A comparison of Kaiser Permanente’s sample fee schedule for 2017 and 2019 showed the member cost to have their ears cleaned jumped 33% in Southern California from $91 to $121. Another odd pricing quirk, that doesn’t seem intuitive, is that it cost more to X-ray a finger than it does an ankle at Kaiser. The sample fee comparison also shows that member costs for the exact same procedure or test is less in Southern California than it is in Northern California.
Before any analysis of the costs, we must give Kaiser Permanente appropriate recognition for even publishing a sample fee schedule. Few health plans publish any realistic dollar amounts about the costs to the health plan members for basic services like Kaiser has done. While many Kaiser members have health plans with set copayments that are lower than the sample fee schedule, consumers who have high deductible health plans, where they are paying the full negotiated rate for the health care service, can at least get feel for how expensive treatment might be.
Kaiser Sample Fee Schedules of Member Costs
In California, Kaiser breaks up their system in Northern and Southern districts. Every year Kaiser publishes a sample fee schedule of over 140 health care services. Most of the listed services, procedures, and tests seem to be the most routine and most often used by their members. I did a sampling of 13 of those services for 2017 and 2019 for both Norther and Southern California. I was interested in how much the cost of care has risen, for routine services, over a two-year period.
Northern California Sample Fee Schedule Comparison
Overall, the member costs have risen more in Southern California than in Northern California. From my unscientific and non-statistical methodology, Southern California costs have risen 20% for those 13 sample fees and only 12% for Northern California. Even with faster increase in prices, the Southern California sample fees were still on average 31% less than Northern California prices. This cost differential is reflected in the health insurance rates as Southern California health plan premiums can be 10% to 20% less than Northern California.
Southern California Sample Fee Schedule Comparison
A couple of sample fees piqued my interest. First was the cost to clean out a patient’s ears. Because I have done this done on numerous occasions in a doctor’s office – Did you say something? – I was surprised the Northern California fee for ear cleaning went from $116 in 2017 to $143 in 2019. I don’t know how Kaiser cleans the wax out of a person’s ears, but the nurse at my doctor’s office uses a squirt bottle and warm water. Not very technical with no specialized equipment.
But a Southern Californian with ear wax build up can have their ears cleaned for $121. This is up from the 2017 price of $91. The ear cleaning price increase is 33%. So, if you encounter more people in Southern California who seem to be hard-of-hearing, you know why.
Fingers cost more to X-ray than Ankles
The second sample fee that gave me a chuckle was the cost to have a finger X-rayed. If you take a nasty spill on your skate board in San Francisco, and have to have your ankle X-rayed at Kaiser, it will cost $102. But if you break your finger poking your political opponent in the chest, that finger X-ray will cost $111. These costs are lower in Southern California where they have more skate boards and finger poking. An ankle X-ray in Southern California will be $71 and the finger at $78. They don’t mention if there is a discount X-ray cost for both if you poked someone and then fell off your skate board. The finger X-ray fee jumped 13% in Northern California over 2017, while the middle finger X-ray in Southern California increased 22%.
The really important services such as diagnostic colonoscopies and CT scans of the chest had fee increases lower than the average. Of course, those are expensive services to begin with, but at least Kaiser doesn’t seem to be trying to price gouge on procedures of life and death for their members. While I have not done a comparison between the health plan rates from 2017 and 2019, the average increase in the sampled fees is more or less in line with the health insurance rate increases over the last couple of years.