Comparing Hospital Prices on This Site

Three ways into the same price data

Clear Hospital Costs publishes hospital prices for Texas, Florida and Tennessee, taken from the hospitals' own files and refreshed twice a week. The same information can be reached from three directions, and each answers a different question.

• Procedure pages start with a service, such as a scan or a colonoscopy, and show how prices differ from one hospital to the next. Browse them at all procedures.
• Hospital pages start with one facility and show its prices across many services. Browse them at all hospitals.
• Insurer pages start with a health plan and show the negotiated rates that plan has with hospitals. Browse them at insurers.

To narrow things by state, the hubs at Texas and Florida are a natural starting point.

Comparing hospitals for one service

Many people begin with a procedure page, because it puts several hospitals side by side for the same service. A few steps can make the comparison cleaner:

1. Identify the service named on your order or referral, by name or code.
2. Look at nearby hospitals and note their prices in the same column, so the comparison is like for like.
3. Check whether the service is listed under the same code at each hospital, since hospitals sometimes group or label services differently. The guide on CPT codes explains how those codes work.
4. Open the hospital pages for the facilities under consideration and look for notes on what the price includes.

City pages cover some common services, including MRI prices in Houston, CT scan prices in Miami and Fort Lauderdale, and colonoscopy prices in Dallas and Fort Worth. For the reasons the same scan can vary so much, why MRI prices vary walks through the main ones.

What the gross, cash and insured columns mean

Each price column answers a different question, and mixing them up is a common source of confusion.

Gross charge

The gross charge is the hospital's list price, kept in its chargemaster, which is its master list of gross charges. Insurers pay negotiated rates rather than list prices, so this figure often differs sharply from what is actually paid. Our guide to the chargemaster explains where these numbers come from.

Cash price

The cash price is the discounted amount many hospitals offer to someone paying without insurance. It is often lower than the gross charge, though not necessarily lower than what an insurer has negotiated. For anyone considering this route, the guide on how to ask for the self-pay price covers the conversation.

Insured, or negotiated, rate

The insured column shows the rate a specific insurer has negotiated with that hospital. Rates can differ by plan, and the insurer rates on this site can include Medicare Advantage and Medicaid managed care plans. For a closer look at how these figures relate, read cash price versus insured rate.

Using insurer pages

An insurer page can help someone with coverage see how a hospital's negotiated rate compares with its cash price or with other hospitals. A negotiated rate is not the same as what a person personally owes. That share depends on the plan's design, such as the deductible and coinsurance, and this site cannot say what any particular plan covers.

Plan design matters when reading these rates. For a member on a high-deductible plan, the negotiated rate shown here is often the amount owed for a service until the deductible has been reached. Many plans also waive cost sharing for certain preventive services delivered by an in-network provider, and the way a visit is billed, as preventive or as diagnostic, can shift what the member pays. More on this is in the high-deductible plan tips.

What these prices do not show

The numbers here are a starting point, not a quote. Several limits are worth knowing.

• Facility charges only. The prices are hospital facility charges from the hospitals' own files. Physicians such as radiologists, surgeons and anesthesiologists usually bill a separate professional fee, so a total bill can be higher. See facility fee versus professional fee.
• Not total cost. Supplies, drugs and added services may appear as separate lines on a bill. Hospital bills often list revenue codes for the department or type of service, and inpatient stays are often paid by MS-DRG, so a bill may not match the code on a price listing.
• Emergency visits are different. Hospital emergency department visits are billed by level, and the site shows hospital ER visit facility charges, not urgent care prices. The guide on ER and urgent care costs explains the billing difference. Price comparison is not meant for an emergency: if someone faces a medical emergency, the usual advice is to call 911 or head to the closest emergency room.
• Data quirks. The files come from the hospitals themselves, and clear data errors are left out as described on our methodology page.

Getting a firmer number before a scheduled service

Because posted prices are not a bill, some people take extra steps for services they can schedule in advance. These are options, not requirements:

• Ask the hospital for an itemized estimate that lists the codes it expects to bill.
• People who are uninsured or choose not to use insurance can ask for a good faith estimate under the No Surprises Act. Providers generally must give one when a service is scheduled at least 3 business days ahead, or when a patient asks. If the final bill is at least $400 more than the estimate, the patient may be able to use a dispute resolution process, which generally must be started within 120 calendar days of the bill date. Details are in the good faith estimate guide.
• Ask whether the hospital has a financial assistance policy. Nonprofit hospitals generally must have one, though each sets its own eligibility rules, and many other hospitals offer assistance with terms that vary. See hospital financial assistance.

To go deeper into the underlying files, the guides on using hospital price transparency files and shoppable services explain what hospitals must post under the federal price transparency rule. In general, hospitals must post a machine-readable file of standard charges, and a shoppable service is one a patient can schedule in advance.