Hospital price data · October 2026 files
Two prices, one hospital: cash costs more than the insurer rate more than half the time
Across 547,654 hospital-and-service price pairs, a hospital's cash price is higher than its own negotiated insurer rate 54% of the time and lower 44%. It depends on the service: cash is higher at most hospitals for 26 of 64 procedures. Pick a procedure and your state to check yours.
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Source: CostKits Cash vs. Insurance Explorer, hospital price files, October 2026. Published prices, not what you will pay.
Want the spread across hospitals instead? Open the Hospital Price Variability Explorer, or see which states run high and low in the Hospital Price Atlas.
Get the Hospital Price Spread Report (free PDF)
The price gaps behind these pages for 20 common procedures, the states at both ends, and the questions to ask before you book.
- The biggest gaps between hospitals, with real numbers
- How cash and insured prices compare
- A short script for asking for a price in advance
Hospitals in this view
| Hospital | City | State | Cash price | Insurer rate |
|---|
Click a row to mark it on the chart. A positive number means the cash price is higher than the insurer rate. See a wrong or missing price? Email hello@costkits.com with the hospital and code and we will check it against the source file.
Cash vs. insurer rate for 64 common procedures
For each procedure, the share of hospitals whose cash price is higher than the rate they negotiated with commercial insurers, and the typical gap. Only hospitals that publish both prices for the same code are counted. Select a name to open it in the tool above.
| Procedure | Hospitals where cash is higher | Typical gap (cash ÷ insurer) | Median cash price | Median insurer rate | Hospitals with both | |
|---|---|---|---|---|---|---|
| Metabolic panel CPT 80053: Comprehensive metabolic panel (blood test) | 73% | 2.0x | $122 | $38 | 2,894 | By state |
| CT scan, head CPT 70450: CT scan of the head, no contrast | 71% | 1.7x | $1,200 | $554 | 3,108 | By state |
| CT scan, abdomen CPT 74160: CT scan of the abdomen, with contrast | 71% | 1.6x | $1,603 | $825 | 3,109 | By state |
| CT scan (all) CPT 71260: CT scan of the chest, with contrast | 70% | 1.6x | $1,569 | $794 | 3,150 | By state |
| CT scan, chest CPT 71260: CT scan of the chest, with contrast | 70% | 1.6x | $1,569 | $794 | 3,150 | By state |
| Cholesterol test CPT 80061: Cholesterol panel (lipid blood test) | 69% | 1.6x | $90 | $38 | 3,044 | By state |
| A1C blood test CPT 83036: Hemoglobin A1c (blood sugar) test | 69% | 1.6x | $62 | $29 | 3,096 | By state |
| MRI (all body parts) CPT 72148: MRI of the lower-back spine, no contrast | 69% | 1.5x | $1,930 | $967 | 3,059 | By state |
| Blood count (CBC) CPT 85027: Complete blood count (CBC), automated | 69% | 1.6x | $52 | $22 | 2,994 | By state |
| Brain MRI CPT 70551: MRI of the brain, no contrast | 69% | 1.5x | $1,840 | $952 | 3,058 | By state |
| Thyroid test CPT 84443: Thyroid (TSH) blood test | 68% | 1.5x | $93 | $45 | 3,055 | By state |
| Knee MRI CPT 73721: MRI of a leg joint (knee, hip or ankle), no contrast | 68% | 1.5x | $1,922 | $1,012 | 2,946 | By state |
| Ultrasound CPT 76705: Abdominal ultrasound, limited | 66% | 1.3x | $508 | $318 | 3,050 | By state |
| Bone density test CPT 77080: Bone density scan (DXA) | 61% | 1.2x | $361 | $236 | 2,766 | By state |
| PET scan CPT 78815: PET/CT scan, skull base to mid-thigh | 60% | 1.1x | $4,676 | $3,732 | 1,831 | By state |
| X-ray (all) CPT 71046: Chest X-ray, 2 views | 60% | 1.2x | $253 | $182 | 3,151 | By state |
| Nuclear stress test CPT 78452: Nuclear heart stress test, multiple studies | 59% | 1.1x | $3,224 | $2,433 | 2,658 | By state |
| Doppler ultrasound CPT 93970: Leg vein ultrasound, both legs | 59% | 1.1x | $920 | $698 | 2,992 | By state |
| Echocardiogram CPT 93306: Echocardiogram, complete with Doppler | 57% | 1.1x | $1,603 | $1,254 | 2,864 | By state |
| Sleep study CPT 95810: Overnight sleep study in a lab (age 6 and up) | 57% | 1.1x | $2,905 | $2,404 | 2,123 | By state |
| Mammogram CPT 77067: Screening mammogram, both breasts | 56% | 1.1x | $278 | $233 | 2,716 | By state |
