测量医院内和跨医院的癌症手术商业价格变动。对实体器官瘤的外科治疗成本高昂，并且商业报价已被隐藏起来，对公众不可见。《医院价格透明规则》于2021年颁布，要求所有医院在其网站上列出谈判后的价格，从而为研究癌症手术定价提供了可能。 本横断面研究使用2021年披露的谈判后价格数据，包括美国医院对10种最常见需要手术治疗的癌症。使用医院内和医院间的比率来衡量价格变动。相对于癌症中心指定和设施水平的Herfindahl-Hirschman指数，使用带有随机截距的混合效应线性回归进行评估。 针对最常见的10种实体器官肿瘤癌症，结果得到来自2,232家医院的495,200个独特的商业价格。妇科癌症手术的中位数价格最高，为每次操作6,035.8美元，而膀胱癌手术的价格为每次操作3,431.0美元。与竞争市场相比，中度和高度集中的市场与显著较高的价格相关（HHI 1501-2500，系数为513.6美元，95% CI，295.5美元-731.7美元；HHI >2500，系数为1,115.5美元，95% CI，913.7美元-1,317.2美元）。国家癌症研究所的指定与较高价格相关，系数为3,451.9美元（95% CI，-2,853.2美元-4,050.7美元）。 对于10种常见的实体瘤恶性肿瘤手术管理，商业付费方谈判后价格在医院内和跨医院间差异较大。较低的竞争市场观察到较高的价格。未来的努力应促进价格竞争并限制医疗市场的集中。版权所有© 2023 Wolters Kluwer Health, Inc. 保留所有权利。

To measure commercial price variation for cancer surgery within and across hospitals.Surgical care for solid organ tumors is costly and negotiated commercial rates have been hidden from public view. The Hospital Price Transparency Rule, enacted in 2021, requires all hospitals list their negotiated rates on their website, thus opening the door for an examination of pricing for cancer surgery.This was a cross-sectional study using 2021 negotiated price data disclosed US hospitals for the ten most common cancers treated with surgery. Price variation was measured using within- and across-hospital ratios. Commercial rates relative to cancer center designation and the Herfindahl-Hirschman Index at the facility level were evaluated with mixed effects linear regression with random intercepts per procedural code.495,200 unique commercial rates from 2,232 hospitals resulted for the ten most common solid-organ tumor cancers. Gynecologic cancer operations had the highest median rates at $6,035.8/operation compared to bladder cancer surgery at $3,431.0/operation. Compared to competitive markets, moderately and highly concentrated markets were associated with significantly higher rates (HHI 1501-2500, coefficient $513.6, 95% CI, $295.5 - $731.7; HHI >2500, coefficient $1,115.5, 95% CI, $913.7-$1,317.2). National Cancer Institute designation was associated with higher rates, coefficient $3,451.9 (95% CI, -$2,853.2-$4,050.7).Commercial payer-negotiated prices for the surgical management of 10 common, solid-tumor malignancies varied widely both within and across hospitals. Higher rates were observed in less competitive markets. Future efforts should facilitate price competition and limit health market concentration.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.