Massachusetts hospitals by law most provide consumers with pricing on the cost of treatment and a procedure to obtain the information.

But a new survey of the state’s biggest hospitals by public policy research organization Pioneer Health finds most hospitals aren’t very price-transparent—online or off.

In particular, big Massachusetts hospitals are lagging in giving patients upfront pricing information or ways to get that information online, according to Pioneer Health.

The survey found that nine institutions—Carney Hospital, Cooley Dickinson Hospital, Emerson Hospital, Holyoke Medical Center, MetroWest Medical Center, Morton Hospital and Medican Center, Saint Vincent Hospital, Signature Healthcare Brockton Hospital and Tufts Medical Center—had no information available on their websites about how to findcost estimates.

Three other hospitals—Baystate Franklin Medical Center, Baystate Springfield Medical Center and Boston Children’s Hospital—required users to submit a request for an estimate online. The websites of other medical centers, including Brigham and Women’s Hospital, Fairmouth Hospital and UMass Memorial Medical Center, provided only a phone number to call.

“Massachusetts hospitals, located in one of the ‘high-tech’ capitals of the world, do a poor job of promoting online price transparency,” says Pioneer Institute senior fellow in healthcare policy Barbara Anthony.

Boston Children’s Hospital performed the best overall with a website that describes state law and informs consumers that a response for a price estimate will be fielded within two days, says Pioneer Institute. The Boston Children’s site also has an online form consumers can use to request an estimate and a number to call.

But other hospital websites were less advanced—and more bureaucratic to use, the report says. For example, Baystate Health System, Baystate Franklin Medical Center and Baystate Springfield Medical Center, allow consumers to request a price estimate online, but they require the name of the prescribing doctor and the diagnostic code, which are unnecessarily burdensome, Anthony says.

“Their websites provide telephone numbers for consumers to call, but this information, is not prominently displayed and requires consumers to do a lot of searching and clicking on various links before locating the correct icon,” she says.

The websites for nine of the 21 hospitals provided just a phone number to obtain an estimate, and finding the number on their websites generally required that consumers click through various screens before finding the words “request an estimate,” says Pioneer Institute.

“Instead of dedicating a page to price transparency or instructions on requesting an estimate, there is often a short blurb providing only a phone number buried in an FAQ or billing information page,” the survey says. “For the remaining nine hospitals, researchers were unable to find any information about price or cost estimates on their websites.”

In general Massachusetts hospitals need to become better at giving consumers more pricing information because costs and treatment options are complicated and prices vary greatly from hospital to hospital, says Pioneer Institute.

“It remains highly unlikely that consumers can get a hospital price estimate within two business days of requesting it,” Anthony says.

Pioneer Institute researchers called 21 hospitals to request a self-pay estimate for an MRI of the left knee, but only nine of the hospitals were able to provide the estimate within two business days, Anthony says.

“Deductibles can range from $1,500 to more than $7, 000,” Anthony says. “Given that reality, access to price information is more important than ever before. This survey once again demonstrates how frustrating and time consuming it is for the average consumer to obtain a price quote. ”

Other survey findings include:

• Researchers asked about self-pay or cash discounts, which ranged from 6% to 47%.
• There was wide variation in the prices quoted.  Undiscounted estimates ranged from $1,061 at Morton Hospital and Medical Center in Taunton to $8,447 at Boston’s Massachusetts General Hospital.  Discounted estimates, which is the price for a self-pay patient, went from $636.73 at Morton to $6,928 at Massachusetts General.
• About two-thirds of the hospitals readily disclosed the self-pay discount, while in the other cases callers had to ask about it.  MRI reading fee discounts were disclosed at a similar rate.
• While state law requires that price estimates be given within two business days, it took an average of two-to-four business days to get pricing information. Response time ranged from a few minutes at Baystate Franklin Medical Center in Greenfield and Morton Hospital and Medical Center in Taunton, to six or seven days at some other hospitals.
• Five of the 21 hospitals required callers to supply a diagnostic code before providing an estimate.  Several others asked for one, but hospital personnel eventually looked up the code “which is much more accessible to the institutions than it is to patients,” the survey says.
• Some hospitals directed callers to a third-party to get a separate estimate for the MRI reading fee, which can delay receipt of a quote by 48 hours or more.  Lahey Hospital and Medical Center and Newton-Wellesley Hospital provided a “consumer-friendly” price.

“The time has come for hospitals to get serious about complying with the state’s price transparency law,” says Pioneer Institute executive director Jim Stergios.