A California Hospital Charged $10,000 for a Cholesterol Test

| Fri Aug. 15, 2014 10:34 AM EDT

By now, I assume we all know that hospitals charge widely varying rates for similar procedures. But it's often hard to pinpoint exactly what's going on. Sometimes it's due to the amount of regional competition. Sometimes the procedures in question vary in ways that simple coding schemes don't pick up. Some doctors are better than others. And of course, hospitals inflate their list prices by different amounts.

All that said, be prepared for your jaw to drop:

Researchers studied charges for a variety of tests at 160 to 180 California hospitals in 2011 and found a huge variation in prices. The average charge for a basic metabolic panel, which measures sodium, potassium and glucose levels, among other indicators, was $214. But hospitals charged from $35 to $7,303, depending on the facility. None of the hospitals were identified.

The biggest range involved charges for a lipid panel, a test that measures cholesterol and triglycerides, a type of fat (lipid), in the blood. The average charge was $220, but costs ranged from a minimum of $10 to a maximum of $10,169. Yes, more than $10,000 for a blood test that doctors typically order for older adults, to check their cholesterol levels.

A lipid panel! This is as standardized a procedure as you could ask for. It's fast, highly automated, identical between hospitals, and has no association with the quality of the doctor who ordered the test. You still might see the usual 2:1 or 3:1 difference in prices, but 1000:1?

So what accounts for this? The researchers have no idea. No insurance company will pay $10,000 for a lipid panel, of course, so the only point of pricing it this high is to exploit the occasional poor sap with no health insurance who happens to need his cholesterol checked. Welcome to health care in America. Best in the world, baby.

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