Why does one service have several different prices?

Hospitals disclose a list price, a cash/self-pay price, and payer-specific negotiated rates. Each answers a different question, and none is a guaranteed estimate of your bill.

Which price is closest to what I would pay?

If you are uninsured or paying directly, the disclosed cash price is the most relevant. If you have insurance, your share is based on the negotiated rate and your plan's benefits — not a number you can read directly off the file.

What is the difference between setting and billing class?

Setting means inpatient or outpatient. Billing class means facility or professional. They are independent and should not be confused.

Guide

How to read hospital price transparency data

A short, practical guide to making sense of the numbers in a hospital's machine-readable file.

Start with the service and its code

Each line describes a service, often with a CPT or HCPCS code. Codes are the most reliable way to compare the same service across hospitals, because plain-text descriptions differ from one hospital to the next.

Then read the prices side by side

List price (gross charge): the full undiscounted charge. Few people pay this.
Cash / self-pay price: what the hospital discloses for paying directly without insurance.
Insurance-negotiated rate: a rate tied to a specific payer and plan.
Allowed amounts: historical reference figures, where disclosed.

Check the setting and billing class

Confirm whether a price is for an inpatient or outpatient setting, and whether it is a facility or professional charge. A “low” price for one setting is not comparable to a different setting.

Look at the source and date

On every page we show the source file URL, the file’s last-updated date when available, and when we ingested it. Always weigh how recent the data is.

Frequently asked questions

Why does one service have several different prices?: Hospitals disclose a list price, a cash/self-pay price, and payer-specific negotiated rates. Each answers a different question, and none is a guaranteed estimate of your bill.
Which price is closest to what I would pay?: If you are uninsured or paying directly, the disclosed cash price is the most relevant. If you have insurance, your share is based on the negotiated rate and your plan's benefits — not a number you can read directly off the file.
What is the difference between setting and billing class?: Setting means inpatient or outpatient. Billing class means facility or professional. They are independent and should not be confused.