Data Source

The CMS Hospital Price Transparency Rule

Since January 1, 2021, the Centers for Medicare & Medicaid Services (CMS) has required every hospital in the United States to publish a machine-readable file of their standard charges for all items and services they provide. This is federal law — hospitals that fail to comply face civil monetary penalties.

These files contain the actual rates hospitals have negotiated with individual insurance plans, their chargemaster (list) prices, discounted cash pay rates, and de-identified minimum and maximum negotiated charges. This data was previously completely hidden from patients.

📋 What the law requires hospitals to publish:

Gross charges (the "sticker price" before any discounts)
Payer-specific negotiated rates for all commercial insurance plans
Discounted cash pay price (for uninsured / self-pay patients)
De-identified minimum and maximum negotiated charges
All services, including procedures, drugs, room fees, and supplies

→ CMS Hospital Price Transparency official page

⚖️ Accuracy statement

Hospitals are legally required under 45 CFR § 180 to publish accurate, current standard charge information. careprices.ai does not independently verify or audit the prices that hospitals publish. We collect and display the data hospitals have filed; we cannot guarantee its accuracy or completeness. If you believe a price on our site is incorrect, please use the reporting form below or contact the hospital directly.

Expanded Coverage

ASCs and Imaging Centers: Now Covered by Federal Transparency Rules

Price transparency requirements don't stop at hospital walls. Under CMS regulations, ambulatory surgery centers (ASCs) and imaging centers are also required to publish standard charge information — and CarePrices is expanding to include these facility types.

                🏥 What CMS 45 CFR § 180.50 covers:
                6,500+ Ambulatory Surgery Centers (ASCs) — outpatient facilities where same-day surgical procedures are performed, from cataract surgery to knee arthroscopy
18,500+ Imaging Centers — standalone radiology facilities providing MRI, CT scan, X-ray, mammography, and ultrasound services
Same price transparency obligations as hospitals: gross charges, cash pay rates, and payer-negotiated rates

            

💡 Why ASCs and imaging centers matter for patients:

ASCs typically cost 40–60% less than hospitals for the same outpatient procedures, according to CMS data
Standalone imaging centers often charge 50–75% less than hospital-based imaging for identical scans
Many procedures done in a hospital outpatient department can be safely performed at an ASC or imaging center — but patients rarely know this option exists, let alone what it costs

→ CMS ASC Payment System reference

CarePrices is actively expanding its database to include ASC and imaging center pricing data. Our existing hospital coverage (6,500+ facilities, 11.5B+ data points) forms the foundation — ASC and imaging center integration is in progress through our facility data pipeline.

Data Collection

How we collect and process the data

We continuously collect, normalize, and maintain price transparency files from 6,500+ hospitals across the United States — with ASC and imaging center coverage expanding. Here's our process:

1

Collection from hospital websites

We retrieve machine-readable price transparency files directly from hospital websites. These files are published in a variety of formats — CSV, JSON, and Excel — and vary significantly in structure between facilities.

2

Normalization and standardization

Raw hospital files use inconsistent naming, code systems, and structures. We normalize procedure names, standardize CPT/HCPCS/DRG codes, and map each line item to a consistent category. This is the hardest part — a knee replacement might be listed under 14 different names across different hospitals.

3

Quality and completeness filtering

Many hospital files contain errors, missing values, or placeholder prices (e.g., "$0.01" or "$9,999,999"). We apply validation filters to exclude records that fail basic plausibility checks or appear to be data entry errors.

4

Geographic and facility attribution

Each price record is attributed to a specific facility with location data (city, state, ZIP) and facility type (hospital, surgery center, imaging center). This enables location-based searches and fair comparisons.

5

Ongoing updates

CMS requires hospitals to update their price files at least annually. We monitor for new file releases and update our database on a rolling basis. Stale data is flagged or removed.

Understanding the Data

What do the different price types mean?

