{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T21:17:54Z","timestamp":1776460674747,"version":"3.51.2"},"reference-count":36,"publisher":"Elsevier BV","issue":"4","license":[{"start":{"date-parts":[[2018,4,1]],"date-time":"2018-04-01T00:00:00Z","timestamp":1522540800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"}],"content-domain":{"domain":["clinicalkey.jp","clinicalkey.com","clinicalkey.es","jacr.org","clinicalkey.fr","clinicalkey.com.au","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of the American College of Radiology"],"published-print":{"date-parts":[[2018,4]]},"DOI":"10.1016\/j.jacr.2017.12.010","type":"journal-article","created":{"date-parts":[[2018,2,22]],"date-time":"2018-02-22T00:56:53Z","timestamp":1519261013000},"page":"607-614.e1","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":32,"title":["Out-of-Pocket Costs for Advanced Imaging\u00a0Across the US Private Insurance\u00a0Marketplace"],"prefix":"10.1016","volume":"15","author":[{"given":"Andrew B.","family":"Rosenkrantz","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gelareh","family":"Sadigh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruth C.","family":"Carlos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"III","given":"Ezequiel","family":"Silva","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr.","given":"Richard","family":"Duszak","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"78","reference":[{"key":"10.1016\/j.jacr.2017.12.010_bib1","doi-asserted-by":"crossref","first-page":"959","DOI":"10.2214\/AJR.17.18360","article-title":"Health care price transparency and communication: implications for radiologists and patients in an era of expanding shared decision making","volume":"209","author":"Sadigh","year":"2017","journal-title":"AJR Am J Roentgenol"},{"key":"10.1016\/j.jacr.2017.12.010_bib2","doi-asserted-by":"crossref","first-page":"1446","DOI":"10.1016\/j.jacr.2015.06.031","article-title":"From gatekeeper to steward: the evolving concept of radiologist accountability for imaging utilization","volume":"12","author":"Durand","year":"2015","journal-title":"J\u00a0Am Coll Radiol"},{"key":"10.1016\/j.jacr.2017.12.010_bib3","doi-asserted-by":"crossref","first-page":"1030","DOI":"10.1056\/NEJMhpr0808703","article-title":"Health insurers and medical-imaging policy\u2014a work in progress","volume":"360","author":"Iglehart","year":"2009","journal-title":"N\u00a0Engl J Med"},{"key":"10.1016\/j.jacr.2017.12.010_bib4","doi-asserted-by":"crossref","first-page":"1277","DOI":"10.2214\/AJR.13.10999","article-title":"Comparative analysis of Medicare spending for medical imaging: sustained dramatic slowdown compared with other services","volume":"201","author":"Lee","year":"2013","journal-title":"AJR Am J Roentgenol"},{"key":"10.1016\/j.jacr.2017.12.010_bib5","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1016\/j.jacr.2013.02.023","article-title":"Trends in the utilization of medical imaging from 2003 to 2011: clinical encounters offer a complementary patient-centered focus","volume":"10","author":"Dodoo","year":"2013","journal-title":"J\u00a0Am Coll Radiol"},{"key":"10.1016\/j.jacr.2017.12.010_bib6","doi-asserted-by":"crossref","first-page":"929","DOI":"10.2214\/AJR.14.14167","article-title":"How much do common imaging studies cost? A nationwide survey of radiology trainees","volume":"205","author":"Vijayasarathi","year":"2015","journal-title":"AJR Am J Roentgenol"},{"key":"10.1016\/j.jacr.2017.12.010_bib7","doi-asserted-by":"crossref","first-page":"1304","DOI":"10.1016\/j.jacr.2016.05.009","article-title":"Knowledge of the costs of diagnostic imaging: a survey of physician trainees at a large academic medical center","volume":"13","author":"Vijayasarathi","year":"2016","journal-title":"J\u00a0Am Coll Radiol"},{"key":"10.1016\/j.jacr.2017.12.010_bib8","doi-asserted-by":"crossref","first-page":"2966","DOI":"10.1007\/s00261-015-0538-1","article-title":"Medicare cost of colorectal cancer screening: CT colonography vs. optical colonoscopy","volume":"40","author":"Pyenson","year":"2015","journal-title":"Abdom Imaging"},{"key":"10.1016\/j.jacr.2017.12.010_bib9","doi-asserted-by":"crossref","first-page":"1564","DOI":"10.1097\/TA.0b013e31826fc85f","article-title":"Repeated computed tomographic scans in transferred trauma patients: indications, costs, and radiation exposure","volume":"73","author":"Jones","year":"2012","journal-title":"J\u00a0Trauma Acute Care Surg"},{"key":"10.1016\/j.jacr.2017.12.010_bib10","unstructured":"Glover L. Why does an MRI cost so darn much? Time. July 16, 2014. Available at: http:\/\/time.com\/money\/2995166\/why-does-mri-cost-so-much\/. Accessed September 30,\u00a02017."