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Price Transparency of Prostate Cancer Care in the United States: An Analysis of Pricing and Disclosure Following the Centers for Medicare and Medicaid Mandate - Beyond the Abstract

The costs incurred for healthcare have historically been opaque, such that patients are often unaware of their treatment costs until their bills come due. To ameliorate this, the Centers for Medicare and Medicaid Services issued a mandate that starting on January 1, 2021, all hospitals in the United States must make the pricing of provided services publicly available on their hospital websites in machine-readable files. We used a dataset that aggregates these publicly-displayed prices to investigate the landscape of pricing for prostate cancer care.

Of 6,013 United States Hospitals that were identified, 3,840 (64%) disclosed pricing for one of the five prostate cancer-related services investigated (free and total prostate specific antigen, prostate magnetic resonance imaging, radical prostatectomy, and prostate intensity-modulated radiation therapy). We found that self-pay (cash) prices for these services were generally higher than prices for patients with insurance, and we found large variability in the self-pay prices of services. This was most notable with radical prostatectomy, for which there was a 32-fold difference between the 90th and 10th percentile of self-pay prices ($47,445 to $1,476). We also found that self-pay prices were higher at academic hospitals, for-profit hospitals, and hospitals in the top quartile of gross annual revenue.

In summary, the majority of hospitals in the United States publicly disclose the pricing of their prostate cancer-related services, with significant variability in the cash prices charged to patients. These data highlight disparities in the cost of prostate cancer care and may be important to patients who are paying out-of-pocket for their treatment.

Written by:

  • Aaron M. Brant, MD, Department of Urology, New York-Presbyterian Hospital, Weill Cornell Medical College, New York, NY, USA
  • Jonathon E. Shoag, MD, Department of Urology, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA
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