http://www.miami.com/mld/miamiherald/7951984.htmConsider a simple paper gown that a surgical patient gets draped in.
The wholesale cost is 36 cents, according to Vista Healthplan's data. List price to consumers: From $8 to $79 -- a potential markup of 21,944 percent.
''I think something weird is going on,'' says Joe Berding, chief executive of Hollywood-based Vista. He is particularly concerned about how such pricing might affect the 56 percent of Florida patients who enter hospitals through emergency rooms.
The problem comes when a hospital is ''out-of-network,'' meaning the insurer has no contract for discounts. In that case, according to state statute, if the hospital and insurer can't agree on the charges, the rate should be what's ``usual and customary.''
''Hospitals feel the statute is crystal clear,'' says Glatfelter. Their customary charges are the ones on their lists, without any discounts.
That means $137 to $478 for a chest X-ray that Vista's research says costs $13.90. And $43 to $265 for a blood-clotting test that costs $19.
''These charges bear no relations to costs,'' says Steven Smith of Blue Cross and Blue Shield of Florida. ``They just made them up, and they think they can get away with it in many cases.''
Put all these full-list charges together, says Berding of Vista, and the average day in a South Florida hospital costs $7,000 or $8,000 -- compared to the $1,800 to the $2,000 that HMOs generally pay.
''There's no rhyme or reason to these charges,'' says Berding. Even among hospitals in the same chain, listed prices differ dramatically. One example: A liter of an intravenous saline solution, used on dehydrated patients or to transmit IV drugs, costs $2.60, but among HCA hospitals in South Florida, that solution can cost $125.05 at Cedars, $65 at Kendall Regional and $99.75 at Aventura, according to Vista data.
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