FARGO It took Nicole Haaland three weeks to figure out she couldnt afford the treatment doctors recommended for her back pain.

She got the runaround before discovering the nerve-dulling injections at the Sanford Brain and Spine Center would cost $5,500 a year too much, she said. By then, she had already shelled out $1,500 for tests to see if that treatment would work.

Officials from the two local health systems say they do their best to help patients understand the possible cost of a procedure, but its hard to make price-shopping a reality.

Between deductibles on different insurance policies, the various government programs that help cover costs and the often unpredictable nature of medicine, it takes work to come up with even a ballpark estimate of a patients out-of-pocket costs.

The Center for Medicare Services data on hospitals average costs for some of the most common treatments gives a glimpse at how prices may differ between Sanford Medical Center and Essentia Health. Those differences are generally minimal.

But as throughout the rest of the country, there are some wild swings in prices for the same procedure at two hospitals in the same area.

In 2011, the newest data available, Sanford averaged $1,200 for an echocardiogram, a common procedure used to detect heart disease or other heart defects. It was nearly half that at Essentia, at $603.

At Essentia, a pacemaker implant cost an average of $33,515 in 2011, nearly 30 percent more than at Sanford.

Dr. Gregory Glasner, president and chief medical officer of Essentias west region, cautioned that those prices arent what an everyday patient receiving that treatment would actually pay. Glasner said he sympathizes with Haalands frustrations, but theres no way to build an accurate price menu that patients can look at before going under the knife.

I wish it was that realistic, Glasner said. It is so complex. I dont think its possible to do that in the way that health care financing has evolved.

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Comparison shopping for health care no easy feat