Nationwide price variability for an elective, outpatient imaging procedure

Out-of pocket expenses for common medical tests and procedures will become increasingly relevant as high-deductible insurance plans gain widespread adoption. The purpose of this study was to determine the variability of pricing for an outpatient, noncontrast knee MRI, based on geographic location and population.

We randomly chose nonhospital outpatient radiology centers in each state's highest-population locality, based on a list generated from the ACR MRI Accreditation Program database. The presence of ≥2 and a maximum of 3 centers within a given locality was required for inclusion. Using a standardized script, we contacted centers by phone to determine the lowest, out-of-pocket, bundled cost (technical fee plus professional fee). The median (interquartile range) costs were calculated within each locality and region, including Midwest, Northeast, South, and West regions. A generalized linear model and Spearman's rank correlation were used to determine the association between cost and region, and cost and population, respectively.

A total of 122 outpatient centers from 43 cities were analyzed. Costs ranged from $259 to $2,042 across all centers. For centers within a locality, the difference between the minimum and maximum costs among centers ranged from $1,592 to $0; median cost differences between localities ranged from $1,488 to $325. Median cost for the West, Northeast, Midwest, and South region was $690, $500, $550, and $550, respectively (P = .849). Median cost was inversely correlated with population density (ρ = -0.417 [correlation coefficient], P = .005).

Out-of-pocket costs for an outpatient knee MRI vary substantially across imaging centers, both locally and nationally. Cost tends to decrease with increasing local population.