Improving Information Access to Medical Prices
for Out-of-Pocket Patients
Brenda Obonyo, Chia-Lun Hsieh, Cole DuBois, & Zachary Greenman
The Problem
Access to radiology services is critical for timely diagnosis, but for uninsured or out-of-pocket patients, unexpected bills and unclear price listings can lead to delayed or avoided care. When patients try to plan their medical expenses, they are met with a broken system:
Extreme Price Variations: For the exact same procedure in the same region, costs vary wildly. For example, the cash price for an MRI of the Lumbar Spine ranges from $979 to $5,699.51 — a staggering gap of over $4,700.
Universal Frustration: Patient interviews revealed that price opacity directly influences behavior, causing emotional distress, care avoidance, and deep skepticism.
Business Analysis Lens
Problem
Patients paying out of pocket cannot reliably find, understand, or compare radiology prices across healthcare systems.
Stakeholders
Patients, hospitals, healthcare technology platforms, and policymakers.
Analysis
Audited 10 hospital websites, analyzed machine-readable pricing data across common radiology procedures, and conducted usability interviews with cost-conscious patients.
Key Gaps Identified
Poor information discoverability, inconsistent pricing data, incomplete third-party aggregation, technical terminology, limited transparency, and low patient trust.
Solution Requirements
Clear navigation, standardized machine-readable data, patient-friendly terminology, granular search functionality, transparent cost breakdowns, and visible data-verification signals.
Methodology
To ensure our findings were both rigorously quantified and deeply grounded in the real patient experience, our team utilized a multi-faceted mixed-methods design:
Quantitative Usability Audit: We evaluated 10 hospital websites in Washington's Tri-Cities region using a custom rubric based on CMS guidelines.
Machine-Readable File Analysis: We extracted and statistically analyzed pricing data for 10 common radiology CPT codes from hospital-provided JSON files.
Qualitative Usability Testing: We conducted guided usability interviews with 9 cost-conscious patients from the Puget Sound area, testing a third-party tool named Turquoise Health. This yielded 1,076 coded excerpts across 7 distinct themes, achieving 100% participant saturation.
Key Findings
1. Hospital Websites Fail the Usability Test
Patients cannot easily find what they are looking for. None of the evaluated hospitals achieved an ideal usability score, with totals ranging from 7 to 12 out of 15. Only 30% of hospitals displayed clear cash prices without requiring patients to log in or provide insurance information.
2. Third-Party Tools Provide an Incoplete Picture
While third-party tools offer cleaner interfaces, they suffer from critical data integrity issues. Our audit found that Turquoise Health omitted the lowest-cost options available in hospital source data. For instance, it missed a $293 option for a CT Head and instead displayed a minimum price of $1,778. This failure in data aggregation risks misleading patients into overpaying by more than $1,400.
3. The Critical Need for Trust
Without a direct referral from a doctor, patients are highly skeptical of online price estimators. Patients want simple verification signals, like "last updated" timestamps and clear cost breakdowns, to trust the tools they are using.
Recommendations
Hospitals and Health Sytems
Remove Barriers: Place pricing links visibly on homepages and eliminate login requirements.
Speak the Patient's Language: Translate complex technical CPT codes into plain, understandable language.
Standardize Data: Ensure machine-readable pricing files are provided in clean, consistent formats like JSON to prevent data corruption.
Improve Navigation: Add granular search filters for specific body parts such as brain, spine, or arm.
Build Trust Through Transparency: Provide detailed cost breakdowns separating facility fees from imaging fees, and display visible timestamps for when prices were last updated.
Tech Platforms and Tool Developers
Policymakers
Enforce Usability: Move beyond basic compliance rules and mandate actual usability standards for how hospitals present price data.
Fund Inclusive Design: Support design audits for underserved groups, prioritizing non-English speakers and those with limited digital access.