Hospital Price Transparency: How to Use It to Save Thousands
Since January 1, 2021, hospitals have been required by federal law to publish their prices online. Yet years later, most patients don't know this data exists—or how to use it. Here's your guide to finding and leveraging hospital pricing data.
🔑 Key Takeaway
Hospitals must publish their prices in two formats: a machine-readable file (for researchers) and a consumer-friendly tool for 300+ "shoppable services." You can use this data to compare prices BEFORE scheduling procedures.
What the Law Requires
The Hospital Price Transparency Rule (45 CFR § 180) requires hospitals to publish:
- Machine-readable file: A comprehensive list of ALL services with negotiated rates for each insurance company, discounted cash prices, and gross (chargemaster) prices.
- Consumer-friendly display: An online tool showing estimated prices for at least 300 "shoppable services" that patients can schedule in advance.
Penalties for non-compliance increased in 2022 to up to $2 million per day for large hospitals. Compliance has improved, though some hospitals still make prices difficult to find.
How to Find Hospital Price Data
Method 1: Hospital Website Search
- Go to the hospital's website
- Look for links labeled: "Price Transparency," "Pricing," "Patient Financial Services," or "Price Estimator"
- Check the footer—many hospitals bury these links
- Use site search: try "price transparency" or "chargemaster"
Method 2: Google Search
Search: [Hospital Name] price transparency or [Hospital Name] chargemaster
Method 3: CMS Hospital Price Transparency Data
CMS maintains a list of hospital machine-readable files at: data.cms.gov/hospital-price-transparency
⚠️ Data Format Warning
Machine-readable files are often in JSON or CSV format with technical codes (CDM, DRG, CPT). These are designed for researchers and comparison tools, not average consumers. For most patients, the consumer-friendly price estimator is more useful.
Understanding the Data
Types of Prices You'll See
| Price Type | What It Means |
|---|---|
| Gross/Chargemaster Price | The hospital's "sticker price." Almost no one actually pays this. It's the starting point for negotiations. |
| Discounted Cash Price | What the hospital charges uninsured patients who pay cash. Often 40-60% less than gross price. |
| Payer-Specific Negotiated Rate | What each insurance company has negotiated for that service. This is the most useful data for insured patients. |
| De-identified Minimum/Maximum | The lowest and highest negotiated rates across all payers. |
Understanding Procedure Codes
- CPT codes: 5-digit codes for specific procedures (e.g., 70553 = Brain MRI with contrast)
- DRG codes: 3-digit codes for inpatient hospital stays grouped by diagnosis
- HCPCS codes: Codes for supplies, equipment, and non-physician services
Step-by-Step: Comparing Prices
Example: You Need a Knee MRI
Step 1: Get the CPT Code
Ask your doctor: "What CPT code would be billed for this MRI?" For a knee MRI without contrast, the code is typically 73721.
Step 2: Find Your Insurance's Negotiated Rate
Go to Hospital A's price transparency page. Look up CPT 73721. Find your insurance company. Note the negotiated rate (e.g., $1,800).
Step 3: Compare to Other Facilities
Repeat for Hospital B, an imaging center, and a freestanding outpatient center. You might find:
- Hospital A: $1,800
- Hospital B: $2,400
- Imaging Center C: $650
- Freestanding Center D: $480
Step 4: Verify with Your Insurance
Call your insurance to confirm the facility is in-network and ask for a cost estimate. Price transparency data shows the allowed amount—your actual cost depends on your deductible and coinsurance.
Why Prices Vary So Much
You might wonder why the same MRI costs $480 at one place and $2,400 at another. Several factors:
- Facility fees: Hospital-based facilities charge extra "facility fees"
- Market power: Larger hospital systems negotiate higher rates
- Location: Urban areas with less competition often have higher prices
- Equipment: Some variation is legitimate (3T vs 1.5T MRI), but most isn't
💡 Pro Tip
For imaging (MRI, CT, X-ray), independent imaging centers almost always cost less than hospital-based imaging—often 50-80% less—with identical equipment and radiologists.
Common Shoppable Services
The law requires hospitals to publish prices for at least 300 shoppable services. High-value services to compare include:
- MRI and CT scans
- Colonoscopy and upper endoscopy
- Mammography
- Joint replacement surgery
- Cataract surgery
- Lab work (blood panels, metabolic panels)
- Childbirth (vaginal and cesarean delivery)
Limitations to Know
- Estimates, not guarantees: Published prices are estimates. Complications or additional services can increase your bill.
- Physician fees separate: Hospital prices often don't include the doctor's fee (which is billed separately).
- Insurance processing: Your actual cost depends on your deductible status, coinsurance, and out-of-pocket maximum.
- Data quality varies: Some hospitals publish incomplete or confusing data.
Tools That Aggregate This Data
Several third-party tools compile hospital pricing data into easier-to-use formats:
- Turquoise Health: Free tool aggregating hospital machine-readable files
- Clear Health Costs: Crowdsourced pricing database
- Healthcare Bluebook: Fair price estimates by procedure
- Your insurance portal: Many insurers now have cost estimator tools
What to Do If a Hospital Isn't Compliant
If you can't find price information on a hospital's website:
- Call the hospital's patient financial services department and ask directly
- File a complaint with CMS:cms.gov/hospital-price-transparency/contact-us
- Consider choosing a more transparent facility
The Bottom Line
Hospital price transparency is a powerful tool—but only if you use it. Before scheduling any non-emergency procedure:
- Get the CPT code from your doctor
- Compare prices at multiple facilities
- Ask your insurance about in-network status and your expected cost share
- Consider freestanding centers for imaging and outpatient procedures
Taking 30 minutes to compare prices can save you hundreds or thousands of dollars.
About the Author
This article was written by the USHealthCosts.com editorial team and reviewed by Michael Torres, our Senior Data Analyst. Last updated: December 18, 2025.