The cost of long-term care services varies widely across the nation, with some people spending seven times more for certain services than others, according to a new study.

The price differences largely depend on where the services are delivered, according to the study commissioned by financial security company Northwestern Mutual. Hawaii, for example, has the most expensive services, with an average cost of $4,406 per month in an assisted living facility. North Dakota offers the cheapest option, with an average monthly rate of $1,901.

Long-term care service prices are generally the highest in the Northeast, where Connecticut, Maine, Maryland, New Hampshire, New Jersey and New York have average monthly costs that average more than $4,000.

"These differences in cost for long-term care services illustrate the choices Americans have and the questions they should ask themselves," continued Terence Holahan of Northwest Mutual. "Americans should prioritize. Is it important to live in close proximity to family, or in a moderate climate? Do you want to remain in your own home, or would you prefer a retirement community? All of these considerations will impact your budget for long-term care."

The most significant difference between locations was the hourly wage of home health aides (HHAs) and the cost of nursing home. For example, residents of Lafayette, La., spend an average of $118 a day for a private nursing home room, while residents of New York City spend five times that amount, at an average of $590 a day. The national average was $210 a day in the markets surveyed.

Similarly, the costs of a private room in an assisted living facility vary widely by region. A room in El Paso, Texas, will cost on average $2,043 per month, versus $4,896 per month in Bridgeport/Stratford, Conn.

The study was conducted in October and November 2008.