Families with health insurance now spend an average of $5,700 per year on premiums, the Kaiser Family Foundation’s annual employer survey found. That’s just the money coming out of each paycheck. Then there’s the bills sent by the physician office, pharmacy and hospital.

Even for families with “good insurance” and relatively minor ailments, medical costs can quickly eat away at money set aside for sports fees, piano lessons, and in some cases, food and housing.  Nearly half of Americans with health insurance say they would need to use credit cards or a loan to pay an unexpected $500 medical bill, if they could pay it at all, Kaiser has found.

Of course, these families typically count themselves as the lucky ones. They have insurance. More than 75 percent of the uninsured say they worry about paying for medical care if they get sick, Kaiser reports. That’s one reason so many uninsured individuals put off or never receive the care recommended by their doctors.  

Faced with higher out-of-pocket costs than ever before, more patients are visiting websites with cost and quality comparisons of medical treatments and providers. Offered by states, non-profits, health plans and others, these sites provide consumers a clear view into two truths long-known by industry insiders:

• Prices vary – a lot.

• Higher cost care generally is not better care.

More than 80 percent of the patients who have used health cost comparison websites say they would do so again and more than 60 percent report they saved money, according to a survey conducted by Public Agenda, a New York non-profit organization, in partnership with the Robert Wood Johnson Foundation.  

NHhealthcost.nh.gov/, a free website developed by the New Hampshire Insurance Department, was among the first of these sites and remains a national leader. It launched in 2007 and now connects nearly 40,000 people a year to information on health care and insurance.

NHhealthcost.nh.gov/ shows estimated costs of more than 100 common medical and dental services including MRIs, CT scans, mammograms, x-rays, ultrasounds and emergency room visits.  The estimates are calculated using a massive database of actual paid claims from insurance companies and show the variation in cost of procedures by provider and insurance company discount. It also provides healthcare provider information by location including which offer discounts to patients without insurance and quality results for hospitals including ratings by patients. Recently, the site added resources and tools for employers to learn more about how the benefits they offer compare to others.

Here are some examples of the cost and quality variation found on nhhealthcost.nh.gov:

• Some dentists charge 3 times more than others for a simple cleaning.

• Average costs range for common lab tests can range from $11 to $123, depending on the lab you choose.

• Patient satisfaction scores for the state’s hospitals range from 88 percent of patients being highly satisfied to 62 percent of patients being highly satisfied.

Jacqui Hodgkins, a wife, pastor, and mom of three, recently shared her experience on the site with friends on Facebook:

“This site is incredible! I would urge you, if you would like to save yourself some money, to check this out before you go have something done. The physical therapist I was seeing was higher than most places on their list. I didn't know about this site prior to my starting physical therapy but really wish I had. The prices weren't higher because I was receiving a "higher" level of care that made it worth it. I hate having the medical bills come in the mail. Why not know before you go?”

In Maryland, WeartheCost.org/ encourages site visitors to join the conversation about health care costs. WeartheCost.org estimates how much of the cost of common procedures comes from potentially-avoidable complications such as an infection after surgery. Here’s an example. WeartheCost.org found the lowest cost for a vaginal delivery listed among hospitals was less than $10,000. The highest cost was more than $14,000. Other sites like www.WACommunityCheckup.org in Washington State, ChooseWellSTL.org in St. Louis, YourHealthMatters.org in Cincinnati, MNHealthScores.org in Minnesota, and CompareMaine.org in Maine provide comparative quality information on local hospitals and primary care physician practices.  In St. Louis, for example, the percent of patients with diabetes that received recommended care ranged from 71 percent to just over 50 percent, depending on the primary care site they visited.

So, what can the average patient do to help their own family find higher quality, more affordable care?

• Try to find comparative price and quality information. If you live in New Hampshire or one of the regions mentioned here, you have a good start. If not, search the web, this type of information is often closer than you realize.

• Remember: Higher cost care generally is not better care.  

• Don’t shy away from talking with your doctor about cost and quality. It’s fair to ask questions like…

• “What are the risks of this procedure?”

• “How much will it cost me?”

• “How often is this procedure done?”

Visit “Questions are the Answer”,  a resource provided by the federal Agency for Healthcare Research and Quality to develop your own list of questions.  

• Doctors sometimes order tests and recommend treatments when they are not necessary. Consumer Reports offers information for patients on these common yet often unnecessary services. The information was developed by the Choosing Wisely initiative, which brings together 70 professional medical societies to identify tests or treatments that are done too often.