This is taken from Elizabeth Rosenthal's fabulous book An American Sickness: How Healthcare became Big Business and How You Can Take it Back


Appendix A: Pricing/Shopping Tools

Price Calculators for Procedures
(Note: These calculators all reflect prices when the patient pays. Many offices quote higher prices if you are using insurance. These sites will not tell you what your insurer will actually pay -- its negotiated rate; there are occasions when your insurer may have negotiated a particularly low price from a high-priced provider or agreed to one that is needlessly high. This is a list of some of the options I find most useful, though it is by no means complete.)

Healthcare Bluebook
This is one of the oldest and most extensive of the medical pricing sites. Based on the data it collects from patients, insurers, and companies, it calculates a "fair price" for a large number of procedures, in different geographic locations. It is clear about what aspects of the care its "fair price" covers, such as whether or not it includes anesthesiologist fees. Many doctors and hospitals charg several times the Healthcare Bluebook "fair price." If you enter your zip code it will identify which options in your area are at or below the "fair price", and which are far aboe. It offers cost-saving tips, such as whether your procedure could be performed as an outpatient for less money. Healthcare Bluebook's "fair price" may also be useful in bargaining with your hospital or insurer over whether charges are reasonable.

ClearHealthCosts
ClearHealthCosts uses crowdsourcing to uncover the prices of medical encounters in the dozen or so cities where it now operates. It is still young, but the more data it takes in, the more useful it will come to be. It also tells you how much Medicare would pay for the encounter you're seeking, which is a useful reference point, though it will nearly always be lower than anything available with commercial insurance. That said, the information it provides is often piecemeal, in part because it relies on self-reporting. Its Medicare charge for a colonoscopy, for example, is only the doctor's fee. One person may report what the doctor charged, but omit to add in the facility fee -- especially if that bill arrived much later.

Fair Health
FAIR Health uses a huge national database of insurance claims to provide a picture of the range of physician charges for a particular type of medical encounter in your zip code. It does not include facility charges of any type. But remember, if all the doctors in your area charge a lot, the FAIR Health price will be high too.

Pratter
The name Pratter stands for "prices matter," and this is a web site where you may find the range of cash prices for procedures where you live, and where you can be directed to the facility associated with each. For entries that have an orange tag, the price has been provided by the facility and is guaranteed. Since the company is young, few entries currently boast an orange price guarantee. Unless the orange tag is displayed, the prices here are not all-inclusive, so you may find they do not include anesthesia, for example.

Medibid
MediBid is a web site to consider if you have a high-deductible plan, meaning you're likely to have to pay for a procedure entirely out of pocket. It is a true marketplace. You post the procedure you're looking for (say a colonoscopy) and doctors offer you a competitive price. Don't assume that doctors who work this way are substandard. Sometimes they may just have a little extra space in their procedure schedule or may like the idea of working independently of insurance bureaucracies.

Price Calculators for Prescriptions

GoodRX
GoodRx asks you to plug in the name of your drug and your zip code and then gves you all the cash prices available in your neighborhood and lets you know about any deals to be had. A special feature for patients on Medicare will calculate your actual co-payment in advance, which allows you and your doctor to choose a different medicine or pharmacy if the price is too high.

PharmacyChecker.com
This was started by a physician and connects patients to overseas mail-order pharmacies, which it vets for quality. It's a good resource for patients who want to import medicines as a way to reduce their drug costs.


Appendix B: Tools for Vetting Hospitals

New York Times Hospital Pricing Calculator
Using the data on hospital bills released by Medicare, the New York Times created a lookup tool that allows you to vet pricing at hospitals in your area -- overall and for various procedures. Here you can find the Medicare hospital payment for different types of hospitalizations (treating pneumonia or placing a stent in the heart, for example). You can see how much more than the Medicare rate your hospital typically bills patients.

The Leapfrog Group
This respected nonprofit rates hospitals ona wide variety of quality issues. See how yours stacks up. The Leaprog program is voluntary, but most hospitals participate.

Hospital Compare
This recently launched website run by Medicare allows patient-consumers to look at various measures of hospital quality, in general and in relation to particular procedures. You can choose three hospitals at a time and see how they stack up on a wide variety of metrics -- such as infection rates after surgery, the presence of resistant microbes, and their use of scans (with guidance about how to figure out if they're doing too many or too few). It offers a fascinating warts-and-all profile of your local hospital.

ProPublica NonProfit Explorer & Guidestar
These websites allow you to download an IRS Form 990 for most hospitals. The tax form is generally a couple of hundred pages long, but you need not read it all. In the first section you'll find the hospital's mission statement and the compensation of its highest-paid executives and doctors. In Schedule H, you'll find what it claims as "charitable" work.