How we measure hospital prices

Data through August 2026. Every figure on this page is computed from the record when the page loads.

Hospital files price the same service many ways. Before we compare two numbers, we make sure they are the same kind of number. This page is for anyone checking our work: a reporter, a benefits adviser, a researcher, or a patient who wants to know what a figure on this site means.

What is the difference between a gross charge, a cash price, and a negotiated rate?

Since January 2021, every hospital has been required to publish a machine-readable file listing its standard charges for every item and service (45 CFR Part 180). The rule defines the price types the file must carry. Here is each one, in the rule's words and in ours.

Gross charge (file column: standard_charge|gross)

The charge for an item or service on the hospital's chargemaster, before any discount. This is the sticker price. Almost nobody pays it, but it is the number most other prices are discounted from. We show it so you can see the size of the discount, not as a price to expect.

Discounted cash price (standard_charge|discounted_cash)

The charge that applies to a patient who pays cash, or a cash equivalent, for the service. On this site this is the cash price. When a hospital lists no cash price, we say so rather than substitute another number.

Payer-specific negotiated charge (standard_charge|negotiated_dollar)

The charge the hospital has negotiated with a named insurer for a named plan. On this site this is an insurance rate or negotiated rate, always shown with the insurer and, where the file gives one, the plan. One insurer can carry many plans at one hospital, and they price differently; we keep each plan as its own row.

De-identified minimum and maximum negotiated charge (standard_charge|min, standard_charge|max)

The lowest and highest charge the hospital has negotiated with any insurer for the service, without naming the insurer. Some hospitals publish only these two numbers and no named rates. Those hospitals appear on this site with a price range, and they contribute nothing to any insurer-versus-cash comparison, because there is no named rate to compare.

A hospital may also express a negotiated rate as a percentage of another number or as a formula rather than a dollar amount. We compare dollar amounts. Where you see an insurance rate on this site, it is a dollar figure the hospital itself published for that plan.

Where our data comes from

Every number on HospitalCost traces to a verifiable federal source. We merge 17 datasets spanning hospital-published prices, CMS quality ratings, patient satisfaction, safety and infection data, Medicare payment data, hospital financials, and financial assistance policies. All sourced from the CMS Hospital Price Transparency Rule and related federal programs.

We don't estimate prices. We publish what the hospitals publish. When a hospital's data is incomplete, missing, or contradictory, we say so.

How we compare two prices

The four coordinates every price sits on

We never compare two prices unless all four match.

1. Care setting. Outpatient, inpatient, or emergency room. A hospital often prices the same scan differently by setting, and its file may list the inpatient line first. When a hospital publishes both, we use the outpatient facility price; the inpatient price is used only for services that have no outpatient line.
2. Plan type. Commercial (employer and individual-market plans), Medicare Advantage, managed Medicaid, TRICARE and other government plans, or workers’ compensation. One insurer’s name covers all of these in a hospital file, and they price very differently. We classify each plan from its name in the file; a plan with no marker counts as commercial. Every insurer figure on this site says which plan types it counts.
3. Insurer and plan. The insurer and the specific plan as the hospital lists them. Six contracts with one insurer stay six rows; we do not average them into one.
4. Billing code. The five-digit code hospitals must use for the service (CPT or HCPCS). When a hospital lists the same code on several lines, for different departments or bundles, we keep the middle-to-low line rather than the first one, and we drop prices above a per-category ceiling as likely file errors.

The benchmark we publish

What we assume, and where it can be wrong

Everything above rests on one assumption: the rates in a hospital’s file approximate what is actually paid. Three known cracks in that assumption, and what we do about each:

• Care setting. Hospitals differ in which setting carries dollar amounts. Two rates compared across settings look like a price gap that is not real. We prefer the outpatient line for that reason.
• Plan type. A Medicare Advantage rate filed under a commercial insurer’s name pulls an average down. We classify plans by name and print the scope beside every share; when a name slips through, we correct the classification and restate the figure with the date.
• The file itself. A hospital can change a price without changing anything else about its file. The “prices as of” date on our pages tells you when we read the file, not that every price in it is current. We read the files again on a schedule, and a changed price is checked before anything about it is published.

Prices on this site are facility fees only; the doctor, radiologist, anesthesiologist, and lab often bill separately. When we correct a figure, we say so on the page that carried it, with the date. If a number here does not match what a hospital told you, tell us.

Checking our work

Every page that carries a price names the hospital, the billing code, the price type, and the date we read the file. To check a figure, open that hospital’s machine-readable file (linked from its profile), find the billing code, and read the same column. If it does not match, report it and we will re-read the file and correct the page with the date of the correction.