Why would two hospitals charge different prices for the same procedure?

Each insurer negotiates its own rate with each hospital, so there is no single market price. Hospitals with little local competition can charge more, and the price often covers different things — the facility alone, or the doctor's fee too.

How do I find the cheapest hospital near me?

Look up the procedure on Patients Price and compare hospitals near you before you book. Then ask the hospital for the cash price in writing, and get a Good Faith Estimate if you are paying yourself.

Why the Same Procedure Can Cost 10x More at Another Hospital

Key takeaways

There is no single price for a procedure. Every hospital sets its own cash price, and every insurer negotiates its own rate with every hospital. The same billing code can carry dozens of different prices.
The gap is wide even in the middle. For an MRI of the brain, hospitals at the 90th percentile charge $3,877, about 8.5 times the $455 at the 10th percentile. For a basic blood test, the gap is 10 times.
A higher price is not a sign of better care. Research finds hospital prices are not linked to quality, so price alone tells you nothing about the care you will get.
Compare before you book. For planned care, the hospital you pick can change your bill by thousands of dollars. A written Good Faith Estimate locks in the number to check against.

A procedure does not have a price. It has dozens of prices. The same MRI, the same colonoscopy, the same blood test can cost a few hundred dollars at one hospital and several thousand at another, a few miles away, for the same care. This is not a billing error. It is how hospital prices work in the United States, and it is the reason comparing hospitals before planned care can save you more than any other single step.

What the gap looks like in our data

Our database holds prices published by 1,062 hospitals: 333,874 rates across 476 procedures. Here is the cash price for seven common procedures, at three points in the range. We compare the 10th and 90th percentile hospitals, the middle 80 percent, so a few oddball prices do not drive the story.

MRI of the brain without contrast (CPT 70551): $455 at the 10th percentile, $1,426 at the median, $3,877 at the 90th percentile, across 697 hospitals. The 90th percentile is about 8.5 times the 10th.
CT scan of the abdomen and pelvis with contrast (CPT 74177): $693, $2,059, and $5,224 across 818 hospitals. About 7.5 times from the 10th to the 90th percentile.
Colonoscopy (CPT 45378): $408, $1,250, and $3,230 across 388 hospitals. About 8 times.
MRI of the knee (CPT 73721): $581, $1,409, and $3,592 across 804 hospitals. About 6 times.
CT scan of the head without contrast (CPT 70450): $423, $913, and $2,321 across 818 hospitals. About 5.5 times.
Screening mammogram (3D) (CPT 77067): $106, $251, and $502 across 660 hospitals. About 5 times.
Comprehensive metabolic panel, a basic blood test (CPT 80053): $27, $108, and $274 across 831 hospitals. 10 times from the 10th to the 90th percentile.

Even a routine blood test costs 10 times more at one hospital than another. And the full range is wider still: the most expensive hospital in our data lists the same brain MRI at $10,890, and the same CT scan at $18,323.

A worked example: the same MRI, $3,422 apart

Take the MRI of the brain without contrast. Same scan, same billing code.

Hospital A, at the 10th percentile, lists a cash price of $455.
Hospital B, at the 90th percentile, lists a cash price of $3,877.

That is $3,422 apart, or about 8.5 times more, for the same scan.

Now say your plan has a $2,000 deductible and you have not met any of it yet. Until you meet that deductible, the hospital's price is your price.

At Hospital A, you pay $455.
At Hospital B, you pay the first $2,000 yourself, and your plan covers the rest (minus any coinsurance).

Same scan, same day, $1,545 more out of your pocket because of the hospital you picked. The cash price is not the whole story if you have insurance: the median rate insurers negotiated for this MRI is $619, well below the median cash price of $1,426. But before your deductible is met, the hospital's price is what lands on you, so the gap between hospitals is your gap.

Why the prices differ

1. Every insurer negotiates separately with every hospital. There is no single market price for a procedure. Each insurer sits down with each hospital and agrees its own rate, and each deal comes out differently. RAND's long-running study of private health plan payments found that in 2022, employers and private insurers paid hospitals on average 254% of what Medicare would have paid for the same services, with wide variation between states. Your insurer's deal at your hospital is one of hundreds of separate bargains.

