Frequently Asked Questions

Yes. You can compare multiple hospitals side-by-side for the same procedure to see price variations in your area.

Comparison is available only if hospitals have published pricing for the procedure you're searching.

You can compare:

1. Multiple hospitals for the same procedure
2. Cash vs insurance prices if both are available
3. Different procedures using CPT codes or keywords
4. Care across our available coverage areas by changing your location
5. Outpatient and inpatient pricing if hospitals have published both settings

Yes. You can compare pricing across our available coverage areas.

Currently, we cover CA, TX, SD, CO, OH, and FL. We are expanding to additional states every quarter.

Cost may contain both outpatient and inpatient pricing if hospitals have published both settings. Note that not all hospitals publish both outpatient and inpatient pricing for every procedure.

Check our interactive coverage map on the home page to see available locations.

A CPT code is a Current Procedural Terminology code—a standardized five-digit code used for billing and pricing all medical procedures and services. CPT codes are used by hospitals, insurers, and billing systems to identify specific procedures.

You can search ExploreCarePricing using:

1. CPT codes directly
2. Keyword searches (e.g., knee surgery, blood test, MRI)
3. Condition codes (ICD codes)
4. Common procedure names

If you don't know the CPT code for your procedure, you can ask your healthcare provider or use keyword in a Google search.

We display bundled procedure prices and component fees when hospitals publish them. Many hospitals do not provide bundled pricing; instead, they list individual component prices that you can review. Anesthesia and facility fees are often missing from hospital price files.

For a complete picture of your total costs, contact the hospital directly to confirm all fees that may apply to your procedure, including anesthesia, facility, and professional services.

Our goal is to eventually cover all U.S. hospitals that publish healthcare pricing transparency data.

Currently, we have pricing data available for:

1. California (CA)
2. South Dakota (SD)
3. Texas (TX)
4. Colorado (CO)
5. Florida (FL)
6. Ohio (OH)

We are expanding our coverage to additional states every quarter.

Check our interactive coverage map on the home page to see the most current list of available states and search for hospitals in your area.

We include facilities that are required to publish machine‑readable price transparency files under the federal Transparency in Coverage (TiC) rule. This generally includes hospitals, specialty hospitals (such as cancer centers and surgical centers), imaging centers, and urgent care facilities—provided they have published compliant pricing files.

Independent labs, skilled nursing facilities (SNFs), Indian Health Service facilities, and VA facilities are not required to publish TiC machine‑readable files and are therefore not included.

Rural hospitals and specialty facilities are included when they meet federal TiC publishing requirements. Coverage depends entirely on whether a facility has released the required transparency files.

It depends on several factors: your insurance plan's deductible status, your coinsurance percentage, the negotiated rates at that specific hospital, and your plan's network status.

For some procedures, cash prices may be lower if your insurance deductible is high. However, insurance also offers tax benefits and liability protection that cash payments don't provide.

The best way to compare is to check both the cash and insurance prices on ExploreCarePricing, then consult with your insurance plan to understand your specific out-of-pocket costs.

HSA/FSA eligibility depends on several factors, including IRS rules for qualified medical expenses, your plan design, and whether the provider accepts HSA/FSA payments. Eligibility requirements are complex and vary by situation. Always verify HSA/FSA eligibility directly with your HSA/FSA administrator and confirm with the provider before paying to ensure the service qualifies for your account.

We display hospital-published and insurer-published prices. Your actual out-of-pocket cost depends on your insurance plan design, including your deductible status, coinsurance, copayments, and out-of-pocket maximum. Contact your insurance plan’s customer service to understand your specific out-of-pocket cost based on your coverage.

For complete Medicare pricing information, contact your provider or visit Medicare.gov.

Yes. We show negotiated insurance rates—the rates that hospitals have agreed to accept from different insurance companies.

These rates come directly from hospital and insurer-published transparency files.

Keep in mind that your actual payment depends on your insurance plan design, not just the negotiated rate.

Medicare prices are published by some hospitals but not all. We show Medicare pricing only if hospitals have published it in their transparency files.

You can search to see if Medicare pricing is available for procedures in your area.

We analyze publicly available data published by hospitals under federal regulations. This includes Hospital Price Transparency Files (Machine-Readable Files or MRFs) that hospitals are required to publish under CMS regulations, and insurer-published Transparency in Coverage files.

