Trying Out Colorado's New Hospital Price Finder

In October, Governor Jared Polis's administration launched a Colorado Hospital Price Finder as part of a long-running initiative to improve pricing transparency in health care.

In an announcement about the tool, the governor's office said the price finder "provides Coloradans the ability to research all available prices at every hospital."

But after testing the tool out, we were left more frustrated than impressed with the new the price finder. Although built with good intentions, the tool currently lacks enough useful information about health plans to be considered transparent and is complicated to navigate.

It's difficult to figure out whether procedure codes, which identify specific medical procedures, refer to the same item across different hospitals in order to accurately compare the same services. Without that clarity, competition for patients is heavily diluted because consumers still can't easily rank prices across medical facilities. And that's not the price finder's only issue.

According to the Colorado Division of Insurance's statistical report for 2023, Humana is the third-most-used health insurance in the state. However, prices for Humana never showed up during Westword's test of the tool.

Not all health insurance companies and hospitals have complied with reporting requirements for the price finder yet, so the data in the tool will be incomplete until they do. Hospitals were meant to begin reporting all price transparency information by 2021, and insurance companies were supposed to make initial disclosures by 2022. The final requirements for full transparency from all companies take effect in 2025. (Just under 800 hospitals had been issued notices for failure to comply by the Centers for Medicare & Medicaid Services as of 2023, but only four facilities have actually been placed on a corrective action plan designed to create compliance.)

The governor's administration worked with nonprofit PatientRightsAdvocate.org (PRA) to launch the Colorado Hospital Price Finder following the passage of a 2022 state law designed to require full disclosure of charges in hospital billing. Colorado's rule followed a 2021 federal law with a similar motive; that law requires hospitals to post standard charges, gross charges, discounted cash prices and payer-specific negotiated rates with insurance companies.

When Westword asked about difficulties navigating the tool, a Polis spokesperson sent a video made by PRA that is on the home page for the tool. The video helps navigate the tool somewhat, but we'd already watched it before testing out the price finder.

One useful tip PRA shares in the video: Check billing codes to look for potential overcharging. Hospitals are required to provide billing codes, though a patient may need to call the billing department and ask for an itemized bill to find them.

From there, patients can locate the hospital where they were treated, enter the billing codes into the tool and check to see if their bill matches up. But if their insurance company still hasn't completed disclosure requirements, that option won't be available.

To use the tool to see prices across hospitals, you have to select each hospital and test the procedure individually, as the tool doesn't allow comparison of prices among hospitals in the same search.

However, users can see if their insurance company is better or worse at each location with the graph feature that shows high, low and medium prices based on insurers. Still, that's only particularly useful when enrolling for a new insurance plan once a year — if you have any say over what insurance provider your employer uses.

Westword tested the tool by comparing five medical procedures at Intermountain Health Saint Joseph Hospital and Denver Health, two large facilities with emergency rooms that are centrally located in Denver.

Some items, like tests for COVID-19 or blood work, did not show up on the tool at all.

"There could be many reasons for this," the video explains. "The item could be bundled into a larger fee for service. The item may be billed under another code. The hospital file has not been updated to comply with the CMS price transparency rule. Or it could just be that the tool did not find a charge for this particular item in the hospital's price transparency file."

Westword intended to find information for Colorado's three most popular health insurance companies: United, Cigna and Humana. But since Humana never showed up, we swapped in Aetna, as it is one of the only plans that seems to consistently appear. When there were multiple options for an insurance plan within one of the companies, we used the PPO price.

Here's how the procedures we tested stacked up:

CT Scan on the Head

Denver Health

United: $327.22

Cigna: 234.51

Aetna: $363

St. Joseph's

United: $1,402 (most expensive of all prices listed)

Cigna: $500 (least expensive of all prices listed)

Aetna: $926

X-Ray on the Ankle

Denver Health (foot)

United: $28.84

Cigna: $20.68

Aetna: $20.97

Denver Health (ankle)

United: $42.52 (most expensive of all prices listed)

Cigna: $30.47

Aetna: 30.90

St. Joseph's (ankle)

United: $368.33

Cigna: 56.14 percent of cost

Aetna: $388.90

(We wanted to test out the prices for a foot X-ray, but that charge code could not be found at St. Joseph's.)

Rapid Strep Test

Denver Health

United: $16.53

Cigna: $10.74

Aetna: no listed price

St. Joseph's

United: not listed

Cigna: 25 percent of cost

Aetna: not listed

(Even common, non-emergency procedures don't always have listed prices at these hospitals.)

Emergency Room Visit With Low to Moderate Severity

Denver Health

United: $102.96 (most expensive of all prices listed)

Cigna: $73.79

Aetna: $74.82

St. Joseph's

United: $1,987.00

Cigna: $1,768.00

Aetna: 44.6 percent of cost

Giving Birth (Vaginal Delivery)

Denver Health

United: $2,521.99

Cigna: $1,807.43

Aetna: $3,573.00 (most expensive of all prices listed)

St. Joseph's

United: $1,784

Cigna: not listed

Aetna: $10,654

(It was difficult to tell which billing codes are actually comparative for giving birth, but this was our best guess.)