The price transparency files contain several types of prices, and they mean very different things. Here's how to interpret each one:

Price Type	What It Is	Who Pays This
Gross Charge (Chargemaster)	The hospital's "list price" — the highest possible amount before any discounts or negotiations	Almost no one. It's the starting point for negotiation.
Discounted Cash Pay	The self-pay or uninsured rate. Most hospitals are required to offer this discount to uninsured patients.	Uninsured patients, or patients who choose to pay out-of-pocket instead of using insurance
Payer-Negotiated Rate	The rate a specific insurance company has negotiated with this hospital for this service	What the insurer pays after your deductible is met. Your cost-sharing (copay/coinsurance) is calculated on top of this.
De-identified Min/Max	The lowest and highest negotiated rates across all payers at this facility	Useful for understanding the range of negotiated rates

When we display prices in our cost guides and comparison tool, we show the range of cash pay and negotiated rates to give you a realistic picture of what care costs at each facility — not just the inflated gross charge.

Important Limitations

What this data can and cannot tell you

We believe patients deserve honest, accurate information. That means being transparent about what our data can't do, not just what it can.

⚠️ This data has real limitations

Your actual out-of-pocket cost depends on your specific insurance plan — deductible status, copay structure, in-network vs. out-of-network, and whether prior authorization is required all affect what you'll owe.
Prices change — hospital files are updated at least annually, but contracts are renegotiated and prices shift. A rate from 12 months ago may not reflect today's reality.
Procedures are bundled differently at different hospitals — a "knee replacement" at one hospital may include anesthesia and post-op PT; at another, it may not. Always confirm what's included in a quoted price.
Not every facility is compliant — some hospitals have been slow to comply with the transparency rule, and their files may be incomplete or missing entirely.
Physician/professional fees are separate — hospital facility fees don't include the surgeon's fee, radiologist's fee, or other professional charges, which are billed separately.

Use careprices.ai to understand the range of prices and identify facilities worth investigating further. Then contact the facility directly for a personalized cost estimate before scheduling any procedure.

Our Commitment

Why we built this, and how we maintain standards

careprices.ai was built by Brad Gambill, founder of Care Decisions Labs, with a single mission: give patients access to the pricing information they need to make informed decisions before receiving care — not weeks later when the bill arrives.

The federal price transparency law was a landmark achievement. But publishing raw machine-readable files that require a data engineer to parse isn't the same as making prices accessible to ordinary people. We do the hard work — collecting, normalizing, and presenting 11.5 billion+ data points from 6,500+ hospitals, with ASC and imaging center coverage expanding — so that anyone can search in seconds.

                Our standards:
                We only publish data from official, federally mandated hospital price transparency files
We do not fabricate, estimate, or interpolate prices — every data point traces back to a source file
We clearly distinguish between price types (chargemaster vs. cash pay vs. negotiated)
We display disclaimers on every page to ensure prices are used appropriately
We never sell your personal data or search history

            

Have questions about our data or methodology? Contact us — we're happy to explain our process or address specific concerns.

Errors & Disputes

Found a pricing error? Here's how to report it.

We display data exactly as published by hospitals in their federally mandated price transparency files. Occasionally, hospitals publish incorrect, outdated, or placeholder values. If you encounter a price that appears wrong, we take it seriously.

1

Report to us directly

Use our contact form and include: the procedure name, the hospital name, the price you saw, and what you believe the correct price is (with any supporting documentation if available). We'll investigate and update our data within 5 business days.

2

Contact the hospital directly

If a hospital's published price differs from what you were actually charged, contact the hospital's patient financial services department. Under 45 CFR § 180, hospitals are responsible for maintaining accurate price files. You can also request a detailed cost estimate before any scheduled procedure.

3

Report non-compliance to CMS

If you believe a hospital is not complying with federal price transparency requirements, you can file a complaint with CMS at cms.gov/hospital-price-transparency/complaint. Non-compliant hospitals face civil monetary penalties.

📬 Contact us about data issues

Email: bgambill@caredecisionslabs.com — or use our contact form. Include "Price Dispute" in the subject line and we'll prioritize your report.

Where our pricing data comes from — and what it means