| Treadmill stress test CPT 93017: Treadmill stress test, tracing only | 55% | 1.1x | $808 | $630 | 2,669 | By state |
| Heart catheterization CPT 93458: Heart artery imaging with left heart catheterization | 55% | 1.1x | $9,170 | $8,240 | 1,723 | By state |
| Home sleep test CPT 95806: Home sleep apnea test | 51% | 1.0x | $487 | $432 | 1,680 | By state |
| Physical therapy CPT 97161: Physical therapy evaluation, low complexity | 51% | 1.0x | $204 | $186 | 2,928 | By state |
| Emergency room visit CPT 99283: ER visit, level 3 | 50% | 1.0x | $620 | $595 | 3,038 | By state |
| IV infusion CPT 96365: IV infusion for therapy, first hour | 49% | 1.0x | $405 | $377 | 3,038 | By state |
| ACL surgery CPT 29888: ACL knee ligament reconstruction, arthroscopic | 49% | 1.0x | $7,456 | $7,839 | 873 | By state |
| Carpal tunnel surgery CPT 64721: Carpal tunnel release, open | 48% | 1.0x | $2,499 | $2,642 | 1,238 | By state |
| Knee arthroscopy CPT 29881: Knee arthroscopy, meniscus removal (one side) | 47% | 1.0x | $3,854 | $4,172 | 1,022 | By state |
| Hysteroscopy CPT 58558: Hysteroscopy with biopsy or polyp removal | 47% | 1.0x | $3,842 | $4,038 | 997 | By state |
| Epidural injection CPT 62323: Lower-back epidural steroid injection (imaging guided) | 46% | 1.0x | $1,349 | $1,424 | 2,196 | By state |
| Hernia repair CPT 49505: Inguinal hernia repair, open (age 5 and up) | 46% | 1.0x | $4,219 | $4,776 | 1,199 | By state |
| Chemo infusion CPT 96413: Chemotherapy infusion, first hour | 46% | 1.0x | $604 | $582 | 2,418 | By state |
| Lung function test CPT 94010: Spirometry (breathing test) | 46% | 1.0x | $242 | $268 | 2,792 | By state |
| Colonoscopy CPT 45378: Colonoscopy, exam only | 46% | 1.0x | $1,546 | $1,615 | 1,759 | By state |
| Cortisone shot CPT 20610: Joint injection or draw, large joint like knee or shoulder (no ultrasound) | 45% | 0.9x | $478 | $520 | 2,829 | By state |
| Ovarian cyst removal CPT 58661: Laparoscopic removal of ovaries, tubes or ovarian mass | 45% | 1.0x | $5,976 | $7,239 | 879 | By state |
| Rotator cuff surgery CPT 29827: Rotator cuff repair, arthroscopic | 45% | 1.0x | $5,952 | $7,604 | 924 | By state |
| Vasectomy CPT 55250: Vasectomy | 45% | 1.0x | $2,056 | $2,581 | 1,069 | By state |
| Ear tubes CPT 69436: Ear tube insertion under anesthesia | 44% | 1.0x | $2,342 | $2,604 | 759 | By state |
| Facet injection CPT 64493: Facet joint injection, lower back (imaging guided) | 44% | 1.0x | $1,576 | $1,670 | 2,065 | By state |
| Endoscopy CPT 43235: Upper endoscopy (EGD), exam only | 44% | 0.9x | $1,473 | $1,615 | 1,840 | By state |
| Hysterectomy CPT 58552: Laparoscopic-assisted vaginal hysterectomy, with ovary and tube removal | 44% | 0.9x | $7,595 | $10,068 | 745 | By state |
| Cholecystectomy CPT 47562: Gallbladder removal, laparoscopic | 44% | 0.9x | $5,993 | $6,794 | 1,071 | By state |
| Bunion surgery CPT 28296: Bunion surgery with bone cut near the toe end | 43% | 0.9x | $3,592 | $4,172 | 860 | By state |
| Cystoscopy CPT 52000: Cystoscopy (bladder scope) | 43% | 0.9x | $1,178 | $1,211 | 1,780 | By state |
| Tonsillectomy CPT 42826: Tonsil removal only, age 12 and up | 43% | 0.9x | $3,590 | $4,191 | 699 | By state |
| YAG laser surgery CPT 66821: YAG laser after cataract surgery | 43% | 0.9x | $960 | $1,152 | 822 | By state |
| Knee replacement CPT 27447: Total knee replacement | 43% | 0.9x | $8,820 | $13,082 | 843 | By state |
| Hip replacement CPT 27130: Total hip replacement | 43% | 0.9x | $9,024 | $13,117 | 806 | By state |
| Glaucoma laser CPT 65855: Laser treatment for glaucoma | 42% | 0.9x | $940 | $1,120 | 583 | By state |
| Pacemaker surgery CPT 33208: Pacemaker insertion, both chambers | 42% | 0.9x | $14,536 | $15,782 | 1,554 | By state |
| Appendectomy CPT 44970: Appendix removal, laparoscopic | 42% | 0.9x | $4,965 | $6,766 | 1,008 | By state |
| Sinus surgery CPT 31267: Sinus surgery, maxillary with tissue removal | 40% | 0.9x | $5,864 | $7,213 | 611 | By state |
| D&C CPT 58120: Dilation and curettage (D&C) | 40% | 0.9x | $3,404 | $3,932 | 1,058 | By state |
| Deviated septum surgery CPT 30520: Deviated septum repair (septoplasty) | 39% | 0.8x | $3,540 | $4,128 | 860 | By state |
