US healthcare price transparency
How TreatCompare Uses US Hospital Price Transparency Data
TreatCompare translates hospital price transparency fields into consumer decision pages. The goal is to help people ask better questions before booking care, not to pretend a published hospital price is the same as a final patient bill.
Using this data?
Methodology, extracts and licensing
Main sources
- CMS Hospital Price Transparency overview
- CMS CSV and JSON machine-readable file template guidance
- Hospital standard-charge files (each linked on the procedure pages)
- CMS Physician Fee Schedule, relative value file RVU26D
- CMS ambulatory surgical center rates, Addendum AA (October 2026)
Methodology: How TreatCompare reads hospital standard-charge files and the CMS Medicare fee schedules into the US procedure pages. Hospital files read: 183 of 238 hospitals, 51 of 51 states, between May 14, 2026 and November 6, 2026.
TreatCompare publishes healthcare, care-cost and treatment-pricing research for consumers, journalists, policymakers and commercial teams.
Core fields
| Term | Meaning | How consumers should use it |
|---|---|---|
| Machine-readable file | A hospital-posted digital file containing standard charges for all items and services provided by the hospital. | Useful for structured comparison, but often too technical for a patient to use without normalisation. |
| Consumer-friendly shoppable services | A display of shoppable services that a consumer can schedule in advance, including ancillary services where applicable. | Usually easier to read than a full MRF, but may still omit patient-specific deductible and network effects. |
| Gross charge | The chargemaster list price before discounts, contracts or patient-specific calculations. | Rarely what a self-pay or insured patient actually owes. |
| Discounted cash price | The hospital charge that applies to a patient paying cash or cash equivalent. | The starting point for self-pay comparison, but it may not include every professional, facility or ancillary bill. |
| Payer-specific negotiated charge | The charge a hospital has negotiated with a specific third-party payer and plan. | A useful insurance-route input, but not the same as patient responsibility after deductible, copay and coinsurance. |
| De-identified minimum and maximum negotiated charges | The lowest and highest negotiated charges across payers, without identifying the payer. | Useful for range context, but not enough to know what a specific plan or patient will pay. |
How TreatCompare reads the files
- One billing code is one service. Figures are never pooled across codes such as brain and spine MRI.
- A line counts only where the file labels its code as CPT or HCPCS. A hospital’s own chargemaster number that happens to match a CPT code is not that service.
- One figure per hospital and code, the hospital’s facility charge. Professional (physician) charges and lines with a modifier are kept apart.
- Cash prices and negotiated rates are separate series, never combined.
- Negotiated rates are shown as a spread across hospitals with a payer count. No insurer or plan is named.
- Hospitals on the same file host publishing the same figure count once.
- A median needs at least 4 hospitals; below that each hospital is named with its own figure.
- A hospital whose file lists several different charge lines for one code is named but not counted.
- Every figure carries the file’s URL and the date it was read.
What TreatCompare does not infer
- We do not turn a hospital negotiated charge into a final bill without plan inputs.
- We do not combine facility and professional fees unless the source supports a bundled estimate.
- We do not publish placeholder prices or calculator defaults as data.
- We do not publish a price for an independent imaging center or surgical center: none has been read.
- We do not say cash is always lower-cost.
- We do not give medical, legal, billing or insurance advice.
What Medicare pays
Medicare amounts come from the CMS Physician Fee Schedule relative value file (CMS Physician Fee Schedule, relative value file RVU26D, read October 26, 2026) and, for surgical procedures, the ambulatory surgical center addendum (CMS ambulatory surgical center rates, Addendum AA (October 2026), read October 26, 2026). They are national amounts before geographic adjustment, labelled as what Medicare pays, never as a patient price. Hospital outpatient rates are not shown: CMS publishes them only behind the AMA CPT licence (last checked November 6, 2026). Code labels are our own; no AMA descriptor text is reproduced.
Sources
- CMS Physician Fee Schedule, relative value file RVU26D, released August 26, 2026. Read 26 October 2026. What Medicare pays a clinician, national amount.
- CMS ambulatory surgical center rates, Addendum AA (October 2026), effective October 1, 2026. Read 26 October 2026. What Medicare pays an ambulatory surgical center, national rate.
Submission and correction standard
Patient-submitted and provider-submitted prices can be useful, but they should not be mixed with independently sourced rows until they have a source label, checked date, confidence rating and clear inclusion/exclusion notes.