But there was nothing to refer to, she said: no public pricing list, just the hospital’s word that the prices were correct. “How do you know you’re not just getting raked over the coals, which you probably are?” Shutt asked. She and Silverstein wanted “to clarify what is being charged, how do you come up with billing, how are your prices charged. Do you pull them out of thin air?” Related: Obamacare helped make a 50% dent in personal bankruptcies Advocates like Silverstein say this is part and parcel of a larger problem: U.S. patients have long been unable to find out the price of a medical procedure until after it occurred. In this, the U.S. health care system is unlike any other customer experience. Imagine sitting down to a meal, going on a flight, or sending your kids off to school, all without knowing the cost or outcome until later, health care advocates say. “There’s no other market in the world where we ask this much of the consumer and give them this little information about what they can expect from us upfront,” said David Vivero, chief executive of health care transparency company Amino . See more: Forget iPhones — many Americans can’t pay a $100 medical bill But hospitals say price transparency is difficult, because a number of factors affect how a patient is charged. Perhaps more importantly, they also say it’s proprietary, leveraged in negotiations with health insurers.

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