The average cost for having knee replacement surgery at Lodi Memorial Hospital is $159,571, compared to $86,002 at Sutter General Hospital in Sacramento.
Lodi Memorial charges $31,907 for a Caesarian section while the same surgery is $17,560 at Sutter.
Those are among the findings in a recent report by the California Public Interest Research Group that shows patients are paying dramatically different base costs for the same surgery depending on where the procedure is done.
Lodi Memorial spokeswoman Carol Farron said hospital costs are complicated and many rates are based on volume.
"What hospitals charge insurers is not actually what they pay. It's just based on negotiated rates with HMOs and PPOs ... and for self-pay patients, we can work out what they can pay," she said.
Hospital pricing is based on a multitude of factors. Unionized hospitals will often have higher costs, according to Jan Emerson-Shea of the Sacramento-based California Hospital Association. Trauma centers or hospitals with burn units can also be more expensive.
Nonprofit versus for-profit status may influence how much hospitals charge.
Statewide, the highest rates are in the Bay Area.
"Overcharges are unacceptable for a service as important as health care," CALPIRG's Daniela Uribe said in a press release. "Consumers, whether it's on their own or through higher insurance premiums, shouldn't be paying 250 percent more for the exact same surgery at different hospitals."
The survey did not include Kaiser Permanente hospitals, nor did it take into consideration costs borne by insurance companies.
Statewide, surgery charges were overall highest in the Alameda and San Mateo areas. The Fresno and Orange County regions charged the least.
For example, the typical patient in the San Mateo region was charged nearly $48,000 for a C-section. For the same surgery in Fresno she was charged less than $13,000.
"According to this data, a pregnant woman in the Bay Area could take a private jet to Fresno, stay at the nicest hotel in the city, and still save thousands of dollars on her birth," Uribe said.
San Joaquin County's rates for C-sections are among the highest, ranging from $28,561 at St. Joseph's Medical Center in Stockton to $57,364 at Doctor's Hospital of Manteca. The statewide median charge is $24,360.
"It might be higher, but it's not what an insurer will pay," Farron said, shifting her attention to Lodi Memorial specifically. "We don't operate at a significant profit. When we do make money, we reinvest it in equipment for the hospital or give back to the community."
Comparing the local hospital to Sutter may be unfair since they are a system of hospitals that have lots of volume, Farron added.
"When it comes to negotiating contracts, they have more leverage," she said.
In the end, regional differences in the cost of living only partially explain the regional variations in common surgery charges, according to the survey.
- The cost of living in the San Francisco-San Mateo-Redwood City area is 46 percent higher than in the Fresno region, hospitals in the San Mateo and San Francisco regions charge 2.1 to 2.7 times as much as in Fresno.
- Hospitals with greater market power can charge more. When dealing with insurers, for example, hospitals that serve the most patients and that are part of large hospital networks have more leverage when negotiating with health insurers on prices, who are willing to pay more to retain a key health care provider in their network.
Contact reporter Jennifer Bonnett at firstname.lastname@example.org.