Updated August 3, 2026. Quick answer: every covered hospital must publish its actual prices online — including a discounted cash price for people not using insurance. That cash price is frequently far below the chargemaster rate, and sometimes below what you would pay through insurance against a high deductible.
What hospitals must publish
45 CFR 180.50(a)(1) (via Cornell CFR mirror): a hospital must establish and make public ‘a list of all standard charges for all items and services online in the form and manner specified in this section.’ 180.50(c)(1)/(c)(2): the information ‘must be published in a single digital file that is in a machine-readable format’ and (from July 1, 2024) ‘must conform to a CMS template layout, data specifications, and data dictionary.’ 180.60(a)(1): ‘A hospital must make public the standard charges identified in paragraphs…
— 45 CFR 180.20 (definitions); 180.30(a)-(c) (applicability/exemptions); 180.50 (machine-readable file); 180.60 (consumer-friendly display)
Two separate things are required. A machine-readable file covering all items and services — gross charges, the discounted cash price, payer-specific negotiated charges, and de-identified minimum and maximum negotiated rates. And a consumer-friendly display for a defined list of shoppable services, with plain-language descriptions.
The number to look for
The discounted cash price is the one that changes decisions. It is what the hospital charges someone paying directly without insurance, and it exists in the file precisely because the rule requires it to.
The comparison worth running before a planned procedure: the cash price against your remaining deductible. If you have not met a large deductible, paying cash can cost less than going through the plan. It usually will not count toward your deductible or out-of-pocket maximum, so this is a real trade-off rather than a free win — but it is a trade-off you can only evaluate if you look up the number.
How to actually find it
- Look for a price-transparency or standard-charges link, usually in the site footer or under billing.
- Use the consumer display for common procedures, which is searchable and readable. The machine-readable file is enormous and built for analysts.
- Ask for the cash price by name if you cannot find it. It is a defined term in the regulation and billing staff should recognise it.
- Get any quote in writing. If you are uninsured or self-pay you are also entitled to a good faith estimate, which is enforceable in a way a verbal quote is not.
- Check the physician separately. Hospital prices do not include the surgeon’s or anaesthetist’s own bill.
Who is not covered
The rule reaches hospitals licensed under state or local law, with narrow exemptions for federally owned facilities (Veterans Affairs and military treatment facilities), Indian Health Program hospitals, and state forensic hospitals treating only people in penal custody. It is close to universal, but it is not literally universal, and compliance in practice varies.
What we could not confirm. CMS.gov returned 403 to every request this session, so CMS’s own guidance could not be read and no CMS-hosted quote was obtainable. The regulation text above comes from Cornell Law School’s reproduction of 45 CFR part 180, because eCFR’s pages redirected to a verification wall. We have not assessed how consistently hospitals actually comply.
Related: auditing a bill you already have · negotiating · charity care.
General information drawn from the Internal Revenue Code, federal regulations, CMS and Medicare materials, not legal, financial or medical advice. Hospital financial-assistance policies are set by each hospital within federal rules, so eligibility bands differ between hospitals in the same city. Billing rules and figures change and every figure here is year-labelled with its source named. We sell nothing on these pages: no debt settlement, no negotiation service, no advocacy.