How to read hospital prices

Since 2021, federal law requires every U.S. hospital to publish a machine-readable file listing its prices. Those files are messy, but they contain real numbers — here's what each one means and how to use them.

The three prices you'll see

Gross charge is the hospital's list price — the "chargemaster" amount before any discount. Almost nobody pays this number, but it's the most consistently published one, so it's the fairest way to compare hospitals side by side. When CareRanks shows a single price for a procedure, it's the gross charge unless labeled otherwise.

Cash price (or "discounted cash price") is what the hospital says it charges a patient paying without insurance. It is often dramatically lower than the gross charge — sometimes lower than what you'd owe through insurance before meeting a deductible. If you are uninsured or have a high deductible, this is the number to ask about.

Negotiated rate is what a specific insurance plan has agreed to pay the hospital for a service. The same operation at the same hospital can have dozens of different negotiated rates depending on the plan. On our pricing pages, the payer picker shows the median negotiated rate we found for each insurer that appears in the hospital's file.

Why the numbers vary so much

Prices are set per hospital, per payer, per contract — not by any national schedule. A hip replacement that lists for $40,000 at one hospital can list for $200,000 at another in the same state, with no difference in quality ratings. That spread is exactly why comparison shopping matters for planned procedures. For context, we also show how a hospital's prices compare with what Medicare pays for the same service — a useful, stable yardstick.

What you'll actually pay

If you're insured, your cost depends on your plan's deductible, coinsurance, and out-of-pocket maximum — not just the hospital's price. Each CareRanks pricing page includes an out-of-pocket estimator: enter your deductible progress, coinsurance, and out-of-pocket max, and it applies them to the hospital's published numbers. It's an estimate, not a quote — but it turns a meaningless list price into a realistic range.

Where our numbers come from

We parse each hospital's own federally required price file (machine-readable file, "MRF") and standardize what we find. We never estimate or model a price: if a number is on CareRanks, a hospital published it. Files that fail our checks — for example, a file that clearly belongs to a different hospital — are excluded rather than shown. Not every hospital publishes a usable file; profiles tell you when we couldn't find or parse one.

Practical steps

  1. Find your procedure on the procedure hub and compare hospitals in your state.
  2. Open a hospital's pricing page and check the cash price and your insurer's negotiated rate, not just the list price.
  3. Use the out-of-pocket estimator with numbers from your insurance card or portal.
  4. Call the hospital's billing office and ask them to confirm the price for your exact procedure code — bring the code from our page.
  5. Ask about financial assistance; most nonprofit hospitals are required to offer it.

CareRanks shows published data for comparison purposes; it isn't a price quote or billing advice. Read more about our methodology.