| Hearing test CPT 92552: Hearing test, pure-tone | 39% | 0.9x | $108 | $137 | 1,061 | By state |
| Spinal fusion CPT 22551: Neck spinal fusion, front approach, with disc removal | 39% | 0.8x | $8,081 | $12,514 | 622 | By state |
| Breast biopsy CPT 19083: Breast biopsy, ultrasound guided (first lesion) | 38% | 0.9x | $2,366 | $2,674 | 2,163 | By state |
| Prostate biopsy CPT 55700: Prostate biopsy, needle | 38% | 0.9x | $2,370 | $2,852 | 1,248 | By state |
| Eye injection CPT 67028: Injection into the eye | 38% | 0.9x | $560 | $719 | 813 | By state |
| Cataract surgery CPT 66984: Standard cataract surgery with lens implant | 37% | 0.9x | $3,043 | $3,764 | 794 | By state |
| Childbirth CPT 59409: Vaginal delivery only | 35% | 0.9x | $2,788 | $3,535 | 1,805 | By state |
How to read this
Each dot is one hospital. Its position across is the insurer rate (the median commercial rate the hospital lists) and its height is its cash price. Dots above the diagonal line are hospitals where the cash price is higher than the insurer rate; dots below are hospitals where it is lower. Both scales are logarithmic, so each step is a multiple of the last.
What this does and does not tell you
- The insurer rate is the total the plan and you share. With insurance you usually pay only part of it, through your deductible, coinsurance or copay. The cash price is what you would pay in full.
- Cash payments often do not count toward your deductible or out-of-pocket maximum. Ask your plan.
- These are published prices, not what you will pay, and a listed insurer rate is not necessarily your plan's rate.
- A facility price may leave out separate bills, such as a radiologist's reading.
Common questions
Is it cheaper to pay cash or use insurance for a brain MRI?
At the same hospital, the cash price for a brain MRI without contrast (CPT 70551) is higher than the rate the hospital negotiated with commercial insurers at 69% of the 3,058 hospitals that publish both, and the typical hospital's cash price is 1.5x its insurer rate. The insurer rate is the total a plan and you share, so with insurance you usually pay only part of it. Which costs you less depends on your deductible, coinsurance and network, so ask the hospital for both prices before you book.
Why would a hospital's cash price be higher than what insurers pay?
Hospitals set their cash prices and their insurer rates separately. Insurers negotiate discounts in exchange for sending patients, and a cash price is usually set as a discount from the hospital's list price that can still sit above what insurers agreed to pay. This data shows the pattern, not the reason, and it differs by procedure and hospital.
When is the cash price lower than the insurer rate?
It depends on the service. Among procedures with at least 300 hospitals publishing both prices, the cash price is lower than the insurer rate most often for Childbirth (CPT 59409) at 64% of 1,805 hospitals; Cataract surgery (CPT 66984) at 62% of 794 hospitals; Eye injection (CPT 67028) at 61% of 813 hospitals. Surgeries may differ in what the cash price includes, so confirm what is covered.
Does paying cash count toward my deductible?
Often not. Payments made outside your plan generally do not count toward your deductible or out-of-pocket maximum unless your plan accepts them. Ask your insurer before choosing to pay cash.
What is the insurer rate in this data?
It is the median of the rates a hospital lists for commercial insurers for a given procedure code. Medicare Advantage, Medicaid, TRICARE and workers' compensation rates are left out. A listed rate is not necessarily your plan's rate.
Where do these hospital prices come from?
Federal rules require hospitals to post a machine-readable file listing cash prices and the rates negotiated with each insurer. CostKits reads those files every month and matches each price to a standard procedure (CPT) code. This page uses the October 2026 files. See the methodology page for how prices are cleaned.
Data: hospital price transparency files, October 2026, processed by CostKits. Full methodology. Questions: hello@costkits.com. See also the procedure cost pages for state-by-state prices.