After her miscarriage, she received two rounds of ultrasounds. Why did one cost 10 times more?

Woman's ultrasound costs wildly differ

No one really knows what anything costs in health care — and too many people are getting surprise medical bills for thousands of dollars. In a new series, "Medical Price Roulette," CBS News will explore the reasons, and we're collaborating with journalists at ClearHealthCosts to bring transparency to health care markets. 


Last fall, Miriam Harper was 12 weeks pregnant when she lost her baby. Suffering a miscarriage was hard enough. But what made it worse was the mix of medical treatments — and prices.  

Her first visit when the bleeding started was to a local birthing center. The visit and two ultrasounds led to a charge of $150. Later in the day, Harper's symptoms worsened and she went to the local county hospital. They sent her home, but early the next morning she collapsed and was found unconscious. 
 
Upon being taken to the hospital, she received the same two ultrasounds — that time at a cost of $1,500. 

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Harper said she was "shocked" by the massive difference in the cost of the two tests.  And the bills kept mounting. "It's a reminder every time I get a bill of just emptiness," she said.  

The hospital, Baylor Scott & White, waived Harper's bills through a financial assistance program, but she still owes money to the surgeon and another facility.  

Medical prices vary greatly, even within the same city. Our reporting partner ClearHealthCosts surveyed prices in the Dallas area and found wide variances. 

A lower back MRI without contrast costs anywhere from $295 to 5,323 for the "cash price." A mammogram screening ranged from $139 to $743.
 
At Texas Health Harris Methodist Hospital, a cardiovascular stress test cost $698. Just a mile away at Baylor Scott & White, the same test was priced at $8,217. 
 
"It's because someone can," said Dr. Aaron Carroll, a professor of pediatrics and health services researcher. "If someone is willing to pay it or has to pay it, then someone is likely to charge that amount of money."

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Miriam Harper was "shocked" by the medical bills she received after a miscarriage. CBS News

Bay Area resident Mark Webb learned about medical pricing the hard way. When his doctor recommended he get a routine colonoscopy, Webb called the provider to make sure he knew the maximum bill he'd face. 
 
He said he was given a price range based on three codes from $1,300 to $2,400. That seemed reasonable to him, but the bills that ultimately arrived did not. 
 
The surgery center tab alone was $4,800. The doctor charged another $3,800. The pathologist wanted $300. 
 
"If they'd told me that I was gonna get almost $9,000 in bills, I would have either postponed it for a while longer or I would have gone somewhere else for the procedure," said Webb
 
Webb wound up paying more than $4,000 out of pocket. "It's either unethical or dishonest," he said about the health care system. 
 
ClearHealthCosts found that prices also vary drastically in the Bay Area. 
 
At SimonMed Imaging in San Francisco, an MRI of the upper back cost $550. Four miles away at St. Mary's Medical Center, the price was $5,751. 

"So I mean, at its base, a lot of it is you have to remember that the people who are providing health care are also trying to make money," said Carroll. "And so a lot of the rationale is, how do we drive revenue, how do we bring in resources, so that we can, you know, make a profit."
 
Ashley Thompson, senior vice president for public policy analysis at the American Hospital Association, said that it would be wrong to say that hospitals are wildly profitable. 
 
"Each hospital sets its pricing according to its own methodology," said Thompson. "What's interesting is that most people look less at what is being charged for a service and really are more interested in what they are going to have to pay out of pocket."

But she admits there are no rules or regulations governing hospital pricing. 

When CBS News asked St Mary's for comment, the hospital said the MRI price in the survey was too high. But it would not disclose what it said would be the self-pay price. ClearHealthCosts, which did the survey, said it stands by its reporting and invited the hospital to fill out a spreadsheet and send it in for any disputed prices.


We'd like to know what you paid for medical procedures. Share your story and learn how you can search ClearHealthCosts' database of prices in our sample markets. You can also email us at healthcosts@cbsnews.com.

CBS News national consumer investigative correspondent Anna Werner and ClearHealthCosts Founder and CEO Jeanne Pinder discuss our "Medical Price Roulette" series on the "CBS This Morning" podcast.