New Study Shows Huge Cost Differences for Having a Baby, Often in the Same City
June 30, 2016
Castlight Health’s Costliest Babies Analysis Ranks the Prices for Routine Vaginal and Cesarean Delivery Across the Nation; San Francisco and Sacramento Areas Lead the Nation in Cost
San Francisco – June 30, 2016 – As we approach July – the month in which most babies are born – Castlight Health, Inc. (NYSE: CSLT) today released its Costliest Babies analysis, which looks at the cost of maternity care, including routine vaginal and cesarean deliveries, in the 30 largest U.S. metropolitan areas. This study is part of Castlight’s ongoing Costliest Cities research series, which analyzes the cost of common healthcare procedures across the nation. The Costliest Babies and Costliest Cities research provides deep and unique insights into what employers and employees actually pay for medical care.
As seen with many common healthcare procedures, the cost of having a routine vaginal or a cesarean delivery not only varies dramatically from city to city nationwide, but also can vary widely even within the same city. Most notably, the analysis found that:
Within a given U.S. city, average prices vary greatly for the same type of maternity care:
- In New York City, the cost for a routine vaginal delivery ranged from $4,022 to $17,646, a 4x price difference.
- In San Francisco, the cost for a cesarean delivery ranged from $8,399 to $41,191, a nearly 5x price difference.
- In Los Angeles, the cost for a routine vaginal delivery ranged from $4,223 to $27,326, a 6x price difference; and for a routine cesarean delivery, the cost ranged from: $6,232 to $42,530, a nearly 7x price difference.
The West Coast is not the best coast when it comes to having a baby. West Coast cities hold three of the top five slots for costliest routine vaginal deliveries, and four of the top five slots for costliest Cesarean delivery. Notably, Sacramento and San Francisco are #1 and #2 in both rankings.
Nationally, average prices also vary greatly for the same type of maternity care:
- A routine vaginal delivery in the costliest city, Sacramento ($15,420) is roughly 2.5x more expensive than one in the cheapest city, Kansas City ($6,075).
- A cesarean delivery in the costliest city, Sacramento ($27,067) is nearly 4x more expensive than one in Pittsburgh ($6,891).
- The cost of a routine vaginal delivery in 17 of the 30 costliest cities was higher than the national average of $8,775.
- The price differential is so great, that a cesarean delivery in Cleveland ($8,772) is less expensive than a routine vaginal delivery in 17 of the 30 costliest cities.
“The birth of a child is such a special time. The fact that these huge price differences exists for maternity care is deplorable. The price variances seen in both routine and cesarean deliveries reflect the larger systemic problems in our nations’ healthcare system,” said Kristin Torres Mowat, senior vice president of Plan Development and Data Operations at Castlight Health. “Our Costliest Babies analysis sheds light on research that is vital to helping employers and their employees understand their benefits and get the highest quality care.”
The primary source of data used for this analysis is medical claims data. Castlight supplements this data with other data including:
- Publicly available data
- Provider information, and actual provider rate sheets that list the negotiated price between a provider and an insurer.
- Castlight then applies proprietary algorithms to obtain the provider prices used for this analysis
Prices are defined as the employee cost-sharing plus the amount paid by the employer.
Pregnancy prices depend on the method of delivery (vaginal or cesarean). Here are the procedures and services included, regardless of the delivery method:
- Included: Prenatal office visits, required ultrasounds, delivery, hospital stay, one visit after delivery
- Not included: Tests, elective ultrasounds, imaging, medicine, anesthesia
Note: Displayed prices are representative of in-network providers.
About Castlight Health
Our mission is to empower people to make the best choices for their health and to help companies make the most of their health benefits. We offer a health benefits platform that engages employees to make better healthcare decisions and can guide them to the right program, care, and provider. The platform also enables benefit leaders to communicate and measure their programs while driving employee engagement with targeted, relevant communications. Castlight has partnered with enterprise customers, spanning millions of lives, to improve healthcare outcomes, lower costs, and increase benefits satisfaction.
 Provisional data from the National Vital Statistics System, National Center for Health Statistics, CDC.