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Glens Falls Hospital and every other hospital has published a list of starting prices for all medical procedures, in compliance with a new transparency law.

Glens Falls Hospital and every other hospital has published a list of starting prices for all medical procedures, in compliance with a new transparency law.

Glens Falls Hospital, and every other hospital in the country, on Jan. 1 published a list of prices for every medical procedure offered. They were required to by law.

But the so-called “chargemaster” list does not show real prices. Instead, it shows the starting price that each hospital begins with before negotiating with health insurance companies.

In other words, the prices are the worst possible scenario: most procedures should cost less in reality.

You can’t just ask your health insurance company for those negotiated rates, although United Health Care offers some prices online on a “price calculator” for members only.

“You could ask the provider for an estimate, but the only way you’ll really know is at the end when they bill you,” said an employee at United Health Care, who asked to be anonymous because she was not authorized to speak to the press.

To view Glens Falls Hospital’s entire chargemaster list, go to https://goo.gl/jKrYW9. Scroll halfway down the page and click on the Standard Charges link.

That can be a serious problem for patients who have large deductibles. If a patient’s deductible is $2,000, one could argue it doesn’t matter how much more the procedure costs: the patient is only going to pay $2,000.

But for those who have much higher deductibles — $10,000 is not unheard of — the cost can matter a great deal.

Patients with medical problems that are not emergencies may want to compare prices to select the cheapest provider, but it’s not easy. Glens Falls Hospital listed its procedures by narrative and by medical code, making it fairly easy to search. But Saratoga Hospital used completely different codes and published its list in a non-searchable document, making it much harder to compare procedures.

And even if a patient wants to go to the cheapest location, there are other factors to consider, ranging from where their doctor can practice to the safety ratings of the facility.

But that’s not to say the list of costs is useless. With some work, and Google, it’s possible to use the chargemaster list to get an idea of the ceiling for the bill. For some items, the chargemaster is double the actual price. For others, it’s pretty close to the final bill.

The key to decoding Glens Falls Hospital’s chargemaster is to Google the CPL codes for each item that appears to be the procedure in question. That can be tedious: there are 158 codes for an MRI, differentiated only by CPL code. Googling those codes, one by one, can lead the patient to the cost of an MRI exam that he or she needs. The codes refer to which part of the body is scanned, whether dye is used, and other details.

The hospital’s starting price ranges from $624 to $2,696, but most of the exams are $1,056 to $1,655.

But it can be worth it to find out the exact cost, because many clinics and other non-hospital locations offer MRIs now.

For example, at Adirondack Radiology Associates, United Health Care says the negotiated cost of an MRI scan of the spine without dye would be $322.

At Glens Falls Hospital, the same scan would be $488 with United Health Care, although the chargemaster lists it at $1,078.

The final cost can be vastly different with other health insurance companies, and even within a company, rates can vary depending on the patient’s insurance plan.

Another common procedure is a knee arthroscopy with meniscus removal. It’s a surgical procedure that Glens Falls Hospital offers.

On the hospital’s chargemaster, the price for that is coded as “Knee Arthroscopy/Surgery (with meniscus repair) (right) 29883.”

Hospitals are required by law to make available information about standard charges for services they provide.These charges represent only the standard charges provided by a hospital. It does not provide a quote or guarantee of actual charges, e.g., how much it will cost for a specific patient’s care. It does not account for any variables in a patient’s medical condition, complications, length of stay, use of laboratory tests, pharmaceuticals, etc. It also does not account for whether a patient has health insurance or the availability of other discounts. Patients should always contact the hospital’s financial services staff for specific information.

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You can reach Kathleen Moore at 518-742-3247 or kmoore@poststar.com. Follow her on Twitter @ByKathleenMoore or at her blog on www.poststar.com.

Once again, the Post Star overlooks the obvious: Including a WEBLINK to the hospital Price List. It really should not be the continuing responsibility of your readers to continue pointing out this continuous issue in 2019. Please add this obvious information.

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