},{"key":"10.1016\/j.jacr.2017.12.010_bib11","unstructured":"That CT scan costs how much? Consumer Reports. July 2012. Available at: https:\/\/www.consumerreports.org\/cro\/magazine\/2012\/07\/that-ct-scan-costs-how-much\/index.htm. Accessed September 30,\u00a02017."},{"key":"10.1016\/j.jacr.2017.12.010_bib12","unstructured":"Ashford K. What i learned when i asked how much my MRI would cost. Forbes. October 31, 2014. Available at: https:\/\/www.forbes.com\/sites\/kateashford\/2014\/10\/31\/how-much-mri-cost\/. Accessed September 30,\u00a02017."},{"key":"10.1016\/j.jacr.2017.12.010_bib13","first-page":"540","article-title":"The effect of narrow network plans on out-of-pocket cost","volume":"23","author":"Gillen","year":"2017","journal-title":"Am J Manage Care"},{"key":"10.1016\/j.jacr.2017.12.010_bib14","article-title":"A\u00a0health trade-off that\u2019s here to stay: lower cost, limited choice","author":"Sanger-Katz","year":"2014","journal-title":"The New York Times"},{"key":"10.1016\/j.jacr.2017.12.010_bib15","article-title":"Less choice, lower premiums. Many exchange plans will offer narrow networks","author":"McQueen","year":"2013","journal-title":"Modern Healthcare"},{"key":"10.1016\/j.jacr.2017.12.010_bib16","unstructured":"Brink J. How can practices shield their patients from \u201csurprise\u201d bills and insurance coverage gaps? ACR Bulletin. Available at: https:\/\/acrbulletin.org\/current-issue\/1073-shielding-surprise-bills-balance-brink. Accessed September 30,\u00a02017."},{"key":"10.1016\/j.jacr.2017.12.010_bib17","unstructured":"Center for Public Policy Priorities. Surprise medical bills take advantage of Texans: little-known practice creates a \u201csecond emergency\u201d for ER-patients. September 15, 2014. Available at: http:\/\/forabettertexas.org\/images\/HC_2014_09_PP_BalanceBilling.pdf. Accessed October 6,\u00a02017."},{"key":"10.1016\/j.jacr.2017.12.010_bib18","unstructured":"Centers for Medicare and Medicaid Services, Center for Consumer Information and Insurance Oversight. Health Insurance Marketplace Public Use Files (Marketplace PUFs). Available at: https:\/\/www.cms.gov\/CCIIO\/Resources\/Data-Resources\/marketplace-puf.html. Accessed September 30,\u00a02017."},{"key":"10.1016\/j.jacr.2017.12.010_bib19","unstructured":"Centers for Medicare and Medicaid Services, Center for Consumer Information and Insurance Oversight. Qualified health plan certification. Available at: https:\/\/www.cms.gov\/CCIIO\/Programs-and-Initiatives\/Health-Insurance-Marketplaces\/qhp.html. Accessed November 1,\u00a02017."},{"key":"10.1016\/j.jacr.2017.12.010_bib20","unstructured":"Centers for Medicare and Medicaid Services, Center for Consumer Information\u00a0and Insurance Oversight. Benefits and Cost Sharing Public\u00a0Use File data dictionary. Available at: https:\/\/www.cms.gov\/CCIIO\/Resources\/Data-Resources\/Downloads\/Benefits-and-Cost-Sharing-Data-Dictionary.pdf. Accessed September 30,\u00a02017."},{"key":"10.1016\/j.jacr.2017.12.010_bib21","unstructured":"Centers for Medicare and Medicaid Services, Center for Consumer Information and Insurance Oversight. 2017 Benefits and Cost Sharing PUF. Available at: http:\/\/download.cms.gov\/marketplace-puf\/2017\/benefits-and-cost-sharing-puf.zip. Accessed May 29,\u00a02017."},{"key":"10.1016\/j.jacr.2017.12.010_bib22","unstructured":"Centers for Medicare and Medicaid Services, Center for Consumer Information and Insurance Oversight. 2017 Plan Attributes PUF. Available at: http:\/\/download.cms.gov\/marketplace-puf\/2018\/plan-attributes-puf.zip. Accessed May 29,\u00a02017."},{"key":"10.1016\/j.jacr.2017.12.010_bib23","unstructured":"Centers for Medicare and Medicaid Services. The \u201cmetal\u201d categories: bronze, silver, gold & platinum. Available at: https:\/\/www.healthcare.gov\/choose-a-plan\/plans-categories\/. Accessed November 2,\u00a02017."},{"key":"10.1016\/j.jacr.2017.12.010_bib24","unstructured":"US Census Bureau. American FactFinder. Median household income. Available at: http:\/\/factfinder2.census.gov\/bkmk\/table\/1.0\/en\/ACS\/16_1YR\/R1901.US01PRF. Accessed October 10,\u00a02017."},{"key":"10.1016\/j.jacr.2017.12.010_bib25","unstructured":"How to avoid surprise medical bills. The Wall Street Journal. Available at: http:\/\/guides.wsj.com\/health\/health-costs\/how-to-avoid-surprise-medical-bills\/. Accessed October 4,\u00a02017."