Research · Q2 2026

Hospital Price Transparency: cash-price spread across U.S. hospitals, Q2 2026

We analyzed published Hospital Price Transparency files from a curated set of U.S. hospitals to characterize the variation in cash-pay prices for twelve commonly-billed procedures. For every featured procedure, the published cash price varies by a factor of one hundred or more across hospitals. We compare median cash prices to Medicare-allowed amounts from the CMS Physician Fee Schedule.

Last reviewed June 2026 · MediBill Saver Editorial Team

At a glance

  • We analyzed 185,649 rate observations from 1,224 hospitals across 56 states.
  • Published cash prices vary by at least 100× for every featured procedure; the widest spread observed was 6,304× on CPT 83036 (hemoglobin a1c).
  • The procedure with the highest median cash ÷ Medicare allowed ratio in our sample was CT head, no contrast (CPT 70450) at 10.65× the Medicare-allowed amount.
  • HPT data is current as of May 12, 2026. Sample is the federally-mandated HPT files published by each hospital under 45 CFR §180.50.

Scope

The analysis covers federally-licensed U.S. hospitals whose Hospital Price Transparency files are present in the dataset MediBill Saver ingests. Our HPT ingest covers a subset of U.S. hospitals; we do not extrapolate from this sample to publication compliance across all hospitals. The cash-pay figures shown are what each hospital publishes in its own HPT file; we do not characterize the published prices as appropriate or inappropriate.

Coverage in this analysis:

  • 1,224 hospitals contributing rate data.
  • 2,974 distinct CPT/HCPCS codes observed.
  • 185,649 individual rate rows across all hospitals and rate types.
  • 56 U.S. states represented.

Top five states by federally-registered hospital count:

  • TX 465
  • CA 378
  • FL 222
  • OH 196
  • IL 194

Findings — cash price vs. Medicare allowed amount

For each featured procedure we report the median published cash-pay price across all hospitals in our HPT sample, compare it against the corresponding Medicare-allowed amount from the CMS Physician Fee Schedule (national, non-locality-adjusted), and show the price spread observed across hospitals. Procedures are grouped by category.

Imaging

CPTProcedureHospitalsMedian cashMedicare allowedMedian ÷ MedicareMax ÷ Min
70450CT head, no contrast794$1,172.90$110.1810.65×193×
71045Chest x-ray, single view791$207.00$26.237.89×2,064×
76700Abdominal ultrasound, complete765$632.06$118.235.35×1,162×
70551MRI brain, no contrast747$1,748.00$202.188.65×288×

Lab

CPTProcedureHospitalsMedian cashMedicare allowedMedian ÷ MedicareMax ÷ Min
80048Basic metabolic panel747$93.00290×
80053Comprehensive metabolic panel739$127.352,447×
80061Lipid panel729$94.50359×
83036Hemoglobin A1c698$68.706,304×
84443Thyroid stimulating hormone (TSH)685$94.20604×
85025Complete blood count with differential683$65.88474×

Visit

CPTProcedureHospitalsMedian cashMedicare allowedMedian ÷ MedicareMax ÷ Min
99213Office visit, established patient, level 3431$146.30$97.781.50×605×
99214Office visit, established patient, level 4387$176.50$139.161.27×61×

Findings — full price-spread distribution

The same procedures, with the published cash price at five points of the distribution — minimum, 25th percentile, median, 75th percentile, maximum — across the hospitals that publish each code. These figures answer the question “what range of cash prices is published for the same procedure across U.S. hospitals.”

CPTProcedureMinP25MedianP75Max
70450CT head, no contrast$39.07$808.49$1,172.90$1,642.50$7,526.00
71045Chest x-ray, single view$11.17$135.00$207.00$271.00$23,056.67
76700Abdominal ultrasound, complete$12.00$421.80$632.06$849.36$13,938.97
70551MRI brain, no contrast$37.44$1,146.60$1,748.00$2,427.00$10,764.00
80048Basic metabolic panel$5.36$55.51$93.00$147.71$1,554.60
80053Comprehensive metabolic panel$6.62$72.64$127.35$191.32$16,200.00
80061Lipid panel$3.83$60.16$94.50$144.50$1,375.12
83036Hemoglobin A1c$2.95$42.61$68.70$97.00$18,597.80
84443Thyroid stimulating hormone (TSH)$1.22$67.52$94.20$138.71$736.35
85025Complete blood count with differential$2.14$41.77$65.88$95.22$1,013.34
99213Office visit, established patient, level 3$13.88$91.28$146.30$226.80$8,402.24
99214Office visit, established patient, level 4$39.68$121.32$176.50$252.71$2,425.81

Methodology

Data sources.Hospital Price Transparency files published by U.S. hospitals under 45 CFR §180.50; CMS Physician Fee Schedule rates published by the Centers for Medicare & Medicaid Services under 42 USC §1395w-4; CMS Hospital Compare facility registry. All three sources are public-domain federal data (17 USC §105). See /methodology for the source-by-source documentation.

Cash-pay aggregation. For each featured CPT we union published rates labeled as cash-pay, self-pay, discounted cash, or similar variants (HPT files use inconsistent column labels across hospitals). Zero and negative values are excluded as data-quality artifacts. Percentiles are computed with percentile_disc on the de-duplicated rate set.

Medicare comparison. For each CPT we use the most-recent national-average CMS Physician Fee Schedule rate (modifier-blank). Locality geographic-practice-cost adjustments are not applied; published HPT cash prices are not locality-adjusted either, so the comparison is like-for-like.

What this is and isn’t.The report describes the variation in published cash prices across our HPT sample. It is not a claim about what hospitals should charge; hospitals legally set their own prices. It is not an audit of any individual hospital. Higher published cash prices do not imply higher paid prices — most patients pay insurance-negotiated rates, charity-care discounts, or self-pay discounts off the published cash price.

Foundation methodology DOI. The audit’s cross-source methodology is published on Zenodo at 10.5281/zenodo.20232731 under CC BY 4.0.

How to cite

MediBill Saver Editorial Team. (2026). Hospital Price Transparency: cash-price spread across U.S. hospitals, Q2 2026. Zenodo. https://doi.org/10.5281/zenodo.20320259

Reporters and editors who would like a press summary, charts, or a methodology call can email press@medibillsaver.com.

Editorial standard

Per the editorial standard documented across our research, this analysis states facts, cites sources, and does not characterize any hospital, provider, or insurer. It does not claim what a charge should cost. Findings are framed as comparisons against federal benchmarks; underlying data is public and verifiable. See /press for the guidance we ask reporters to follow.