Hospital Price FAQ & Guides
Plain-English answers about why hospital prices vary so much, what the different prices mean, and how to use them to pay less for care.
Why does the same procedure cost so much more at one hospital than another?
Hospital prices are set by negotiation, not by a national price list. Each hospital negotiates separately with each insurer, so the same service can have dozens of different prices even within one building — and prices between hospitals a few miles apart routinely differ by several times. The price often has little to do with the quality of care. That spread is exactly why comparing before non-emergency care can save you a large amount.
What is the difference between negotiated, cash, and gross prices?
Gross (or 'chargemaster') is the hospital's list price before any discount — almost nobody actually pays this. Negotiated is the rate a specific insurance plan has agreed to pay, and it varies by insurer. Cash (or 'discounted cash') is the price for a self-pay or uninsured patient paying directly. Surprisingly, the cash price is sometimes lower than the negotiated insurance rate, so it can be worth asking for the cash price even if you have insurance.
Should I ever pay the cash price instead of using my insurance?
Sometimes, yes. If your deductible is high and you haven't met it, the hospital's cash price can be lower than what you'd pay toward your deductible at the negotiated rate. Ask the hospital's billing office for the self-pay or cash price in writing and compare it to your expected out-of-pocket cost. Note that paying cash usually means the amount won't count toward your deductible, so weigh that if you expect more care this year.
Are hospitals required to publish their prices?
Yes. Since 2021, federal price-transparency rules (45 CFR §180) require hospitals to publish a machine-readable file listing their standard charges — gross, cash, and negotiated rates — for the items and services they provide. OpenHospitalCost reads those public files and makes them searchable. Compliance is uneven: some hospitals publish clean, complete files, while others publish incomplete or hard-to-parse data.
Where does OpenHospitalCost get its data?
Directly from each hospital's own machine-readable price transparency file, published under federal rule 45 CFR §180. We don't estimate or model prices — we show what the hospital reported, and every hospital page links back to the exact source file and the date we ingested it. If a hospital updates its file, our numbers update when we re-ingest.
How current are the prices?
Each price is dated to when we last ingested that hospital's file, and that date is shown on the hospital's page. Hospitals update their files on their own schedules — some monthly, some far less often — so always confirm the current price with the hospital before scheduling care.
Can I use these prices to negotiate my hospital bill?
Often, yes. If you've been quoted or billed more than the published rate, you can point to the hospital's own transparency file and ask to be charged the cash price or a documented negotiated rate. Bring the specific number and the source. Ask for an itemized bill, check it for errors, and request financial assistance or a payment plan if you qualify — many nonprofit hospitals are required to offer charity care.
Why do some hospitals show very few prices or none at all?
We only show hospitals whose published files we can parse into reliable, comparable prices. If a hospital's file is missing, malformed, incomplete, or uses formats that don't include usable amounts, it may show limited data or be excluded from comparison pages. We're continually expanding coverage as we improve our parsers and as hospitals publish better files.
Are these prices a guarantee of what I'll be billed?
No. The figures are for comparison and information only. Your final bill depends on your exact care, your insurance plan, complications, and the individual hospital. Always confirm directly with the hospital and your insurer before a procedure. OpenHospitalCost shows published data as-is and is not a quote.
Is OpenHospitalCost free, and how is it funded?
It's free to use. The site is supported by advertising and stays independent of hospitals and insurers — we publish their data as reported and have no financial relationship with the facilities listed.
Guides
- How to compare hospital prices — Search a procedure, read the three kinds of price, and trace every number back to its source.
- National Hospital Price Report — The biggest price swings, the priciest shoppable procedures, and where cash beats the list price.
- How we derive each price — What a 'representative facility price' means and how we keep comparisons fair across hospitals.
- Browse prices by state — See hospital pricing across all 50 states plus territories, then drill into a single facility.
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Still have a question? Contact us — or, if a price looks wrong, submit a correction.