I will say that it is a problem for anyone - even outside the health field - to deal with location associated...

I will say that it is a problem for anyone - even outside the health field - to deal with location associated differences in overhead costs, and that is something to legitimately consider in setting payment rates. However, that should be an adjustment after the fact. The baseline cost of a procedure should be the same everywhere.

http://www.cbsnews.com/news/one-simple-solution-to-skyrocketing-medical-costs/
http://www.cbsnews.com/news/one-simple-solution-to-skyrocketing-medical-costs/