What "Shoppable" Healthcare Actually Means

When was the last time you bought a plane ticket without checking at least two or three sites for the best price? Or booked a hotel without scrolling through options? Most of us instinctively comparison-shop for purchases over a few hundred dollars. It's second nature.

Now, when was the last time you compared prices for a medical procedure? If you're like the vast majority of Americans, the answer is never. And that's strange, because healthcare is the one area where the bills can easily run into thousands or tens of thousands of dollars, and the price variation between providers is often larger than in any other industry.

What Makes a Healthcare Service "Shoppable"

A shoppable healthcare service is one where the patient has time to plan, compare options, and make a choice before receiving care. This is in contrast to emergency services, where you obviously don't have the luxury of price comparison. If you're having a heart attack, you go to the nearest ER.

The federal price transparency rule defines about 300 common shoppable services that hospitals must include in their consumer-friendly pricing displays. These include things like joint replacements, cataract surgery, colonoscopies, MRIs and CT scans, lab panels, and routine diagnostic procedures. These are all services where the patient typically has days or weeks to decide where to go.

The category is broader than most people realize. Estimates vary, but shoppable services account for roughly 30-40% of total healthcare spending. That's hundreds of billions of dollars per year where, in theory, patients could be comparing prices and choosing lower-cost options.

The $80 Billion Question

Health affairs researchers have estimated that if American healthcare consumers had transparent price information and actually used it for shoppable services, the potential savings could reach $80 billion annually. The math isn't complicated: there are enormous price differences for the same procedures, and shifting even a modest percentage of patients toward lower-cost options would save a staggering amount of money.

How enormous are the price differences? Let me give you some examples from our data. In the Chicago area, a knee replacement (CPT 27447) ranges from about $12,000 to over $62,000 depending on the hospital and your insurance. An MRI of the lower back ranges from $300 to $3,400. A colonoscopy ranges from $800 to over $6,000. These aren't different procedures or different levels of quality. They're the same service at different facilities, often just a few miles apart.

The natural follow-up question is: if the savings potential is so large and the price differences are so extreme, why aren't more people shopping for healthcare? The answer is a combination of information barriers, systemic complexity, and habits that the industry has had decades to entrench.

Why Most People Can't Comparison-Shop (Yet)

There are a few real obstacles standing between patients and effective healthcare price shopping.

The first is that most people don't know prices are available. Despite the federal mandate, awareness of hospital price transparency data is remarkably low. Surveys consistently show that fewer than 10% of Americans have tried to compare hospital prices, and those who have tried usually found the experience confusing and unhelpful.

The second is complexity. Even when you can find pricing data, it's incredibly difficult to interpret. A single hospital visit might involve separate charges from the facility, the surgeon, the anesthesiologist, the pathologist, and several other providers. The price you see on a hospital's machine-readable file might be the gross charge, the discounted cash price, or an insurance-specific negotiated rate. Understanding what you'd actually pay out of pocket requires knowing your insurance plan's deductible, coinsurance rates, and whether you've met your annual out-of-pocket maximum.

The third obstacle is that the healthcare system isn't built for shopping. Your doctor refers you to a specific hospital or specialist, and most patients follow that referral without question. The scheduling process is designed to keep you in-network and in-system, not to help you compare options. And frankly, when you're dealing with a health issue, the emotional burden of researching prices on top of everything else feels like too much.

Closing the Gap

Every one of these obstacles is solvable. Not easily, and not overnight, but solvable.

Awareness will grow as more tools make price information accessible and as media coverage of the transparency rules increases. Complexity can be reduced by building tools that do the hard work of normalization and comparison behind the scenes. And the referral default can be disrupted by giving patients clear, trustworthy information that makes them comfortable asking their doctor about alternatives.

This is exactly what we're trying to do with Panopticare. We take the raw, messy, machine-readable pricing data from hospitals, combine it with insurer-specific negotiated rates, normalize everything into a consistent format, and present it in a way that answers the simple question: "How much will this procedure cost me at different hospitals near me?"

We're nowhere near the point where healthcare price shopping is as easy as booking a flight. But the data is getting better, the tools are getting better, and the financial pressure on patients, especially those with high-deductible plans, is making price awareness a necessity rather than a curiosity. The $80 billion in potential savings isn't going to be unlocked by any single regulation or tool. It's going to happen incrementally, as more patients learn that they have options, and as more tools make those options visible.