Health Care Stewardship: Labs and radiology—buy carefully

Have you been stunned by rising prices on certain products like movie theater popcorn, bottled water, or greeting cards? As a consumer, you quickly understand that businesses maximize profits for these products based on amazingly effective pricing strategies.

Health care markets have unique pricing strategies of their own. The price for a core service may be low, but necessary related services such as labs and imaging are often priced with a higher profit margin. But the popcorn analogy starts breaking down when you realize that the price is different depending on who you are in health care!

Labs and radiology have some of the most outrageous markups in health care, and there are considerable variations in prices in the same market for the same services. This linked chart shows a miscellaneous basket of services, including labs and radiology, in the Denver, Colorado, market. It reveals, for example, a 1,329 percent price variation for a chest X-ray and a 320 percent variation for a CBC blood test.

Samaritan Ministries members can help keep Share amounts low by being wise buyers of high-quality, lower-cost lab and radiology services. While the prices are certainly not as high as surgeries, the volume of lab and radiology adds up and impacts our Share amounts. But how do we find a great price?

For labs, order through third parties like Direct Labs rather than going directly to Quest, which DOES NOT offer reasonable discounts to self-pay patients. Third parties like Direct Labs contract with Quest to purchase power discounts. To be clear, you will likely end up at a Quest or Labcorp facility, as they are the dominant players in the labs market, but you will be getting a far better price when you purchase through these third parties. Discounts for labs are often in the 90 percent range, so be very careful to order them on your own, asking your doctor to write down for you the labs to be ordered. In some markets, you may also learn about unique direct arrangements where you can get great prices, or your direct primary care doctor might get special deals.

For radiology, please be aware that hospital prices can be very high. Generally, free-standing radiology facilities will offer much better prices. As with labs, it can help to shop for the best cash prices through third parties like Radiology Assist. They will even help you set appointments. Your doctor may be able to point to recommended facilities, but you’ll want to be sure the price is fair by using Healthcare Bluebook™ (through Health Resources in your Samaritan Dashboard) as a reference. Price and quality typically don’t correlate in the health care market, but if you have any concerns about quality or the radiology technology at your selected radiology site, ask your doctor for insights.

After you do your research, you can check Healthcare Bluebook to use the Fair Price™ reference to ensure you are getting good value.

Remember, labs and radiology are some of the most significant opportunities to keep Share amounts low. Our popcorn analogy has completely broken down at this point, but you can be sure that there will be more room in your budget for a night out at the movies if all Samaritan members are good health care shoppers.

The information provided in this article is for educational purposes and is not meant as medical advice. It is the opinion of the writer. The information is not meant to replace a one-on-one relationship with a qualified health professional.