{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T02:40:08Z","timestamp":1792118408921,"version":"4.4.0"},"reference-count":24,"publisher":"American Medical Association (AMA)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n For uninsured or out-of-network patients, uncertainty regarding the expected prices for urology appointments presents a meaningful barrier to timely evaluation. Although price variation for hospital-based services is well documented, self-pay price information in the ambulatory urology setting remains uncharacterized.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To quantify self-pay appointment prices and characterize the availability and structure of financial assistance programs (discounts and payment plans) in urology clinics nationwide.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This national, cross-sectional, audit study was conducted from July 1 through August 31, 2025, at outpatient urology clinics across all 50 US states. A random sample of up to 30 urology clinics per state was selected from a nationwide directory, totaling 1150 clinics. Clinics in closed or membership-restricted health systems were excluded. Researchers used a standardized script to pose as family members of uninsured patients calling for a kidney stone consultation. Calls were limited to 5 minutes and were conducted with front-office staff and\/or billing personnel.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The primary outcome was the self-pay price for a new patient appointment, adjusted for regional cost-of-living variability. Secondary outcomes included the availability and specific terms of financial assistance programs.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among 1150 urology clinics, 865 (75.2%) provided a self-pay price. The national median (IQR) self-pay price was $265 ($208-$361). Compared with private practices, academic (odds ratio [OR], 0.28; 95% CI, 0.16-0.47;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001) and hospital-based (OR, 0.42; 95% CI, 0.28-0.65;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001) clinics were associated with lower odds of providing self-pay price information. Conversely, hospital-based (OR, 2.64; 95% CI, 1.57-4.44;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001) and academic (OR, 1.65; 95% CI, 1.01-2.69;\n P<\/jats:italic>\n \u2009=\u2009.04) clinics were associated with higher odds of offering financial assistance. However, specific terms were often unspecified for discounts (76 [27.9%]) and payment plans (313 [75.8%]).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this national cross-sectional study of 1150 urology clinics, most clinics provided self-pay appointment prices, although substantial price transparency gaps remained; hospital-based and academic clinics were associated with lower odds of providing self-pay prices but higher odds of offering financial assistance programs. Ambiguous financial assistance terms may limit the ability of self-pay patients to navigate self-pay prices, suggesting a need for standardized disclosure to improve access to urologic care.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.30651","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T15:00:26Z","timestamp":1787670026000},"page":"e2630651","source":"Crossref","is-referenced-by-count":1,"title":["Self-Pay Prices and Financial Assistance Programs for Urology Appointments"],"prefix":"10.1001","volume":"9","author":[{"given":"Walter","family":"Hsiang","sequence":"first","affiliation":[{"name":"Department of Urology, University of California, San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darren","family":"Chau","sequence":"additional","affiliation":[{"name":"Department of Urology, University of California, San 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California, San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Hoang","sequence":"additional","affiliation":[{"name":"Department of Urology, University of California, San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marshall","family":"Stoller","sequence":"additional","affiliation":[{"name":"Department of Urology, University of California, San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2026,8,25]]},"reference":[{"issue":"6","key":"zoi260837r2","doi-asserted-by":"publisher","first-page":"1944","DOI":"10.1111\/1475-6773.12192","article-title":"Variation in inpatient hospital prices and outpatient service quantities drive geographic differences in private spending in Texas.","volume":"49","author":"Franzini","year":"2014","journal-title":"Health Serv 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