Same procedure, different price: what US hospitals charge cash-paying patients
For the same outpatient procedure, a patient paying without insurance
can be charged many times more at one hospital than at another. Take
MRI of knee or other lower-limb joint, no contrast dye (code 73721): the cheapest tenth of 2,968 hospitals
list $584 or less, the most expensive tenth
$4,888 or more — 8.4 times
as much.
Across the 16 common procedures below, that gap ranges from
5.3× to 18.5×. Measured against Medicare, the typical
hospital cash price is 3.5× Medicare's 2026 rate for the
same service (median across 395 procedures).
Every number is computed from the hospitals' own machine-readable price
files (45 CFR 180.50), collected by SelfPayRates. Data as of Nov 8, 2026.
Free to cite with a link to this page.
The gap, procedure by procedure
Each hospital counts once, at its lowest outpatient cash price for the code.
P10 and P90: a tenth of hospitals charge less / more.
Procedure The service and its billing code (CPT or HCPCS). Opens the comparison of every hospital that prices it. More
Hospitals How many hospitals publish a cash price for this code here. Each hospital counts once, at its lowest outpatient cash price.
P10 A tenth of hospitals charge less than this. More
Median The middle cash price: half of the hospitals charge less, half charge more. One price per hospital. More
P90 A tenth of hospitals charge more than this. More
P90 ÷ P10 How many times more the expensive tenth of hospitals charges than the cheap tenth.
Median ÷ Medicare How many times the median cash price is above Medicare's rate for the same service. More
Median ÷ Medicare: the median cash price divided by Medicare's 2026 national
base rate for the same service outside a hospital stay (hospital outpatient rate from OPPS
Addendum B, lab tests from the Clinical Laboratory Fee Schedule); the hospital rate includes
the patient's share and is before the local wage adjustment. Sources: CMS; the rate is in the CSV below.
Emergency room visits: the hospital's price for a visit level is its facility
fee; the emergency physician bills separately, and tests and medicines are added on top.
Cash prices against Medicare
For 395 procedures with 100+ hospitals and a
comparable Medicare rate, the median hospital cash price is a median
3.5× Medicare's 2026 national rate; for 140 of them it is 5× or
more. The cheapest tenth of hospitals list about 1.1× Medicare, the most
expensive tenth 9.9×. Highest multiples among services Medicare pays
$25 or more for:
Medicare Medicare's 2026 national rate for the same outpatient service, including the patient's share, before the local wage adjustment. A yardstick, not a price you can pay. More
Medicare's rate: the hospital outpatient rate (OPPS Addendum B) or, for lab
tests, the Clinical Laboratory Fee Schedule. Surgery with a comprehensive Medicare rate and
dental work are left out, because the hospital's cash line often covers only part of what
that rate pays for. Every procedure's rate is in the CSV below.
MRI of knee or other lower-limb joint, no contrast dye: median by state
Median of each hospital's lowest outpatient cash price, states with at least
10 hospitals whose prices come from at least 5 separate
websites — so one hospital system cannot set a state's number. Lowest first. The typical price in
Utah ($4,650) is
11.2× the typical price in
New Jersey ($415).
MRI of knee or other lower-limb joint, no contrast dye: shopping around in the same metro
The largest metro areas in the data. “Saves” is the typical local price minus
the lowest. In 14 of these 15 metros the lowest price is half the
local median or less.
The figures on this site are free to reuse under
CC BY 4.0: please credit SelfPayRates
with a link to this page.
Method
Source. Since 2021 every US hospital must publish its standard charges,
including the discounted cash price, in a machine-readable file (45 CFR 180.50). We read those
files directly and keep every price exactly as published, with a link to its file.
One price per hospital. A hospital often lists several lines for one
code. Each hospital counts once, at its lowest outpatient cash price for the code, so a
hospital with many lines does not outweigh one with a single line.
Comparable prices only. Outpatient prices only; prices for both sides of
the body, physician-only or technical-only components, and lines below $1 or below a tenth of
the national median for the code (almost always a separate fee or a placeholder) are left out.
Maryland is exempt from the tenth-of-the-median rule: its hospital rates are set by a state
commission and are genuinely low.
Percentiles, not extremes. The spread is the 90th percentile divided by
the 10th. Hospital files contain occasional errors, and a single wrong line should not
decide a headline, so we do not report the single lowest or highest price nationally.
States. A hospital system usually publishes the same price for all its
hospitals from one website. A state is compared only when its prices come from at least
5 separate websites; the by-state CSV has every state.
What is not covered. Hospitals only — not freestanding imaging centers
or labs, which are often cheaper. A cash price is a published charge, not a quote: a
separate physician fee may apply.
Contact
Questions about the data, custom cuts for a state or metro, or corrections:
[email protected].