Importance Health care price transparency legislation is intended to reduce the ambiguity of hospital charges and the resultant financial stress faced by patients.

Objective To evaluate the availability, usability, and variability of standard reported prices for ophthalmologic procedures at academic hospitals.

Design, Setting, and Participants In this multicenter economic evaluation study, publicly available price transparency web pages from Association of American Medical Colleges affiliate hospitals were parsed for standard charges and usability metrics. Price transparency data were collected from hospital web pages that met the inclusion criteria. Geographic practice cost indices for work, practice expense, and malpractice were sourced from the Centers for Medicare & Medicaid Services. Data were sourced from February 1 to April 30, 2021. Multiple regression was used to study the geographic influence on standard charges and assess the correlation between standard charges.

Main Outcomes and Measures Availability and variability of standard prices for Current Procedural Terminology (CPT) codes 66984 (removal of cataract with insertion of lens) and 66821 (removal of recurring cataract in lens capsule using laser).

Results Of 247 hospitals included, 191 (77.3%) provided consumer-friendly shoppable services, most commonly in the form of a price estimator or online tool. For CPT code 66984, 102 hospital (53.4%) provided discount cash pay estimates with a mean (SD) price of $7818.86 ($5407.91). For CPT code 66821, 71 hospital (37.2%) provided discount cash pay estimates with a mean (SD) price of $2041.72 ($2106.44). The top quartile of hospitals, prices wise, listed included prices higher than $10 400 for CPT code 66984 and $2324 for CPT code 66821. Usability issues were noted for 36 hospitals (18.8%), including requirements for personal information or web page navigability barriers. Multiple regression analysis found minimal explanatory value for geographic practice cost indices for cash discount prices for CPT codes 66984 (adjusted R² = 0.54; 95% CI, 0.41-0.67; P < .001) and 66821 (adjusted R² = 0.64; 95% CI, 0.51-0.77; P < .001).

Conclusions and Relevance Despite recent legislature that codified price transparency requirements, some current standard charges remain ambiguous, with substantial interhospital variability not explained by geographic variability in costs. Given the potential for ambiguous pricing to burden vulnerable, uninsured patients, additional legislation might consider allowing hospitals to defer price estimates or rigorously define standards for actionable cash discount percentages with provisions for displaying relevant benchmark prices.

重要性 医疗保健价格透明度立法旨在减少医院收费的模糊性以及患者面临的由此产生的财务压力。

目的 评估学术医院眼科手术标准报告价格的可用性、可用性和可变性。

设计、设置和参与者 在这项多中心经济评估研究中，对来自美国医学院附属医院的公开可用的价格透明度网页进行了解析，以了解标准费用和可用性指标。从符合纳入标准的医院网页收集价格透明度数据。工作、实践费用和医疗事故的地理实践成本指数来自医疗保险和医疗补助服务中心。数据来源于 2021 年 2 月 1 日至 4 月 30 日。多元回归用于研究地理对标准收费的影响，并评估标准收费之间的相关性。

主要成果和措施 当前程序术语( CPT ) 代码 66984（通过植入晶状体去除白内障）和 66821（使用激光去除晶状体囊内复发性白内障）标准价格的可用性和可变性。

结果 在包括的 247 家医院中，191 家（77.3%）提供消费者友好的购物服务，最常见的形式是价格估算器或在线工具。对于CPT代码 66984，102 家医院 (53.4%) 提供了折扣现金工资估计，平均 (SD) 价格为 7818.86 美元（5407.91 美元）。对于CPT代码 66821，71 家医院 (37.2%) 提供了平均 (SD) 价格为 2041.72 美元（2106.44 美元）的折扣现金工资估计。列出的医院价格最高的四分之一包括CPT代码 66984的价格高于 10 400 美元和CPT的价格高于 2324 美元代码 66821。注意到 36 家医院 (18.8%) 的可用性问题，包括对个人信息或网页导航障碍的要求。多元回归分析发现， CPT代码 66984（调整后的R ²  = 0.54；95% CI，0.41-0.67；P  < .001）和 66821（调整后的R ²  = 0.64；95 ）的现金折扣价格的地理实践成本指数的解释价值最小% CI，0.51-0.77；P  < .001)。

结论和相关性 尽管最近的立法机构对价格透明度要求进行了编纂，但目前的一些标准收费仍然模棱两可，医院间的巨大差异不能用成本的地域差异来解释。鉴于模糊定价可能会给弱势、未投保的患者带来负担，额外的立法可能会考虑允许医院推迟价格估计或严格定义可操作现金折扣百分比的标准，并提供显示相关基准价格的规定。