Hospital Price Transparency:
Your Right to Know What Healthcare Costs
Since January 2021, hospitals are required by federal law to publicly post their prices. Here’s everything you need to know about using this data to save money.
The Rules Explained
How to Use Price Transparency Data
Find your hospital's MRF file
Check the hospital's website, usually under "Patient Resources," "Billing," "Financial Information," or "Price Transparency."CMS requires a direct link from the homepage or a clearly labeled page.
Identify your procedure
Use the CPT or HCPCS code from your doctor's order, referral, or prior authorization letter. If you don't have the code, ask your doctor's office for the specific billing codes they plan to use.
Compare prices across hospitals
The same procedure can vary 300-500% between hospitals in the same city. Check at least 3 facilities, including both hospital-based and independent (ambulatory surgery center or freestanding imaging) options.
Negotiate using price data
"Hospital B charges $X for this procedure. Can you match that?"Having concrete data from published MRF files gives you real leverage in price negotiations.
Use FairVisitHealth
We've already parsed 2.2M hospital prices and 47.0M payer rates so you don't have to. Search any procedure, compare across providers, and get a fair price estimate in seconds.
Compliance Reality Check
~36%
Hospitals fully compliant
PatientRightsAdvocate.org, 2024
5,149+
Compliance reviews conducted
CMS.gov, as of 2024
2,291
Warning notices issued
CMS.gov, as of 2024
27
Monetary penalties assessed
CMS.gov, as of 2024
Why Compliance Remains a Challenge
- •Many MRF files are incomplete, hard to find, or improperly formatted, making it difficult for consumers and researchers to use the data.
- •Some hospitals bury pricing links in obscure pages, require multiple clicks, or use file names that are difficult to locate via search engines.
- •Enforcement has been slow: of the thousands of non-compliant hospitals identified, only 27 have received monetary penalties as of 2024.
“CMS’s enforcement of the hospital price transparency requirements has been limited and inconsistent, reducing the incentive for hospitals to fully comply.”
— HHS Office of Inspector General (OIG), Compliance Review Report
Price Variations: Why Comparison Matters
These illustrative examples, based on CMS pricing data and published hospital MRF files, show how the same procedure can cost dramatically different amounts depending on where you go.
Total Knee Replacement (CPT 27447)
| Community Hospital A | $28,500 |
| Regional Medical Center B | $42,000 |
| Academic Health System C | $67,300 |
| Medicare reimbursementFacility fee only | $772 |
MRI of Lower Extremity (CPT 73721)
| Freestanding Imaging Center | $425 |
| Hospital Outpatient Dept. | $1,850 |
| Academic Medical Center | $3,200 |
| Medicare reimbursementTechnical component | $202 |
Colonoscopy with Biopsy (CPT 45380)
| Ambulatory Surgery Center | $1,200 |
| Hospital A (outpatient) | $3,400 |
| Hospital B (outpatient) | $5,800 |
| Medicare reimbursementASC rate | $376 |
C-Section Delivery (CPT 59510)
| Community Birth Center | $12,500 |
| Regional Hospital | $22,000 |
| University Hospital | $38,000 |
| Medicare reimbursementProfessional + facility | $2,274 |
Illustrative examples based on CMS pricing data and published hospital machine-readable files. Actual prices vary by location, insurance, and provider. Medicare rates shown are facility fees only and do not represent total patient costs.
Your Rights as a Patient
Right to a Good Faith Estimate
Uninsured and self-pay patients must receive a written estimate of expected charges before any scheduled or non-emergency service. If the final bill exceeds the estimate by $400+, you can dispute it.
Right to an Itemized Bill
You can request a fully itemized statement showing every charge, CPT code, and the provider who performed each service. Hospitals must comply.
Right to Dispute Charges
You can formally dispute any medical bill. Under the No Surprises Act, patient-provider dispute resolution is available for bills that exceed Good Faith Estimates.
Right to Request Cash/Self-Pay Pricing
You can ask any provider for their discounted cash or self-pay rate. Many hospitals offer 30-60% discounts for patients who pay out-of-pocket.
Right to Shop Across Facilities
For non-emergency care, you have the right to compare prices at different facilities and choose where to receive treatment based on cost and quality.
No Surprises Act Protections
Emergency care at any hospital is protected from balance billing. You pay only your in-network cost-sharing amount, regardless of the provider's network status.
Good Faith Estimate Requirement
Under the No Surprises Act, all healthcare providers and facilities must give uninsured or self-pay patients a Good Faith Estimate of expected charges before providing non-emergency services. If the final bill is $400 or more above the estimate, you have the right to dispute the charges through the patient-provider dispute resolution process.
Read our full Surprise Billing GuideHow FairVisitHealth Uses This Data
We parse machine-readable files from thousands of hospitals and insurance companies, combine them with Medicare fee schedules and other government pricing databases, and present the results in a searchable, comparable format that anyone can understand.
Our automated data pipelines refresh pricing data monthly, ensuring you always have access to current information when comparing providers and negotiating bills.
Hospital MRF files
4.2M prices
Payer TIC files
27.2M rates
Medicare fee schedules
13.5K+ procedures
CMS quality ratings
21,700+ providers
NADAC drug pricing
33,500+ NDCs
Medicaid benchmarks
4.0M rates
Frequently Asked Questions
Sources & References
Federal Rules & Legislation
This guide is provided for informational purposes only and does not constitute legal, medical, or financial advice. Information is current as of February 2026. Rules and regulations may change. Consult a healthcare billing advocate or attorney for advice specific to your situation.
Stop Overpaying for Healthcare
FairVisitHealth gives you the power of price transparency data without the hassle of reading raw hospital files. Compare prices across 9 million+ providers, find fair pricing, and negotiate with confidence.