Los Angeles vs. Cincinnati: Who’s Winning on Healthcare Prices?

When the Cincinnati Bengals meet the Los Angeles Rams this weekend for Super Bowl LVI (that’s Super Bowl 56), they’ll play in L.A.’s SoFi Stadium. Our hope is that everyone walks off the field healthy and unhurt – but the reality of the NFL is that players regularly get injured during games.

For this week’s blog post, we took a look at the cost of treatments for two common football injuries in the two cities represented in the big match:

  • MRI of the brain, often used when a player has experienced a concussion.
  • CT scan of the abdomen or pelvis, which can be used to evaluate damage to the midsection.

As you might expect, the price of treatment varies widely.

Price of an MRI in L.A. vs. Cincinnati

The first number we looked at was the gross price listed for billing code 70553, MRI of the brain.

A quick note before we reveal the numbers: “gross price” is the price listed in what’s sometimes called a hospital’s chargemaster file. It’s usually considered the starting point for negotiations with insurance providers – meaning the actual price that insurance companies pay hospitals for an MRI varies.

And while hospitals are required to list all the different prices they’ve negotiated for shoppable services like MRIs with all the different insurance providers they work with for all the different plans they accept, many hospitals still aren’t in compliance (more on that later).

Because not every hospital we looked at had plan-level prices published, we decided the best way to get an apples-to-apples comparison was to look at gross prices, which are generally available.

In Los Angeles, the average gross price of an MRI of the brain is $5,719; in Cincinnati, the average gross price is $2,727 (see Figure 1).

Los Angeles vs Cincinnati Average Gross Price of an MRI
Figure 1: Average gross price of an MRI of the brain, Los Angeles vs. Cincinnati

In other words, an MRI in LA is 109 percent more expensive than one in Cincinnati.

How does that compare with other cost of living differentials between the two cities?

L.A. is a more expensive city overall – and people tend to earn more there. The median income in L.A. is $49,682, compared with $34,002 in Cincinnati, making median income about 46 percent higher in the City of Angels.

And if you’re in the market for a home, you’ll find much better prices in Cincinnati, where the average home price is $200,000, compared with a whopping $883,400 in L.A. Put differently, you could buy 3.4 homes in Cincinnati for the price of one in Los Angeles. Yikes!

Price of a CT Scan of the Abdomen in L.A. vs. Cincinnati

The second procedure we looked at was billing code 74177, CT scan of the abdomen or pelvis.

The average gross price in L.A. is $6,061. In Cincinnati, it’s $2,607 (see Figure 2). That makes a CT scan of the abdomen 1.3 times more expensive in Los Angeles than in Cincinnati.

Los Angeles vs. Cincinnati Average Gross Price of a CT Scan of the abdomen or pelvis
Figure 2: Average gross price of a CT scan of the abdomen or pelvis, Los Angeles vs. Cincinnati

The big-picture takeaway: medical care is more expensive in Los Angeles than in Cincinnati, even accounting for the difference in residents’ income.

Of course, one important thing to keep in mind here is that average prices are just that – averages. If you’re actually in L.A. or Cincinnati and in need of an MRI or CT scan, you’d likely want to shop around to compare prices at various hospitals.

To do that, of course, the hospitals would have to publish their prices. So let’s take a look at how these cities are doing on compliance with the CMS’s Hospital Price Transparency Rule.

Hospital Price Transparency Compliance: Los Angeles vs. Cincinnati

We mentioned earlier that not all of the hospitals we looked at in Los Angeles and Cincinnati were compliant with the Hospital Price Transparency Rule – meaning they did not publish their actual, payer-plan-negotiated prices for various services.

In fact, as many as 94 percent of hospitals around the country are still not in compliance. That makes it nearly impossible for people to effectively compare prices before they actually get care.

So how compliant are hospitals in Los Angeles and Cincinnati? We looked at 21 hospitals in L.A. and 12 in Cincinnati to answer that question (see Figure 3), using our compliance dashboard as a measuring stick.

Average hospital compliance score in Los Angeles vs. Cincinnati
Figure 3: Average hospital compliance score in Los Angeles vs. Cincinnati

When it comes to compliance, Cincinnati wins. Cincinnati hospitals have an average compliance score of 7.3 out of 10, compared with Los Angeles’ 6.2.

Digging in a little, the numbers get even more interesting:

City Zero Compliance Full Compliance
Los Angeles 19% 33%
Cincinnati 25% 58%

In other words, in Cincinnati, hospitals are more likely to be fully compliant with the Hospital Price Transparency Rule – meaning they’re more likely to have posted the pricing information healthcare consumers need to make an informed decision about their care.

Is it also possible that prices are lower in Cincinnati as a direct result of hospitals there publishing prices? Does price transparency result in lower prices? CMS hopes so, and we agree.

Super Bowl Tickets vs. Healthcare Costs in L.A.

One thing that healthcare and Super Bowl tickets (unfortunately) have in common is that they’re often both expensive. 

For instance, the most expensive ticket to Super Bowl LVI is $147,304. The most expensive healthcare service at the Rams’ official healthcare provider (Hoag Memorial Hospital Presbyterian) is an “endovascular repair of visceral aorta and infrarenal abdominal aorta” (billing code 34848), which has a gross price of $116,413.

When Hospitals Are Compliant, Everyone Wins

Hospital pricing transparency is hugely important for everyone who uses the US healthcare system. But many hospitals struggle to find the resources to get into compliance – which can hurt their patient experience and ultimately their bottom line. If your hospital is not yet fully compliant with the CMS’s Hospital Price Transparency Rule, get in touch – we can help you get there.

Regardless of your compliance status, we can also help you find out what your competitors are getting paid for various services. Let us know if you’d like insight into where your rates stack up against the providers you compete with. We’d be happy to let you test drive our platform to see whether it delivers the value you need.