The costliest cities for women's health

Across the country, there are huge price differences for mammograms and other critical women's health procedures, a new report finds.

Castlight Health, Inc. released its second annual U.S. Costliest Cities Analysis, ranking the 30 most populous cities in the country on what employers and employees pay for women's health care and other standard medical procedures.

CBS News' chief medical correspondent Dr. Jon LaPook reports that in 2008, when Nancy Marie Bergman of Merrick, N.Y., was diagnosed with breast cancer, she struggled not only with her disease, but with figuring out how much it would all cost.

"I was more concerned financially than of the diagnosis itself," she said.

A mammogram done in Bergman's town for suspected cancer costs $221, but 40 miles away, in Teaneck, N.J., the same test is $95.

"I think consumers need to take a more proactive role in their health care future," said Bergman.

For the first time, the report examined the prices of OB/GYN follow-up visits, preventative gynecological exams, mammograms and HPV tests. For the second year in a row, the group also ranked the costs of other common medical services - from primary care check-ups to radiology tests to routine blood panels.

The results showed huge price disparities not only from state to state, but also within cities.

For example, nationwide, woman could pay anywhere from $43 to $1,898 for a mammogram - a 44x difference. In Dallas, the city with the widest range for mammogram costs, the procedure could cost anywhere between $50 and $1,045. In New York City, where the most expensive mammograms in the country were found, prices vary between $130 and $1,898.

The following are the costliest cities for mammograms, along with the average price of the procedure:

• Sacramento, CA -- $485
• Indianapolis, IN -- $431
• San Francisco -- $425
• Boston, MA -- $409
• Washington, DC -- $390
• New York, NY -- $371
• Minneapolis, MN -- $358
• Miami, FL -- $307
• Denver, CO -- $294
• Houston, TX -- $283

The cities with the least expensive mammograms, on average, include: Cincinnati at $159, Tampa at $162 and St. Louis at $175.

When it came to OB/GYN follow-up visits, Minneapolis and Seattle were the most expensive and Phoenix and Las Vegas were the cheapest.

The San Francisco Bay Area was the costliest for both a preventative gynecological exam and an HPV test. On average, those services cost 6 times more in San Francisco than in Charlotte, North Carolina -- the least expensive city for both.

Within a single city, Philadelphia, an HPV test could cost anywhere between $32 and $626.

"These numbers are eye-opening. It's especially disturbing that women and their employers could be needlessly overpaying for mammograms and other critical health services," Kristin Torres Mowat, Vice President of Strategic Alliances and Data Operations at Castlight Health, said in a statement. "Despite mandated insurance coverage for certain services, evidence shows that women forgo basic preventative care due to cost considerations and that delaying preventative care can harm patient health and increase future medical spending."

The investigators also looked at the prices of other common medical services, including preventive primary care visits, lipid panels (a cholesterol test), CT scans and MRIs.

According to the report, the costliest cities on average for primary care visits are:

• Minneapolis, MN -- $228
• San Francisco, CA -- $215
• Portland, OR -- $206
• Sacramento, CA -- $192
• Seattle, WA -- $190
• Charlotte, NC -- $188
• Boston, MA -- $178
• Pittsburgh, PA -- $155
• Atlanta, GA -- $154
• San Diego, CA -- $154

The same lipid panel test could cost anywhere between $14 and $1,070 in New York City, the city with the highest national range among all eight procedures. The researchers noted that the average price of the test increased in all but one of the 30 cities in the report, with an increase of 282 percent in San Francisco, 214 percent in Sacramento and 198 percent in Pittsburgh.

Dr. LaPook spoke with Michelle Scott, general counsel for Fair Health, a consumer organization that tried to make health care costs more transparent.

When asked if there has there been anything that just knocked her socks off, Scott said, "Sometimes the fact that there are such disparities in pricing and that they can occur within blocks of each other."

Scott says there's a wide range of prices because there's a lot of different circumstances.

"And the costs may be driven up by other factors -- overhead, rental considerations and the methods doctors use to perform the procedures," she said.

In the majority of cities, the report showed the price also rose over the past year for routine primary care exams, CT scans and MRIs.

"This study has data that is vital to understanding how broken the U.S. health care system really is, and we sincerely hope that employers and consumers take note," said Dr. Giovanni Colella, co-founder and chief executive officer at Castlight Health. "The only way that employees and their employers can even begin to manage health care spend is by understanding how much it costs."