This public data includes negotiated insurance rates, cash/self-pay discount prices, facility fees, and procedure descriptions. All data comes directly from official hospital and insurer sources—we do not access, use, or store private medical records or confidential insurance contracts.

We continuously ingest and process new transparency files from hospitals and insurers as they publish updates. However, the underlying data is updated on different schedules by each provider and payer. Some hospitals and insurers update pricing files weekly or more frequently, while others update monthly or quarterly.

We process and display new data as soon as it's available. Always verify current pricing directly with your provider or insurer before scheduling care, as rates can change and published files may not reflect the most recent updates.

No. ExploreCarePricing is not affiliated with, sponsored by, or endorsed by any hospitals, health systems, or insurers.

This independence is critical to our mission. We do not receive payments from hospitals to favor them in search results or comparisons. Hospitals do not pay to be listed on ExploreCarePricing.

Our listings are based entirely on publicly available pricing data that hospitals are required to publish under federal regulations. A hospital appears in search results if they have published required transparency files—not based on any financial arrangement or sponsorship with us.

Our role is to make publicly available pricing data searchable and understandable—neutral and independent from industry interests.

No. ExploreCarePricing is an educational and informational tool for healthcare pricing analysis only.

We do NOT provide medical recommendations, diagnoses, treatment advice, financial advice, or insurance recommendations of any kind. All medical decisions should be made with your licensed healthcare provider.

The prices shown on ExploreCarePricing are informational and may change. They reflect published hospital and insurer data at the time of publication but are not guaranteed prices or binding quotes.

Your actual bill may differ based on your insurance plan terms, deductible and coinsurance, medical necessity determinations, clinical coding decisions, changes to published rates, and individual billing circumstances.

Always contact your hospital or insurance company for a personalized estimate before scheduling care.

No. ExploreCarePricing cannot determine your exact out-of-pocket cost.

Your final out-of-pocket responsibility depends on:

1. Your deductible (how much you've paid toward your annual deductible)
2. Your coinsurance percentage (typically 10-30% after deductible)
3. Your copayments for specific services
4. Whether you've met your out-of-pocket maximum
5. Your plan's network status (in-network vs. out-of-network)
6. Medical necessity determinations by your insurer

Use ExploreCarePricing to compare what hospitals charge and what insurance companies have negotiated as rates. Then contact your insurer to ask about your specific deductible, coinsurance, and network status to estimate your personal out-of-pocket cost.

We do not alter, modify, or adjust hospital-published prices. We display prices exactly as hospitals and insurers publish them. We do not verify accuracy independently—hospitals and insurers are responsible for their own data.

If you notice an inaccuracy, contact the hospital or insurer directly, or report it using our Contact Us form.

No. The prices shown on ExploreCarePricing are informational only and are not guaranteed.

Prices are subject to change and may vary based on your individual care circumstances, clinical decisions, insurance coverage, and changes to published rates. Always verify current pricing and get a personalized estimate from your provider before scheduling care.

Sometimes hospitals publish incomplete or unusual pricing data. This can happen for several reasons: hospitals may publish incomplete data sets, bundle procedures differently than expected, show extremely high charges that are rarely paid (chargemaster rates), or include data entry errors.

If a price seems incorrect or unusually high or low, verify it directly with the hospital. You can also report unusual data using our Contact Us form.

Yes. Errors can occur in hospital-published transparency files. Common errors include data entry mistakes, incomplete information, or incorrect code mapping.

We do not correct or fix hospital-published pricing data. We display prices exactly as hospitals and insurers publish them in their transparency files.

If you believe there's an error in hospital-published pricing, contact the hospital directly to request a correction. You can also report data issues to us using our Contact Us form.

For billing questions or disputes, contact the hospital or your insurance company directly.

A hospital or facility may not appear in ExploreCarePricing for several reasons:

1. They have not yet published required price transparency files
2. The facility is closed
3. They are outside our current coverage area

ExploreCarePricing currently does not include:

1. Skilled Nursing Facilities (SNF)
2. Behavioral Health and psychiatric facilities
3. Office-based medical practices and physician offices
4. Dental providers and dental services
5. Optical and vision centers
6. Durable Medical Equipment (DME) suppliers
7. Pharmacy services
8. Home health agencies
9. Ambulance services
10. Other non-hospital healthcare entities

These providers are not required under current federal regulations to publish machine-readable price transparency files.

