division of General Internal Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA.
Peter
P
Cram
Department of Urology, University of Iowa Carver College of Medicine, Iowa City, IA. Electronic address: brad-erickson@uiowa.edu.
Bradley A
BA
Erickson
D000046:Academic Medical Centers / Q000191:economics; D022126:Access to Information; D000230:Adenocarcinoma / Q000191:economics / Q000601:surgery; D000758:Anesthesia / Q000191:economics; D004469:Economics, Hospital / Q000706:statistics & numerical data*; D005251:Fees, Medical / Q000706:statistics & numerical data*; D017722:Hospital Charges / Q000706:statistics & numerical data*; D006777:Hospitals, Proprietary / Q000191:economics; D006788:Hospitals, Voluntary / Q000191:economics; D006801:Humans; D008297:Male; D017057:Medically Uninsured / Q000706:statistics & numerical data*; D011468:Prostatectomy / Q000191:economics*; D011471:Prostatic Neoplasms / Q000191:economics / Q000601:surgery; D014481:United States