title: What Does a Shoulder MRI Cost the Consumer?
abstract: BACKGROUND
  More than 100 MRIs per 1000 inhabitants are performed in the United States annually, more than almost every other country. Little is known regarding the cost of obtaining an MRI and factors associated with differences in cost.
  
  
  OBJECTIVE
  By surveying all hospital-owned and independent imaging centers in Iowa, we wished to determine (1) the cost to the consumer of obtaining a noncontrast shoulder MRI, (2) the frequency and magnitude of discounts provided, and (3) factors associated with differences in cost including location (hospital-owned or independent) and Centers for Medicare & Medicaid Services designation (rural, urban, and critical access).
  
  
  METHODS
  There were 71 hospitals and 26 independent imaging centers that offered MRI services in Iowa. Each site was contacted via telephone and posed a scripted request for the cost of the technical component of a noncontrast shoulder MRI. Radiologists' reading fees were not considered. Statistical analysis was performed using standard methods and significance was defined as a probability less than 0.05.
  
  
  RESULTS
  The mean technical component cost to consumers for an MRI was USD 1874 ± USD 694 (range, USD 500-USD 4000). Discounts were offered by 49% of imaging centers, with a mean savings of 21%. Factors associated with increased cost include hospital-owned imaging centers (USD 2062 ± USD 664 versus USD 1400 ± USD 441 at independent imaging centers; p < 0.001; mean difference, USD 662; 95% CI, USD 351-USD 893) and rural imaging centers, unless designated as a critical access hospital (USD 2213 ± USD 668 versus USD 1794 ± USD 680; p = 0.0202; mean difference, USD 419; 95% CI, USD 66-USD 772).
  
  
  CONCLUSIONS
  In Iowa, the cost to the consumer of a shoulder MRI is significantly less at independent imaging centers compared with hospital-owned centers. Referring physicians and healthcare consumers should be aware that there may be substantial price discrepancies between centers that provide advanced imaging services.
  
  
  METHODS
  Level IV, Economic and decision analysis.
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Iowa, 200 Hawkins Dr., 01008 JPP, Iowa City, IA, 52242, USA.
authors.forename: Robert W
authors.initials: RW
authors.lastname: Westermann
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Iowa, 200 Hawkins Dr., 01008 JPP, Iowa City, IA, 52242, USA.
authors.forename: Cameron
authors.initials: C
authors.lastname: Schick
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Iowa, 200 Hawkins Dr., 01008 JPP, Iowa City, IA, 52242, USA.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Graves
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Iowa, 200 Hawkins Dr., 01008 JPP, Iowa City, IA, 52242, USA. kyle-duchman@uiowa.edu.
authors.forename: Kyle R
authors.initials: KR
authors.lastname: Duchman
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Iowa, 200 Hawkins Dr., 01008 JPP, Iowa City, IA, 52242, USA.
authors.forename: Stuart L
authors.initials: SL
authors.lastname: Weinstein
mesh_terms: D022126:Access to Information; D054626:Consumer Health Information; D003362:Cost-Benefit Analysis; D003695:Delivery of Health Care / Q000191:economics*; D017048:Health Care Costs; D019538:Health Care Surveys; D005102:Health Expenditures; D054625:Healthcare Disparities / Q000191:economics; D017721:Hospital Costs; D006801:Humans; D007484:Iowa; D008279:Magnetic Resonance Imaging / Q000191:economics*; D018803:Models, Economic; D011237:Predictive Value of Tests; D012782:Shoulder / Q000000981:diagnostic imaging*