Yes. Hospitals are required to keep their machine-readable price transparency files updated and accessible to the public. Updates must be made regularly as prices change. ExploreCarePricing continuously processes new transparency files from hospitals as they publish updates, though the frequency of updates varies by facility.

No. We do not alter, adjust, or modify hospital-published prices in any way. We standardize the formatting of hospital and insurer-published data to make it searchable and comparable across facilities, but all pricing figures come directly from the source. We display prices exactly as published. ExploreCarePricing does not interpret, estimate, or predict healthcare costs. All prices come directly from hospital and insurer-published transparency files.

Ads help fund the platform so we can keep healthcare price transparency free for everyone. Ad revenue covers hosting, data processing, ongoing improvements, and platform maintenance.

Ads never influence search results, pricing data, or how hospitals appear in ExploreCarePricing. All pricing information comes directly from hospital and insurer-published transparency files.

Our search algorithm and ranking are independent of any advertising relationships. Ads are placed in non-intrusive locations designed to minimize disruption to your experience.

Pricing information and search results are never hidden, obscured, or interfered with by advertisements.

No. We do not sell personal data to advertisers. We do not share your search history, medical interests, or any identifying information with advertising partners.

Advertisers see only general, non-identifying analytics about the platform itself—never your individual searches or healthcare interests.

We do track general platform analytics (page views, traffic patterns) to understand how the platform is used and improve the experience. However, this tracking is never connected to your personal identity or medical searches.

See our Privacy Policy for complete details.

Our mission is to keep healthcare price transparency accessible to everyone, regardless of income or ability to pay.

Subscription fees would create a barrier to access for many people who need pricing information most. Advertising allows us to sustain and expand the platform while keeping it free for all users.

You can contact us using the Contact Us form on our website.

We respond to support inquiries via email. You can also report data issues, pricing errors, suggest improvements, or ask questions through the same Contact Us form on the home page.

We can explain healthcare pricing concepts and help you understand how pricing works. However, we cannot provide personalized medical billing advice or interpret your individual hospital bill.

For questions about your bill, contact your hospital's billing department or your insurance company directly. They can explain the charges specific to your care and payment situation.

ExploreCarePricing provides pricing data to help you understand and compare costs. However, the choice of which hospital or provider to use should be made with your healthcare provider, considering factors including medical reputation, quality ratings, your insurance network, convenience, and pricing.

Medical decisions should never be based on price alone. Always consult your provider for recommendations.

For cost estimates based on your specific insurance plan, contact your insurance plan's customer service.

The cash price is the amount a hospital charges patients who pay without insurance coverage. Cash prices are the rates published by hospitals for patients paying out of pocket.

Insurance prices are the negotiated rates between hospitals and insurance companies. These rates vary by insurer and by insurance plan—the same hospital may charge different rates to different insurance companies.

Insurance prices are typically lower than cash prices, but your actual out-of-pocket cost also depends on your deductible, coinsurance, and plan design.

Healthcare pricing varies significantly because:

1. Each hospital negotiates individual contracts with each insurance company, resulting in different rates for the same procedure.
2. Prices vary by location—rural hospitals may have different pricing than urban facilities.
3. Facility type matters—hospital outpatient departments, ambulatory surgery centers, and independent facilities charge different rates.
4. Market competition affects pricing.
5. Volume discounts and regional relationships influence negotiated contracts.

Prices shown on ExploreCarePricing reflect published hospital and insurer transparency data but are NOT personalized estimates of your final bill.

Actual prices may vary based on your specific clinical needs, insurance plan design, deductible status, coinsurance percentage, whether you meet network requirements, and medical necessity determinations.

Always verify current pricing with your provider before scheduling care.

Yes, you can trust the prices as official sources.

All prices come directly from hospital and insurer-published transparency files required by federal regulations.

However, it's important to understand that hospitals update prices regularly, and your actual cost depends on your insurance plan and clinical situation.

The prices you see are starting points for comparison, not personalized estimates of what you will pay.

Always verify current pricing directly with your provider or insurer before scheduling care.