Short, plain explainers on how hospital prices work and how to use the published prices on this site for Texas and Florida hospitals. General information only, not medical or legal advice.
The No Surprises Act gives self-pay patients a right to a good faith estimate and generally limits some surprise out-of-network bills. This guide explains what the law covers and how a price list relates to an estimate.
4 min readA hospital can list several prices for one service: a gross charge, a discounted cash price and different negotiated rates for each insurer. This guide explains why they can differ and how to compare them.
4 min readAn itemized hospital bill lists each service and supply separately. This guide explains the columns, codes and units, how charges differ from adjustments and the patient balance, and how to ask a hospital for an itemized statement.
4 min readA hospital chargemaster is a master list of gross charges. Those list prices differ from what insurers pay and what many self-pay patients are offered. This guide explains how gross charges, cash prices and negotiated rates fit together.
4 min readLearn who to call at a hospital, which codes and details to have ready, and what to ask for in writing when seeking a self-pay price for a scheduled service before it is booked.
5 min readMany hospitals offer financial assistance, also called charity care. This guide explains what nonprofit hospitals must have under IRS section 501(r), how eligibility differs by hospital, and the steps for applying, including after a bill arrives.
4 min readOne hospital visit can generate separate bills from the hospital and from the physicians involved. This guide explains facility fees, professional fees, and why the prices on this site cover the facility side only.
5 min readTwo MRIs of the same body part can carry very different prices. This guide explains billing codes with and without contrast, hospital versus imaging center settings, insurer contracts, and cash discounts, so the numbers on paperwork make more sense.
4 min readHospitals must post their prices online in two forms: a large data file and a patient-friendly display of services. This guide explains what each contains, where hospitals post them, and what they cannot tell you.
5 min readHospitals must post prices under a federal rule, including a set of shoppable services patients can schedule in advance. This guide explains what that means and why planned care is generally easier to compare than emergencies.
4 min readLearn how to read an itemized bill, compare it with the hospital's posted prices, ask about self-pay discounts, payment plans and financial assistance, and keep clear records of every call and letter along the way.
5 min readWith a high-deductible health plan, the insurer's negotiated rate is often what a member pays before the deductible is met. This guide covers finding that rate, asking your insurer for an estimate, and comparing in-network hospitals.
4 min readCPT, HCPCS and MS-DRG codes are the shorthand hospitals use in price files and bills. This guide covers who maintains each system, where the codes show up, and why one procedure name can map to several codes.
4 min readA plain guide to how hospital emergency room visits are billed by level, how urgent care billing generally differs, and what the No Surprises Act says about emergency services. General information only, not medical advice.
4 min readA plain walkthrough of comparing hospital prices on Clear Hospital Costs: where to start, what the cash, gross and insured columns mean, and what the numbers cannot tell you about a final bill.
4 min read