What 482 hospitals charge vs. what insurers pay, from their own files

About What 482 hospitals charge vs. what insurers pay, from their own files

Across 420 hospitals' own price files, a moderate ER visit is listed at a median $1,285 while insurers pay $288. Data from 482 US hospitals.

In the maker’s words

US hospitals must publish a machine-readable file of their prices, including the rate they've negotiated with each insurer. The files are huge (one is 36GB), in four formats and often messy, so almost nobody reads them. I built a crawler that finds each hospital's official file and pulls out 29 common services. Across 482 hospitals: a moderate ER visit is listed at a median $1,285 while insurers pay $288; a metabolic panel is listed at $207 while insurers pay $11.46. To keep it honest: only per-service fee-schedule dollar rates count (no case rates or percentages, which cover a whole visit), each figure needs at least 3 insurers, and every value is checked against Medicare reference rates. Surgery is excluded because insurer surgery rates cover the whole operation while the list price is one line item. Each hospital page links its source file. Feedback on the methodology is very welcome.

Where people found it

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