"In real terms, the price of CT has come down," Launders said.

The list price for a midrange, 20 to 64-slice CT scanner now averages $1.2 million, according to ECRI. Launders says, oddly enough, the average list price for most cutting-edge equipment has stayed pretty constant. When 4-slice came out in 1998, it also listed for $1.2 million. And when 16-slice came out in 2004, it listed for $1.2 million too, he said.

Now a 16-slice CT carries a much lower list price, of around $800,000, ECRI said. Plus, the older numbers have not been adjusted for inflation. Once you adjust for inflation, you can see how big the price change has really been. When a 4-slice scanner debuted, it actually cost about $2.3 million in 2010 dollars - in other words, it was in the neighborhood of today's premium scanners.

Services add to the total

List prices are also just that - the prices listed by the company during the initial steps in a transaction. In reality, hospitals rarely pay the full amount. According to information ECRI provided, quoted vendor prices for different models typically average around 50-65 percent of the list price. For premium scanners, for instance, hospitals shell out on average about $1.5 million. It's not cheap, but it's also not $2.7 million.

Still, the vendor prices don't capture one of the big continuing expenses of scanners: service costs. These typically run over $100,000 per year. And the price differential for a premium scanner over a lower-slice scan can be huge. Premium scanners, which can have something like 300 plus detector rows, can run up to $70,000 a year more in service costs than cheaper models, ECRI said. Over the 8-10 year lifetime of the highest-end scanners, a hospital would be looking at an almost an $800,000 difference, according to ECRI's figures.

Service costs are also not falling that fast. Although companies are under pressure from rivals offering multi-vendor services and third-party firms to provide cheaper offerings, the high price of replacement glassware limits their options - it can cost upwards of $200,000 to replace a tube on a premium system outside of a service contract, Launders said.

"The big thing is the glassware; these are very expensive service items," he said.

Still, companies are trying to give buyers more bang for their buck. For instance, Launders said the major manufacturers are offering remote monitoring, so they can notify providers of problems early to swap out tubes before they fail or otherwise minimize downtime. Also, fixing equipment remotely is cheaper than sending in an engineer "every time the phone goes," Launders said.

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