Methodology details

Key Source

Since 2021 federal rules (45 CFR Part 180) have required every U.S. hospital to publish a machine-readable file of its standard charges: the list price, the discounted cash price and the rates it has negotiated with each insurer, per billing code. We locate each hospital’s file, download it, parse it and load it into one corpus, per hospital. Prices are never pooled up to a hospital system, and nothing is surveyed, sampled, modelled or estimated. A hospital whose file we cannot reach or parse is simply absent, and its absence is counted, not filled in.

Statistics

Percentiles

Discrete, never interpolated: the median and every other percentile is a price some hospital actually filed. We report the 10th, 20th, 25th, 50th, 75th, 80th and 90th.

Average of the middle 60%

The arithmetic mean of the usable prices between the 20th and 80th percentiles. It is the only average we publish, and it is always labelled as such. Unusable prices are excluded first, then the trim is applied — trimming is not a substitute for removing placeholders.

Never published

The plain mean, the minimum and the maximum. The extremes in hospital price files are chargemaster artefacts, not prices anyone pays, and a mean that includes them is not information.

Settings

Outpatient and inpatient are separate distributions and are never mixed. The outpatient figure is the headline where both exist.

Cash vs list

The median of each hospital’s own cash-to-list ratio, over hospitals where both are usable — not the ratio of two medians.

Thresholds

• A procedure gets a report page only when at least 100 hospitals have a usable cash price for it in a setting.
• A state shows a figure only with at least 10 hospitals; a hospital segment (type, ownership, system affiliation) only with at least 20. Below that the row shows its count and no number.
• A figure that was not computed is shown as not available. We never print a zero in place of a missing number.

The Medicare comparison

Where Medicare has a separately payable national rate for a code under the hospital outpatient schedule (OPPS), the page shows it, unadjusted for locality, with the schedule year, and the median cash price as a multiple of it. Codes with no such rate show no comparison. Inpatient pages do not carry one.

Hospital type, ownership and affiliation

Hospital type and ownership come from CMS Care Compare, matched by the hospital’s CMS certification number. “Part of a system” means the hospital’s price file is published under a brand shared by at least one other hospital in the corpus.

Procedure names and codes

The billing code is the identity of every page; the plain-language title is ours. Hospitals file HCPCS codes in the same column as CPT codes, so a page shows the code’s own shape (HCPCS for a letter-plus-four-digits code). Codes priced per unit and codes that are not a valid billing code are not given pages.

How current the figures are

Hospitals will periodically change their prices. We make no guarantees that our prices are fully up to date. Check with providers for the latest prices.

Limitations

• A price is the hospital’s published charge for a specific code. Actual treatment may involve several different codes. Follow-up care is often billed separately.
• A published price is not a quote. Hospitals update files, make errors and apply financial assistance; confirm with the hospital before care.
• Coverage is not complete. Some hospitals’ files cannot be reached or parsed, and some codes are filed by few hospitals; where a page shows a completeness ledger, it says how many contributed.
• Procedure reports may not include any or all negotiated rates.