Nancy Chockley, president of the National Institute for Health Care Management, a non-profit dedicated to improving American health care, said multiple studies have backed up that point.
"Is there any rhyme or reason?" Chockley asked rhetorically. "One thing we know, higher prices do not reflect higher quality."
Indeed, despite its higher prices, CAMC scored lower than St. Francis on all 10 questions of a survey given to Medicare patients at both hospitals.
Private insurers negotiate with hospitals individually, usually asking for a discount from the chargemaster price. Hospitals and insurers sign nondisclosure agreements, so there is no complete list showing what private insurers pay for these procedures.
Reinhardt gave an example of how the negotiation can go and how the chargemaster numbers are important, even if almost nobody pays them.
"Private insurers go usually with the chargemaster and ask for a 60-percent discount, and then the hospital says we need 65 and they settle on 62," Reinhardt said. "If I have a wildly inflated chargemaster and then give you a 60-percent discount, that looks like a lot."
Chockley said larger hospitals can command higher prices because they have more clout with insurers.
"If you are in a market and you have a very high market share, you can tend to charge more because the insurer needs you more," Chockley said.
Fred Earley, the president of Highmark Blue Cross Blue Shield West Virginia, said many factors go into their negotiations with hospitals, but that a hospital's size within its community matters.
"The more significant presence they have in a market, the more negotiating prowess they have," he said.
Chockley, though, disputed the oft-repeated claim that no one pays the chargemaster prices.
"Hospitals are quick to say, 'We don't really charge many people these prices,'" she said. "The people who pay that price are the uninsured. The people who are least able to afford it are paying the highest prices."
Many of those people receive free or discounted charity care. Hudson said CAMC had $135 million in uncollectible accounts last year -- a combination of charity care and unpaid debt.
CAMC offers charity care to the uninsured who fall below certain income guidelines and do not qualify for government programs such as Medicare and Medicaid.
For a family of four, the income threshold is $44,700 per year.
However, if someone does not apply for charity care or is above the income threshold, they can be presented with a bill with chargemaster prices.
"You fall off your chair when you see those charges. Some patients will go to the hospital and plead, and the hospital might, case by case, give a discount," Reinhardt said. "If you can't pay them, they figure out a payment plan. If you miss payments they turn it over to a collection agency."
Staff writer Lori Kersey contributed to this report.
Reach David Gutman at david.gut...@wvgazette.com or 304-348-5119.