CHICAGO - What do hospitals charge to remove an appendix? The startling answer is that it could be the same as the price of a refrigerator - or a house.

CHICAGO � What do hospitals charge to remove an appendix? The startling answer is that it could be the same as the price of a refrigerator � or a house.

It�s a common, straightforward operation, so you might expect charges to be similar no matter where the surgery takes place. Yet a California study found huge disparities in patients� bills � $1,500 to $180,000, with an average of $33,000.

The researchers and other experts say the results aren�t unique to California and illustrate a broken system.

�There�s no method to the madness,� said lead author Dr. Renee Hsia, an emergency-room physician and researcher at the University of California, San Francisco. �There�s no system at all to determine what is a rational price for this condition or this procedure.�

The disparities are partly explained by differences among patients and where they were treated. For example, some had more costly procedures, including multiple imaging scans or longer hospital stays. A very small number were treated without surgery, though most had appendectomies. Some were sicker and needed more-intensive care.

But the study found no explanation for about one-third of the cost differences.

The study was published yesterday in the journal Archives of Internal Medicine.

President Barack Obama�s health-care overhaul, now in the hands of the U.S. Supreme Court, would have little effect on the kinds of disparities seen in the study, policy experts say.

The researchers examined 2009 data that hospitals were required to submit to the state on 19,368 patients with appendicitis. To get the fairest comparisons, the researchers included only uncomplicated cases with hospital stays of fewer than four days. Patients were 18 to 59 years old.

The study looked at what patients were billed, before contributions from their health insurance �p p p p if they had any. The figures don�t reflect what hospitals were actually paid. Insurance companies often negotiate to pay less than what they are billed, and what patients pay depends on their health plans. Those least able to pay � the uninsured � could be socked with the full bill.

Uninsured and Medicaid patients had slightly higher bills than those with private insurance. Charges were highest at for-profit hospitals, followed by nonprofits. County hospitals, typically safety-net hospitals, had the lowest charges.

The highest bill, totaling $182,955, involved a woman who also had cancer. She was treated at a hospital in California�s Silicon Valley. Her bill didn�t show any cancer-related treatment. The smallest bill, $1,529, involved a patient whose appendix was removed in rural northern California. Otherwise, the cases were similar: Both patients were hospitalized for one day, had minimally invasive surgery, and had similar numbers of procedures and tests on their bills.

Many cases involved charges well over $100,000 and under $2,000, Hsia said. Also, within geographic regions, the lowest and highest charges differed by tens of thousands of dollars.

Data from the federal Agency of Healthcare Research and Quality and the International Federation of Health Plans show that the average price nationwide for an appendectomy is almost $28,000.