"Hospital Price Transparency Legislation and Published Costs of Breast Reconstruction in Texas.".

Abstract

Price transparency is important for patient autonomy, especially in elective surgery. To address this, in 2021 the U.S. Centers for Medicare and Medicaid Services (CMS) mandated that government-funded hospitals clearly publish pricing on their webpages. One year after the rule went into effect, only 13% of hospitals were compliant with any plastic surgery procedures. We sought to investigate the state of hospital price transparency for breast reconstruction procedures in 2025. We investigated a cohort of 32 hospitals, including all adult Level 1 hospitals and private hospitals that rank among the fifteen largest in Texas, all subject to the CMS mandate. Two separate medical- and web-fluent investigators searched the website of each hospital system to find the price list. Prices related to several breast reconstruction codes were noted. Differences among insurers were also compiled. Only 18 hospitals (41%) had some prices published online for any breast reconstruction procedures, and in many cases the data were presented in highly obfuscating formats. There were wide differences in price publication rates across different procedure types and between different insurance providers. There was large variation in prices for individual procedures, with differences reaching up to nearly $33,000. Despite a legal mandate, there is still a paucity of price transparency in breast reconstruction on hospital websites. Even when hospitals did post prices, the format was often obfuscated and burdensome to read. Access to price information is limited, with wide variance across procedures and insurers, greatly impairing patients' ability to make informed healthcare decisions.