In this guide
Since 1 January 2021, US hospitals have had to publish their prices online: a machine-readable file of standard charges, including the discounted cash price, plus a consumer-friendly list of "shoppable" services or a price estimator. If you pay out of pocket, the cash price is the number to use, and you should ask the hospital to confirm it in writing.
The rule in brief
Under the federal hospital price transparency rule, each hospital must publish:
- A machine-readable file with its standard charges for all items and services, including gross charges, discounted cash prices, the rate negotiated with each insurer, and the lowest and highest negotiated rates.
- A consumer-friendly display of at least 300 shoppable services (services you can schedule in advance), or an online price estimator.
CMS tightened the rules for 2026 and has enforced the new version since 1 April 2026. If you can't find a hospital's prices online, you can file a complaint with CMS.
Step by step
- Search for the hospital's name plus "price transparency" or "standard charges."
- Start with the estimator or shoppable-services list. It's far easier to read than the full file.
- Find your service. Use the plain name ("MRI brain without contrast") or the billing code if you have it from your doctor.
- Note the discounted cash price. That's the self-pay price.
- If you're insured, look at your insurer's negotiated rate too, and check what your plan says you'd pay.
- Ask for it in writing before you book. If you're uninsured or self-pay, request a Good Faith Estimate (see below).
The three prices you'll see
| Price | What it means |
|---|---|
| Gross charge | The "sticker price." Almost nobody pays it, but it anchors everything else. |
| Payer-specific negotiated rate | What a given insurer has agreed to pay. Your share depends on your plan. |
| Discounted cash price | What the hospital charges people paying themselves. |
Compare across settings
The same scan can cost very different amounts at a hospital outpatient department and at an independent imaging center. Hospital-owned clinics may also add a facility fee on top of the doctor's fee. Ask before booking: "Is this location hospital-owned, and is there a facility fee?"
Your right to a Good Faith Estimate
If you're uninsured or choose not to use insurance, the No Surprises Act gives you the right to a Good Faith Estimate before scheduled care. If a provider's final bill is $400 or more above its estimate, you can start a federal dispute process within 120 days of the bill. Tell the provider up front that you're paying yourself, and keep the estimate.
How we use these files
We use hospital price files and published self-pay schedules as the US side of our price comparisons with hospitals abroad, always with the date and source.
Sources
- CMS: hospital price transparency cms.gov
- CMS: hospital price transparency fact sheet (March 2026, PDF) cms.gov
- CMS: dispute a medical bill (Good Faith Estimate) cms.gov
- InvestigateTV "Costly Care": facility fees (Jul 2026) kfvs12.com
Please note. General information, not legal or billing advice.
Reviewed at least every three monthsNo paid placementsInformation, not medical adviceOur editorial standards
Joe Yang, PhD, Economics. Joe Yang holds a PhD in economics from the University of Washington. For four years Joe evaluated the costs and savings of US health programs for insurers and employers at a health-analytics company, and before that studied pricing and demand as an economist at Amazon and a data scientist at Oracle. These guides apply the same discipline to a simpler question: what care really costs, and where.
