Every price range on CostKits — on a procedure cost hub, a state page, or inside the Estimator, Forecast, or Provider Map tools — comes from the same underlying pipeline. This page explains where the numbers come from, how often they're refreshed, and — just as important — what they don't tell you.
CostKits prices procedures using federally mandated hospital and payer price transparency data, published under CMS price transparency rules, combined with CMS fee schedule data for Medicare-based reference pricing. Facility-level detail (the specific hospitals and imaging centers behind a state or metro page) is sourced from the same transparency files, matched to physical facilities and verified against public facility directories.
Where a procedure's negotiated-rate data is sparse or unreliable in the raw files (a known issue with hospital price transparency data industry-wide — files are large, inconsistently formatted, and not always complete), we supplement with CMS fee schedule benchmarks and note the wider uncertainty in the estimate.
We reference the same organizations named in our Editorial Policy for narrative and educational content: CMS, KFF, and AHRQ.
Hospital and payer price transparency files are refreshed on an ongoing basis as source files are updated. Individual procedure and geo pages carry a visible "as of" date reflecting when that page's underlying data was last refreshed — we don't backdate or silently age out stale pricing.
| What we show | What it represents | What it isn't |
|---|---|---|
| The headline price range (e.g. "$901–$2,191") | The typical range a commercially insured patient's plan and facility combine to before your deductible/coinsurance apply — physician + facility fees combined where both are available | Not a guarantee, not your specific out-of-pocket cost, and not a cash-pay quote |
| The median facility price | The midpoint of reported negotiated rates across facilities we found pricing data for in that area | Not every facility in the area — only ones with usable published data |
| Medicare context, where shown | CMS fee schedule reference pricing — what Medicare pays, which tends to run well below commercial rates | Not what a Medicare beneficiary will personally owe (that depends on their supplement/Advantage plan) |
Healthcare pricing isn't one number. The same procedure at the same facility can have three, four, or more different prices depending on who's paying:
When our data lets us show more than one of these, we do. When it doesn't, we default to the commercial-insurance view and say so.
Facility names, addresses, and NPI/CCN identifiers in the raw price transparency files are frequently inconsistent — the same hospital can appear under multiple name variants across different files. We match facilities to a canonical directory using name, address, and identifier matching, then verify against public CMS facility listings before a facility appears on a CostKits page. Facilities we can't confidently match are excluded rather than shown with uncertain attribution.
Where this shows up in the product: Estimator, Forecast, and Provider Map all use this same pricing pipeline. Every procedure cost hub and state page cites the CMS transparency and fee schedule sources described above.
If something looks wrong — a price that seems out of range, a facility that's misattributed — tell us. See our Editorial Policy for how we handle corrections, or reach us directly at hello@costkits.com.
