Hospital prices

Read it this way Every service line sits above the Medicare reference line, from substance abuse and mental health at 134.5 percent up to emergency department and imaging at over 330 percent. The markup is not uniform, so a single national average hides which services are priced furthest above cost. Use this chart to see which dimension of price variation is being shown, payer, hospital, service line, state, or compliance, and how it supports stronger transparency and benchmarking.

RAND, Prices Paid to Hospitals by Private Health Plans (Round 5.1) · 2022 · source

Read it this way Darker tiles mark states where private plans pay hospitals the most relative to Medicare. Maryland is shown as no-data rather than zero because it sets hospital rates for all payers, so its absence on the map is a methodology choice, not a low markup. Use this chart to see which dimension of price variation is being shown, payer, hospital, service line, state, or compliance, and how it supports stronger transparency and benchmarking.

Caveat 49 states plus the District of Columbia. Maryland is excluded because of its all-payer rate-setting program and is rendered as no-data, never as zero.

RAND, Prices Paid to Hospitals by Private Health Plans (Round 5.1) · 2022 · source

Read it this way Every dot sits above the Medicare line, and the ranked view makes the 2.1x spread between Florida's 346 percent and Arkansas's 162.4 percent explicit in a way the shaded map cannot. Use this to compare specific states rather than reading color intensity by eye. Use this chart to see which dimension of price variation is being shown, payer, hospital, service line, state, or compliance, and how it supports stronger transparency and benchmarking.

Caveat 49 states plus the District of Columbia. Maryland is excluded because of all-payer rate-setting.

RAND, Prices Paid to Hospitals by Private Health Plans (Round 5.1) · 2022 · source

Read it this way Each hospital's bar shows how much its own price varies by insurer, not just how hospitals differ from one another. The highest rate anywhere is 3.97 times the lowest, confirming the identical procedure has no fixed price even within one hospital. This is illustrative single-metro simulated data, not a national figure. Use this chart to see which dimension of price variation is being shown, payer, hospital, service line, state, or compliance, and how it supports stronger transparency and benchmarking.

Caveat Illustrative, one metro, 12 hospitals, 5 payers, from simulated machine-readable-file data. Across all of them the highest rate is 3.97 times the lowest for the same procedure.

Hospital machine-readable files, CMS Hospital Price Transparency rule · 2024 · source

Read it this way Every shoppable service shows a 3-to-4x gap between the cheapest and priciest hospital for the identical code, so the colonoscopy spread charted beside it is not an outlier. This is illustrative single-metro data and should not be read as a national ratio. Use this chart to see which dimension of price variation is being shown, payer, hospital, service line, state, or compliance, and how it supports stronger transparency and benchmarking.

Caveat Illustrative single-metro, simulated data. Every shoppable service shows a 3-to-4x gap for identical care.

Hospital machine-readable files, CMS Hospital Price Transparency rule · 2024 · source

Read it this way Nine insurer plans pay nine different negotiated rates for the same knee replacement in the same building, from $12,307.79 to $37,656.23. Because the price is a negotiated outcome rather than a cost of care, which plan a patient carries can triple what gets billed, independent of which hospital they choose. Use this chart to see which dimension of price variation is being shown, payer, hospital, service line, state, or compliance, and how it supports stronger transparency and benchmarking.

Caveat Illustrative single-hospital, simulated data. UnitedHealthcare's plan lands at $12,308 while Humana's sits at $37,656 in the same building.

Hospital machine-readable files, CMS Hospital Price Transparency rule · 2024 · source

Read it this way Compliance climbed for two years, peaked at 36 percent, then reversed and fell to 21.1 percent by November 2024. A reading that stops at 'transparency is improving' would miss that the trend turned negative in its most recent points. The caveat notes these are PatientRightsAdvocate.org's strict scores, which hospital groups dispute. Use this chart to see which dimension of price variation is being shown, payer, hospital, service line, state, or compliance, and how it supports stronger transparency and benchmarking.

Caveat These are PatientRightsAdvocate.org scores under a strict definition, not CMS's official figure, and hospital groups dispute the methodology. The September 2025 report stopped publishing a single compliance percentage, so 21.1 percent is the last comparable value.

PatientRightsAdvocate.org, Semi-Annual Hospital Price Transparency Reports · 2024 · source

Read it this way Three-quarters of reviewed hospitals now post prices as algorithms an expert is needed to interpret, and 43 percent post fewer usable prices than a year earlier. Read this alongside the compliance-percent chart as evidence hospitals can satisfy a checkbox requirement while making the actual price harder to find. Use this chart to see which dimension of price variation is being shown, payer, hospital, service line, state, or compliance, and how it supports stronger transparency and benchmarking.

Caveat PatientRightsAdvocate.org September 2025 interim report, kept off the compliance-percent line above because it measures a different thing. AHA and HFMA dispute the methodology.

PatientRightsAdvocate.org, Semi-Annual Hospital Price Transparency Reports · 2025 · source