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Most reputable companies that provide services tell you what you鈥檒l get for your money. Hospitals are an exception. They haven鈥檛 traditionally made public the cost of operations and other procedures. This secrecy has let hospitals set widely different prices for the same procedure. It鈥檚 also made it impossible to do any comparison shopping.

Yesterday鈥檚 release to the public of a shows just how big the differences can be from hospital to hospital.

On the South Side of Chicago, where I grew up, one hospital鈥檚 charge for implanting a pacemaker to keep the heart beating at a steady rhythm was $49,601, while another hospital charged $63,979 to do it. In Boston, a hospital not far from where I work charged $76,121 to implant a pacemaker while another hospital less than three miles away charged $55,687.

According to , the Keck Hospital of the University of Southern California charged an average of $123,885 for a major artificial joint replacement (six times the average amount that Medicare reimbursed for the procedure) while Centinela Hospital Medical Center, also in Los Angeles, charged $220,881 for the same type of joint replacement surgery.

The database, released by the Centers for Medicare and Medicaid Services, details what 3,300 hospitals charged for the 100 most common treatments and procedures in 2011.

The data reinforce the big differences in charges from one part of the U.S. to another. What鈥檚 new and surprising are the huge differences sometimes seen between hospitals in the same city, or even the same neighborhood.

Keep in mind that these 鈥渃harges鈥� aren鈥檛 hard and fast. Medicare doesn鈥檛 pay the full charge. Insurers don鈥檛 either, as many of them negotiate lower charges. As , 鈥渋t sounds like what you鈥檝e got is a survey of the sticker prices in car lots all around America, but every deal is a special deal.鈥�

At least for now, the database isn鈥檛 especially easy to use. It鈥檚 just an Excel spreadsheet listing the hospitals by state along their charges for the 100 procedures. created a nifty interactive tool that you can use to look at charges in your state for 10 conditions. Choose your state and the tool shows how its hospitals stack up against the national average, as well as the highest and lowest charges for these ten procedures. Expect other creative apps incorporating this information to be coming along soon.

If you decide to dive into the data, be aware鈥攅specially if you have private insurance (not Medicare)鈥攖hat appearances can be deceiving. It may look like Hospital A charges more than Hospital B, but that may not be so. Your insurer and Hospital may have actually agreed on a lower payment. So the data don鈥檛 necessarily say what your insurance company is actually going to pay.

Reverberations

A few weeks ago, I finally finished reading Steven Brill鈥檚 extraordinary Time magazine article on the crazy cost of healthcare in America. I say 鈥渃razy鈥� because, according to Brill, how hospitals set their prices has little rhyme or reason. The database from the Centers for Medicare and Medicaid Services reinforces that notion.

Publishing this information is one small step toward making the cost of healthcare more transparent. While it will be a long time before most of us will be able to figure out how much an operation or a hospital stay costs, the database could nudge hospitals with exorbitant charges to bring them in line.