Zurik: Routine bloodwork leads to shocking bills for many consumers

NEW ORLEANS (WVUE) - Kim Spencer spends much of her day outside.

"I'm a gardener," she says. "That's the work I do... And I volunteer at the greenhouse in City Park."

She's leads an active life, her green thumb caring for her precious plants.

"I'm been healthy so far," Spencer says.

This year, Spencer changed health insurers and doctors. "A couple of people had recommended this doctor at Tulane," she tells us.

She set up a January introductory visit with her new primary care physician. "I wasn't going for anything except to just say, 'OK, you're my doc now,'" she says.

And the end of the visit, her new doctor scheduled routine blood work. "I just figured she was establishing a baseline," she recalls. "I didn't question it."

But to Spencer, the bill seems anything but routine. Her cost: $412 for the visit and lab work.

"It's incredibly frustrating," she says.

Spencer paid the first bill she received but, after seeing our Cracking the Code series, now wants some questions answered.

"I have not paid the second bill because I want an explanation," she says. "Is this really what I owe? I feel like I want to know that, yes, this is what you really owe and then I'll decide what to do."

Spencer had the tests at Tulane Medical Center. According to her health insurer, Humana, Spencer is being charged $284 for a metabolic panel. But, according to our online database of prices, you can take the same blood test and pay cash for $19 at Clinical Pathology Laboratories, $34 at Quest Diagnostics, $40 at Ochsner.

"I don't see how there's justification, for that's more than 10 times as much," Spencer says. "How can that be justified...? This isn't a price difference, that's a gulf between this and that - and, that it's just hidden."

Another FOX 8 viewer contributed to our database of prices and commented, "I'm so upset about this." She went to Ochsner for blood work; it cost her $600.

The viewer called her insurance company, Cigna, and they were "shocked." If she would have gone to Quest Diagnostics instead, the $600 worth of blood work would have cost just $59.

She says her insurance company "went through line by line and compared the charges." She wrote, "They are not up front and honest with patients about this."

"Absolutely it's about making money," warns former New Orleans health director Brobson Lutz.

Doctor Lutz says these overpriced tests and procedures make little sense.

"If you were getting a hamburger at one place and caviar at the other place, you would say, well... you're getting better food at one place than the other," Lutz suggests. "But you're not - you're usually getting more or less the same level of care, especially for simple things."

As FOX 8 viewers have contributed prices to our interactive database, we've learned that, many times, where you get this routine work matters.

Last year one state employee had routine blood work at Quest Diagnostics, through his LSU health plan. It cost him $27.91. This year, he had the same routine work done at East Jefferson Hospital; the price shot up to $284.

"Medicine is not that complex, or it should not be that complex," Lutz insists. "It's been made more complex. We've got a lot of procedures that are... high cost/low value. What we need are procedures that high value/low cost."

Prices for a simple blood test can vary widely in the New Orleans area. Without insurance but by paying cash, a metabolic panel at Ochsner in Slidell costs $185. At nearby Slidell Memorial Hospital, you can have the same test for $36.

"In most things... when you buy something, you know what the price is, Spencer says. "That informs your decision about what you're going to buy. But I would never have thought that day to ask, 'So, what are the things you're going to be checking in my blood and what is the cost? And let me do shopping and I'll get back to you.'"

Now, Spencer says she'll have to take a break from her flowers and do some shopping before her next trip to the doctor.

"Things are not out in the open," she tells us. "And it's not meant for the consumer to have access, to have ready access."

What is it meant for, then?

"Profit," she tells us. "Otherwise, show your hand. Let us make a decision based on all the information."

In response to our story, Ochsner told us, "Understanding the patient's request for anonymity and without additional information, we cannot comment on specifics."

HCA, which owns Tulane Medical Center, responded, "The 'cash' price for a metabolic panel at Tulane Medical Center is comparable to the cost of the test at other area facilities. If a patient's insurance requires them to pay more out of pocket than that amount, they should review their plan and its deductible with their insurance provider."

We wanted to know if that was in fact Tulane's cash price is comparable. We asked HCA to give us their cash price for a metabolic panel. They never responded.

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You can read NOLA.com's Cracking the Code coverage here.

And remember: we want you to join our investigation. Please contribute your prices, your stories to our database.

• Go online to fox8live.com/health
• email us at health@fox8live.com
• or call us at 504-483-1558.

We want to see the prices you have to pay on any procedure. 

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