},{"key":"10.1016\/j.jacr.2017.12.010_bib26","unstructured":"New York State Department of Financial Services. Protection from surprise bills and emergency services. Available at: http:\/\/www.dfs.ny.gov\/consumer\/hprotection.htm. Accessed October 3,\u00a02017."},{"key":"10.1016\/j.jacr.2017.12.010_bib27","unstructured":"California Legislative Information. Assembly Bill No. 1305, Chapter 641. Limitations on cost sharing: family coverage. October 8, 2015. Available at: https:\/\/leginfo.legislature.ca.gov\/faces\/billNavClient.xhtml?bill_id=201520160AB1305. Accessed October 3,\u00a02017."},{"key":"10.1016\/j.jacr.2017.12.010_bib28","unstructured":"115 th US Congress. H.R. 3877. Fair Billing Act of 2017. September 28, 2017. Available at: https:\/\/www.congress.gov\/115\/bills\/hr3877\/BILLS-115hr3877ih.pdf. Accessed October 6,\u00a02017."},{"key":"10.1016\/j.jacr.2017.12.010_bib29","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1016\/j.jacr.2014.11.024","article-title":"Nationwide price variability for an elective, outpatient imaging procedure","volume":"12","author":"Pasalic","year":"2015","journal-title":"J\u00a0Am Coll Radiol"},{"key":"10.1016\/j.jacr.2017.12.010_bib30","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1016\/j.jacr.2014.12.016","article-title":"How much is that head CT? Price transparency and variability in radiology","volume":"12","author":"Paul","year":"2015","journal-title":"J\u00a0Am Coll Radiol"},{"key":"10.1016\/j.jacr.2017.12.010_bib31","doi-asserted-by":"crossref","first-page":"1874","DOI":"10.1001\/jama.2016.4288","article-title":"Association between availability of a price transparency tool and outpatient spending","volume":"315","author":"Desai","year":"2016","journal-title":"JAMA"},{"key":"10.1016\/j.jacr.2017.12.010_bib32","doi-asserted-by":"crossref","first-page":"1851","DOI":"10.1377\/hlthaff.2014.0792","article-title":"Health benefits in 2014: stability in premiums and coverage for employer-sponsored plans","volume":"33","author":"Claxton","year":"2014","journal-title":"Health Aff (Millwood)"},{"key":"10.1016\/j.jacr.2017.12.010_bib33","unstructured":"Schleifer D, Hagelskamp C, Rinehart C. How much will it cost? How Americans use prices in health care. March 9, 2015. Available at: http:\/\/www.publicagenda.org\/pages\/how-much-will-it-cost. Accessed October 9,\u00a02017."},{"key":"10.1016\/j.jacr.2017.12.010_bib34","unstructured":"Centers for Medicare and Medicaid Services. Medicare provider utilization and payment data: physician and other supplier. June 15, 2017. Available at: https:\/\/www.cms.gov\/Research-Statistics-Data-and-Systems\/Statistics-Trends-and-Reports\/Medicare-Provider-Charge-Data\/Physician-and-Other-Supplier.html. Accessed October 9,\u00a02017."},{"key":"10.1016\/j.jacr.2017.12.010_bib35","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1007\/s11606-016-3917-6","article-title":"A\u00a0randomized trial of displaying paid price information on imaging study and procedure ordering rates","volume":"32","author":"Chien","year":"2017","journal-title":"J\u00a0Gen Intern Med"},{"key":"10.1016\/j.jacr.2017.12.010_bib36","doi-asserted-by":"crossref","first-page":"1298","DOI":"10.1016\/j.jacr.2017.02.042","article-title":"Radiologists may now be accountable for containing Medicare costs and spending under MACRA","volume":"14","author":"Rosenkrantz","year":"2017","journal-title":"J\u00a0Am Coll Radiol"}],"container-title":["Journal of the American College of Radiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1546144017316198?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1546144017316198?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2018,8,23]],"date-time":"2018-08-23T22:54:17Z","timestamp":1535064857000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1546144017316198"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,4]]},"references-count":36,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2018,4]]}},"alternative-id":["S1546144017316198"],"URL":"https:\/\/doi.org\/10.1016\/j.jacr.2017.12.010","relation":{},"ISSN":["1546-1440"],"issn-type":[{"value":"1546-1440","type":"print"}],"subject":[],"published":{"date-parts":[[2018,4]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Out-of-Pocket Costs for Advanced Imaging\u00a0Across the US Private Insurance\u00a0Marketplace","name":"articletitle","label":"Article Title"},{"value":"Journal of the American College of Radiology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jacr.2017.12.010","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2017 American College of Radiology","name":"copyright","label":"Copyright"}]}}