Clear Hospital Costs

Methodology

Where the Data Comes From

All pricing data on this site comes from machine-readable files that hospitals are required to publish under the CMS Price Transparency Rule (45 CFR § 180).

This rule, which took effect on January 1, 2021, requires every hospital operating in the United States to make public a machine-readable file containing their standard charges for all items and services. As of April 1, 2026, CMS has strengthened enforcement, with penalties of up to $5,500 per day for large hospitals that fail to comply.

These files are published on hospital websites and are available to anyone. We download them directly. We do not use any third-party data intermediaries. For more information about the rule, see the CMS Hospital Price Transparency page.

What We Display

From each hospital's pricing file, we extract and display:

  • Numeric procedure codes (HCPCS, DRG, APC): these are public domain identifiers
  • Hospital-provided descriptions: the text hospitals use in their own files to describe each item
  • Gross charges: the hospital's list price before any discounts
  • Cash/self-pay prices: discounted rates for uninsured patients
  • Payer-specific negotiated rates: what each insurance plan actually pays, as published by the hospital

We write our own consumer-friendly headings for page titles and section headers. The pricing data itself is displayed as published by the hospitals.

What We Do Not Display

  • AMA CPT® descriptors: CPT is a registered trademark of the American Medical Association. We display procedure codes (which are public domain facts) and hospital-provided descriptions. We do not use AMA CPT descriptors.
  • Out-of-pocket cost estimates: Your actual cost depends on your specific insurance plan, deductible, co-insurance, and other individual factors. We cannot estimate this and do not attempt to.

We do display payer-specific negotiated rates where hospitals publish them in their transparency files. This is the data showing what each insurance plan actually pays, and it is published by the hospitals themselves as required by CMS.

How We Process the Data

Hospital pricing files come in various formats, most commonly JSON and CSV. Our data pipeline performs the following steps:

  1. Format detection: Identify whether the file is JSON, CSV, or another format
  2. Procedure code mapping: Match items to common procedure codes (MRI, colonoscopy, ER visits, etc.)
  3. Rate extraction: Extract gross charges, cash prices, and payer-specific negotiated rates
  4. Quality checks: Validate that extracted prices are within reasonable ranges and flag anomalies for manual review

We do not modify prices. If a hospital's file contains an unusual value, we display it as published and link to the source file so you can verify.

How We Keep Data Current

Hospital pricing files can change at any time. We maintain data freshness through a systematic approach:

  • We check hospital pricing files for changes every week using lightweight HTTP requests that detect whether a file has been modified without downloading the full file
  • When a hospital updates their file, we re-download and re-extract the data, typically within 7 days of the change
  • Every pricing page on this site shows two dates: when the hospital last updated their file, and when we last accessed it
  • We link directly to the hospital's source file so you can verify the data yourself at any time
  • If a hospital's data has not been updated for more than 90 days, we add a prominent warning to affected pages

Despite weekly checks, we cannot guarantee real-time accuracy. Hospital prices can change between our checks. Always confirm pricing directly with the hospital or your insurance provider before scheduling any procedure.

Limitations

There are important limitations to the data we display:

  • Not all hospitals publish complete pricing files. Some files are missing negotiated rates, cash prices, or certain procedure categories.
  • Some published files contain errors or omissions. We display data as published.
  • Prices change over time and our data may not reflect the most current charges.
  • Published prices are gross charges and facility fees. Your actual out-of-pocket cost depends on your insurance plan, deductible, co-insurance, and individual circumstances.
  • Facility fees do not include separately billed items such as physician fees, anaesthesia, lab work, or pathology.

For our full legal terms covering data accuracy and liability, see our Terms of Use.

CPT Code Disclaimer

We display procedure codes and hospital-provided descriptions. We do not use AMA CPT® descriptors. CPT is a registered trademark of the American Medical Association.

Questions or Corrections

If you have questions about our methodology or believe any data is incorrect, please contact us. We review all reports and correct verified errors within 5 business days.