How the numbers are built

Every price on this site comes from a public file a hospital or CMS published. This page shows the path from those files to a number on a page, and what we do (and don't do) along the way.

Coverage right now
0facilities with prices in Arizona
82procedure / DRG codes tracked
0facility × code price rows
7insurers with facility-level negotiated rates
September 2026last refresh (rebuilt weekly)
Data flow
Data flow from public sources to pages Hospital price files and CMS fee schedules are fetched weekly, parsed, filtered to the tracked codes, aggregated per facility into a columnar dataset, benchmarked against Medicare, and rendered as compare, payer-rate, and site-of-care pages. PUBLIC SOURCES PIPELINE · WEEKLY APP · PER REQUEST Hospital price files CMS machine-readable files, one per hospital (CSV / JSON) 45 CFR 180 · published by hospitals Medicare fee schedules OPPS (hospital outpatient) PFS RVUs × conversion factor CLFS labs · IPPS DRG weights ASC Addendum AA / BB cms.gov · yearly or quarterly CMS quality data Care Compare star ratings hip / knee complication rate data.cms.gov · by facility CCN 1 · Fetch every file re-downloaded, streamed, nothing kept 4 · Aggregate per facility × code: cash, negotiated min / median / max 5 · Payer rates plan names → 7 insurers median per facility × insurer 2 · Parse tall CSV · wide CSV · JSON one row per code × payer 3 · Keep tracked codes 82 shoppable codes kept, everything else dropped 6 · Columnar dataset Parquet by state and code, swapped in atomically Reference tables (loaded at start) Medicare benchmarks by code and source quality by facility · metros · sites with published prices Benchmark & statistics ×Medicare · IQR band · outliers typical price · ask target percentile of your rate Compare pages every facility, cheapest first Payer rates facility × insurer matrix, CSV Site of care hospital outpatient vs ASC Payer & site-of-care views paste a bill, get the numbers

Sources

WhatWhere it comes fromVintage
Facility prices (cash, negotiated)Each hospital's CMS machine-readable file, linked from its cms-hpt.txt or price-transparency pageWhatever the hospital last published; re-fetched weekly
Hospital outpatient benchmarkMedicare OPPS Addendum B, national unadjusted payment rateCY2025
Physician / office benchmarkMedicare PFS: non-facility total RVU × conversion factor ($32.3465)CY2025
Lab benchmarkMedicare Clinical Laboratory Fee ScheduleCY2025
Inpatient (MS-DRG) benchmarkIPPS: DRG relative weight × (operating + capital national base rate), wage index 1.0FY2026 Final Rule Tables 5 and 1A/1D
ASC benchmarkMedicare ASC Addendum AA/BB national payment rate; packaged codes shown as not separately payableJanuary 2026 update
QualityCare Compare overall star rating; hip/knee replacement complication rate (COMP_HIP_KNEE), matched to facilities by CCN or nameLatest Care Compare release

What we compute, exactly

Which rows are kept

Only rows whose code is on the tracked list (82 codes). A hospital file typically has hundreds of thousands of rows; a few thousand survive. Rows without a usable code, and files that contain only chargemaster items with no CPT/HCPCS/DRG codes, are dropped and logged.

The per-facility price

For each facility and code: cash is the published discounted cash price; negotiated min / median / max summarize every payer row for that code. The facility list shows cash where published, otherwise the negotiated median.

Payer rates

Raw plan names are collapsed to 7 insurers (all Aetna plans → Aetna, Blue Cross / Blue Shield / Anthem → BCBS, and so on). The rate shown for a facility and insurer is the median across that insurer's plans. Plans that don't map to a major insurer are excluded from the payer view but still count in the negotiated range.

Typical price and the band

Across the facilities in the selected area, the typical price is the median with implausible values excluded: anything under 25% of the Medicare rate (a mis-keyed file), and anything outside the Tukey fences (1.5× the interquartile range). The band shown is the 25th to 75th percentile; flagged outliers stay visible in the table, marked.

Medicare multiples and the ask

Every price is expressed as a multiple of the Medicare benchmark for its setting (OPPS for hospital outpatient, IPPS for inpatient DRGs, PFS for office). The suggested ask is the lower of 2× Medicare or the local cash price, a figure most facilities accept for self-pay.

Site of care

Medicare's own hospital-outpatient (OPPS) and ASC rates for the same code give the reference differential. The per-case shift figure is the hospital typical price minus the median of published non-hospital prices for that code, using only sites that publish a price.

Percentiles

"Your rate is at the Nth percentile" means N% of facilities in the selected column have a lower published rate. It is computed over the facilities shown, not a national sample.

What this is not

The tracked codes

Every code the pipeline keeps, by category. Codes marked with a link have a dedicated page per metro.

