Every US hospital is required to publish its negotiated rates. Almost no one can read them. ClearPrice reads them at national scale — 560.4M negotiated rates served for instant query across all 50 states — and fuses them with how well hospitals actually care for patients. Below is a working sample. Your market is in here.
Pick a procedure. Each dot is a state's median negotiated rate — the same care, priced by geography. And state medians flatter the chaos: comparing hospitals’ typical prices, the same procedure typically spans 16x nationally, priciest 5% of hospitals against the cheapest 5%.
Medians exclude hospitals we have identified restating list prices as negotiated rates. City-level prices: see the cost explorer →
Every dot is a hospital: its price percentile against its CMS star rating. If quality set prices, the cloud would climb to the right. It doesn't — the medians barely move. The green zone is where value lives: top-rated care, bottom-third prices.
Thick ticks mark the median price percentile at each star rating — near-identical at every tier.
We benchmark every commercial negotiated rate against what Medicare pays for the identical service at the identical hospital. Darker means your plan dollars stretch less. If you sponsor a health plan, this is the map your renewals never show you.
Click a state to make it your market. 1.0× = Medicare pays it. Each service is benchmarked against the Medicare schedule that actually prices it — inpatient stays vs. IPPS, outpatient facility care vs. OPPS, professional services vs. the Physician Fee Schedule, and lab tests vs. the Clinical Lab Fee Schedule — across a standardized basket of shoppable services, so states compare on price, not service mix. These are unweighted per-procedure medians: every service counts equally, so they do not reflect dollar-weighted employer spend, which is typically higher. A blank state is withheld, not zero — currently only Maryland, whose all-payer rate-setting leaves too few comparable rates.
Price index by state and service line, where 100 is the national median. Your market pins to the top row — see exactly which service lines drive its costs.
Each cell is the median of per-procedure ratios (state median ÷ national median), unweighted by volume. Extremes are real: Alaska’s lab index — the median across lab tests — sits near six times the national median in hospitals’ own files. Maryland sets hospital rates statewide under its all-payer system, so too few Maryland hospitals have comparable negotiated rates to index — a blank cell means not enough data, never zero.
At Southern California Hospital at Hollywood, the same diagnostic colonoscopy (CPT 45378) is negotiated at $147.33 by Aetna and $3,855.00 by Cigna — 26x apart, same building, same procedure code. Both are outpatient facility case rates from the hospital’s own federally mandated file — the same kind of rate, for the same thing. Neither number is a mistake.
Aetna’s file at this hospital also lists a second facility case rate of $506.81 for the same plans; $147.33 is the lower of the two listed. VERIFIED
| Payer | Plan | Rate | Methodology |
|---|---|---|---|
| Aetna | All Gatekeeper / Non-Gatekeeper Plans | $147.33 | case rate |
| Aetna | Same plans, second listed rate | $506.81 | case rate |
| Cigna | Commercial | $3,855.00 | case rate |
At Lee Memorial Hospital in Fort Myers, the posted cash price for a colonoscopy is $2,244.92. Every commercial insurer that disclosed a rate there negotiated a higher one — the best of them, BCBS Florida, pays $3,877. The cash price and every negotiated rate here are the hospital’s own published numbers for the same outpatient procedure line — like for like.
It’s not one hospital: 69% of the negotiated colonoscopy prices in our files are higher than the same hospital’s posted cash price.
This is legal, documented across independent studies, and structural — it’s how contracting in the dark works. A practical caveat that matters: paying cash usually does not count toward your deductible or out-of-pocket maximum — check with your plan before choosing the cash price.
And at the extreme: at one Idaho surgical hospital the same procedure spans $848 cash to a single PPO’s $20,127 negotiated rate — 23.7x.
Re-derived from hospitals’ published files; methodology + queries documented. VERIFIED
| Payer | Plan | Rate | Methodology |
|---|---|---|---|
| Cash (self-pay) | Discounted cash price | $2,244.92 | posted cash price |
| BCBS Florida | BC FL PPO [21000101] | $3,877.00 | case rate |
| Wellpoint Florida | WELLPOINT FLORIDA [25026501] | $6,061.28 | percent of total billed charges |
| AvMed | AVMED HEALTH PLAN CONTRACTED [25020401] | $6,622.51 | percent of total billed charges |
| Global Excel | GLOBAL EXCEL CONTRACTED [25024101] | $7,295.99 | percent of total billed charges |
| Claritev/MultiPlan | CLARITEV MULTIPLAN NETWORK [25022301] | $8,979.68 | percent of total billed charges |
| Cash (self-pay), Idaho secondary | Discounted cash price | $847.80 | posted cash price |
| Commercial PPO (name withheld pending review) | PPO | $20,127.00 | case rate |
For the identical colonoscopy (CPT 45378), the median commercial rate ranges from 0.34x Medicare in Maine to 2.89x in Utah.
Caveat: state medians of one procedure’s ratio; individual hospitals vary above and below. *Rhode Island (n=7) and Delaware (n=6) carry thin samples; Maryland (grayed, n=2) is shown but not reliable. Medicare benchmark ratios use winsorized state medians ([0.25, 10] per-hospital ratios); methodology documented. VERIFIED
Every rate is read from a hospital's own machine-readable file, published under the federal Hospital Price Transparency Rule — a real published number, not an invented one. Where we compute — spreads, multiples, value scores — the method is documented and auditable, run on verified data.
Hospitals we have identified restating list prices as negotiated rates are excluded from the medians on this page. Fabricated and duplicate rate patterns are detected and excluded before any number is published.
Every headline statistic carries an as-of date and a verifiable source. Hover any ✓ VERIFIED badge to see exactly where a number comes from.
A market briefing takes 30 minutes: your states, your procedures, your payer mix — against the only dataset that fuses the price and the quality of American hospital care.