Since 2021, hospitals are legally required to post their prices online. In practice, finding these files takes some digging — but the information is there. Here's how to find it and what to do with it.
Method 1: Hospital price transparency files
Every hospital that accepts Medicare must publish a machine-readable file with all standard charges. To find it:
- Go to the hospital's website
- Search for "price transparency," "standard charges," or "chargemaster"
- Download the CSV or JSON file — it will contain chargemaster prices AND negotiated rates by payer
- Search by CPT code (procedure code) for your specific service
The negotiated rates by payer are especially valuable — they show what your insurer actually pays, not just the inflated list price.
Method 2: Third-party price tools
Several tools aggregate hospital price data and make it more searchable:
- BillKarma — look up any CPT code against the Medicare rate and see how your hospital's charge compares
- RAND Hospital Price Transparency — research tool comparing commercial rates across hospitals
- Turquoise Health — consumer tool for searching negotiated rates by hospital and insurer
- CMS.gov — official Medicare rates searchable by CPT code and geography
Method 3: Ask the hospital directly
For scheduled (non-emergency) procedures, you have the right to a Good Faith Estimate under the No Surprises Act. Call the hospital's billing department and ask:
- "What CPT code will be used for this procedure?"
- "What is your self-pay or cash-pay rate for this procedure?"
- "Can I get a Good Faith Estimate in writing?"
Many hospitals have a separate self-pay rate that's 30–60% lower than the chargemaster. You have to ask — it's not offered automatically.
Using Medicare rates as your benchmark
The Medicare rate is the most reliable benchmark for judging whether a hospital price is fair. Look up the Medicare rate for any CPT code on BillKarma, then apply this rule of thumb:
- Under 2x Medicare: fair price
- 2–3x Medicare: typical / acceptable
- 3–5x Medicare: high — negotiate or look for alternatives
- Over 5x Medicare: very high — strong grounds for negotiation or dispute
What to do with the price information
- Get quotes from 2–3 hospitals if the procedure is non-emergency. Prices for the same procedure at hospitals in the same city can vary by 5–10x.
- Call your insurer to verify the facility is in-network and get your estimated cost-sharing before scheduling.
- Negotiate upfront. If you can pay at time of service, many hospitals offer 10–20% discounts.
- After the procedure, audit the itemized bill against the quoted CPT codes to make sure you were only billed for what was discussed.