Joint replacement (6)

CPT 27447Total knee replacement (arthroplasty)
CPT 27130Total hip replacement (arthroplasty)
CPT 27446Partial (unicompartmental) knee replacement
CPT 23472Total shoulder replacement (arthroplasty)
CPT 27487Revision total knee replacement
CPT 27134Revision total hip replacement

Inpatient (MS-DRG) (7)

DRG 470Major hip/knee joint replacement, inpatient, w/o MCC
DRG 469Major hip/knee joint replacement, inpatient, w/ MCC
DRG 468Revision of hip or knee replacement, inpatient, w/o CC/MCC
DRG 451Single-level spinal fusion except cervical, inpatient, w/o MCC
DRG 448Multi-level spinal fusion except cervical, inpatient, w/o MCC
DRG 473Cervical spinal fusion, inpatient, w/o CC/MCC
DRG 481Hip & femur procedures except major joint, inpatient, w/ CC

Arthroscopy & sports (10)

CPT 29881Knee arthroscopy with meniscectomy
CPT 29880Knee arthroscopy, medial and lateral meniscectomy
CPT 29888ACL reconstruction, arthroscopic
CPT 29827Shoulder arthroscopy, rotator cuff repair
CPT 29826Shoulder arthroscopy, subacromial decompression
CPT 29824Shoulder arthroscopy, distal claviculectomy
CPT 29823Shoulder arthroscopy, extensive debridement
CPT 29806Shoulder arthroscopy, capsulorrhaphy (labral/instability)
CPT 29914Hip arthroscopy, femoroplasty (FAI)
CPT 29891Ankle arthroscopy with osteochondral repair

Spine (10)

CPT 22551Anterior cervical discectomy & fusion (ACDF), 1 level
CPT 22612Lumbar spinal fusion, posterior, 1 level
CPT 22633Lumbar interbody + posterior fusion (TLIF/PLIF), 1 level
CPT 63030Lumbar discectomy (laminotomy), 1 level
CPT 63047Lumbar laminectomy (decompression), 1 level
CPT 62323Lumbar epidural steroid injection, with imaging
CPT 64483Transforaminal epidural injection, lumbar, 1 level
CPT 64493Facet joint injection, lumbar, 1 level
CPT 64635Radiofrequency ablation, lumbar facet, 1 level
CPT 22514Kyphoplasty, lumbar

Fracture care (6)

CPT 27236Hip fracture (femoral neck), open treatment / hemiarthroplasty
CPT 27245Hip fracture (intertrochanteric), intramedullary nail
CPT 25608Distal radius (wrist) fracture, open reduction & fixation
CPT 27792Ankle fracture (lateral malleolus), open reduction & fixation
CPT 23615Proximal humerus fracture, open reduction & fixation
CPT 27814Bimalleolar ankle fracture, open reduction & fixation

Hand & upper extremity (5)

CPT 64721Carpal tunnel release
CPT 26055Trigger finger release
CPT 25000De Quervain's release
CPT 24359Tennis elbow (lateral epicondylitis) release
CPT 64718Cubital tunnel (ulnar nerve) transposition

Foot & ankle (5)

CPT 28296Bunionectomy with osteotomy (hallux valgus)
CPT 27650Achilles tendon repair
CPT 28285Hammertoe correction
CPT 28060Plantar fasciotomy
CPT 27870Ankle fusion (arthrodesis)

Imaging / radiology (12)

CPT 73721MRI knee (lower extremity joint), without contrast
CPT 73221MRI shoulder (upper extremity joint), without contrast
CPT 72148MRI lumbar spine, without contrast
CPT 72141MRI cervical spine, without contrast
CPT 73718MRI lower extremity (non-joint), without contrast
CPT 73700CT lower extremity, without contrast
CPT 72131CT lumbar spine, without contrast
CPT 73560X-ray knee, 1-2 views
CPT 73030X-ray shoulder, 2+ views
CPT 72110X-ray lumbar spine, 4+ views
CPT 73502X-ray hip, 2-3 views
CPT 77080DEXA bone density scan

Injections (6)

CPT 20610Major joint injection/aspiration (knee, hip, shoulder)
CPT 20611Major joint injection with ultrasound guidance
CPT 20605Intermediate joint injection (wrist, elbow, ankle)
CPT 20550Tendon sheath / ligament injection
HCPCS J7325Hyaluronan (Synvisc-One) knee injection, per mg
HCPCS J7321Hyaluronan (Hyalgan/Supartz) knee injection, per dose

Office visits (4)

CPT 99203New patient office visit, low complexity
CPT 99204New patient office visit, moderate complexity
CPT 99213Established patient office visit, low complexity
CPT 99214Established patient office visit, moderate complexity

Therapy, casts & splints (6)

CPT 97110Physical therapy, therapeutic exercise, 15 min
CPT 97140Physical therapy, manual therapy, 15 min
CPT 97161Physical therapy evaluation, low complexity
CPT 97162Physical therapy evaluation, moderate complexity
CPT 29125Short arm splint application
CPT 29405Short leg cast application

Braces & DME (5)

HCPCS L1832Knee orthosis (brace), adjustable, prefabricated
HCPCS L1833Knee orthosis, adjustable knee joints, custom-fitted
HCPCS L0650Lumbar-sacral orthosis (back brace), prefabricated
HCPCS L3908Wrist-hand orthosis (splint), prefabricated
HCPCS E0143Walker, folding, wheeled

Freshness and reproducibility

The whole dataset is rebuilt from scratch every week: every file is downloaded again, parsed, filtered, and swapped in atomically, so the site never serves a half-built dataset. Hospital files change on their own schedules; the vintage shown on each page is our last rebuild (September 2026). Every source above is public and linkable, so any number here can be traced back to a row in a hospital's own file.

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