Hospitals must publish their prices — here's the rule
Since January 1, 2021, federal regulations at 45 CFR Part 180 require every hospital operating in the United States to publish its standard charges for the items and services it provides. The rule implements a provision of the Public Health Service Act and is enforced by the Centers for Medicare & Medicaid Services (CMS). There are two separate requirements.
1. A comprehensive machine-readable file
Every hospital must post a single machine-readable file listing the standard charges for all items and services. As of July 1, 2024, that file has to follow a standardized CMS template, in CSV or JSON format, with a defined data dictionary — which is what makes it possible to compare hospitals at all. The file must include four kinds of standard charge:
- Gross charge — the chargemaster list price, before any discount.
- Discounted cash price — what a self-pay patient is charged.
- Payer-specific negotiated charge — the rate for each insurer and plan.
- De-identified minimum and maximum negotiated charges — the range across all payers.
Recent updates also require hospitals to encode an estimated allowed amount (what a plan actually pays) and to attest that the data is true and complete.
2. A consumer-friendly display of 300 shoppable services
Separately, each hospital must present prices for 300 "shoppable" services in a consumer-friendly format — or offer a price-estimator tool that gives a personalized out-of-pocket estimate. Shoppable services are the ones you can plan ahead for: imaging, lab tests, common procedures, scheduled surgery.
Why the files are hard to use (and where we come in)
The data exists, but it's not built for humans. The machine-readable files are often hundreds of megabytes, formatted differently by every hospital, and full of billing codes without plain-English labels. Compliance is also uneven — some hospitals publish clean, complete files; others publish incomplete or hard-to-parse data.
OpenHospitalCost reads those public files, normalizes them into comparable prices, and makes them searchable by procedure, hospital, and state — with every number dated and linked back to its source file. We don't estimate or model; we show what the hospital reported. How we source this →
How to use the law to your advantage
- Compare before non-emergency care. The whole point of the rule is to let you shop. Look up the procedure and compare hospitals near you.
- Check a bill against the published rate. If you're billed more than a hospital's own published cash or negotiated price, that's leverage to ask for the documented rate.
- Ask for the cash price. It's one of the four charges hospitals must publish, and it's sometimes lower than the negotiated insurance rate.
- Confirm before you book. Files are dated and can lag, so verify the current number with the hospital.
A note on accuracy
These figures are published data for comparison, not a quote. Coverage is partial and growing, some files are incomplete, and your actual cost depends on your care and your insurance. Always confirm directly with the hospital and your insurer.
Frequently asked questions
Are hospitals required to publish their prices?
Yes. Since 2021, federal rule 45 CFR §180 requires every US hospital to publish its standard charges — gross, cash, and negotiated — in a machine-readable file, plus a consumer-friendly display of 300 shoppable services or a price-estimator tool.
What prices are in a hospital's machine-readable file?
Four kinds: the gross (list) charge, the discounted cash price, the payer-specific negotiated rate for each plan, and the de-identified minimum and maximum negotiated charges.
When did hospital price transparency become law?
The regulations took effect January 1, 2021. A standardized CMS file template became required July 1, 2024.
Why are the price files so hard to read?
They're built for machines, not people — often very large, inconsistently formatted, and full of billing codes. Sites like OpenHospitalCost translate them into searchable, plain-English prices.
Related
Prices in this guide are as of June 2026 and link to the live page for current figures. Published data is for comparison, not a quote — always confirm with the hospital. Spotted something off? Submit a correction.