2. Market power sets the price more than cost does. A hospital that is the only option in town can charge more than one with three competitors down the road, and RAND's research has found that hospitals facing little competition generally charge higher prices. The price reflects what the hospital can get, not what the care costs to provide. RAND also found that how many Medicare and Medicaid patients a hospital treats explains very little of what it charges.

3. The starting number was never tied to cost. Hospital "chargemasters", the long price lists behind these numbers, began decades ago as opening bids for negotiations with insurers, then were raised year after year with no connection to the cost of the care. Our 2026 Hospital Price Report found the same pattern in surgery prices, where a hip replacement runs from $1,076 at the 10th percentile hospital to $25,580 at the 90th.

4. The price often covers different things. One hospital's price may be the facility alone, while the doctor, the anesthesiologist, or the radiologist bill separately. A scan at a hospital outpatient department can also cost more than the same scan at an independent imaging center. The billing code matches, but the bundle behind it does not always. Ask what is included before you compare.

5. Price does not track quality. A higher price is not a sign of better care. RAND's research found that hospital prices are not linked to quality, so a hospital charging $3,877 for an MRI is not giving you a better scan than the hospital charging $455. Check quality separately, for example through the federal Care Compare ratings, and let price be a price decision.

Five things to do before you book planned care

1. Look up the procedure first. Search the procedure on Patients Price and compare hospitals near you before you book, not after the bill arrives. An MRI of the brain without contrast, a CT scan of the abdomen and pelvis with contrast, and a colonoscopy are good places to start. The hospital you pick is often the biggest factor in your bill.

2. Ask for the cash price in writing, and get a Good Faith Estimate. If you are paying yourself, the hospital must give you a written estimate before scheduled care. If the bill comes in $400 or more over that estimate, you can dispute it (see If the Bill Is $400 Over Your Good Faith Estimate, You Can Dispute It). Ask what the price includes: facility only, or the doctor's fee too.

3. Ask about a different setting. For a scan or a routine procedure, ask whether the same care is available at an independent imaging center or surgery center, and what it would cost there. The same procedure in a different setting can carry a very different price.

4. Check the cash price against your plan. About 3 times in 10, the hospital's cash price beats the median rate insurers negotiated (see Should You Use Your Insurance, or Pay Cash?). But cash payments usually do not count toward your deductible, so do the math for your plan before you choose. If you are picking a plan, check hospital prices before you pick it (see Picking a Health Plan? Check the Hospital's Prices First).

5. Check financial assistance even if you have insurance. A big deductible can still leave you owing thousands, and nonprofit hospitals must offer financial assistance. Our financial-assistance screening tool checks your household size, income, and ZIP code against the policies of 852 hospitals and tells you whether you might qualify. If you might, apply before you pay anything (see You Might Not Have to Pay That Hospital Bill).

Two honest caveats

Published prices are not a promise. Hospitals have been required by federal law to publish their prices since 2021, but a few published prices are plainly wrong: our data holds a $1 blood test and a $60,054 blood test for the same code. That is why this article compares the 10th and 90th percentile hospitals instead of the cheapest and most expensive. Always confirm the price with the hospital before scheduled care, and get it in writing.
In an emergency, you do not get to shop. Go to the nearest hospital. Federal surprise-billing protections cover emergency care (see Your Rights Against Surprise Bills), and you can still ask for an itemized bill and financial assistance afterward.

The bottom line

The same procedure has many prices. For an MRI of the brain, the 90th percentile hospital charges about 8.5 times the 10th percentile hospital. For a basic blood test, 10 times.
The gap comes from separate negotiations, market power, and different bundles, not from better care. Price does not track quality.
Compare before you book. Look up the procedure, ask for the cash price in writing, and ask what is included.
Check the setting and the plan. An independent center can cost less, and a cash price can beat your plan's rate, but mind your deductible.
Check financial assistance — even with insurance, you may qualify for free or discounted care.

Sources: hospital prices from the Patients Price database — 1,062 hospitals, 476 procedures, 333,874 rates (data as of November 2026). MRI brain without contrast (CPT 70551): 10th percentile $455, median $1,426, 90th percentile $3,877, max $10,890, median negotiated rate $619, across 697 hospitals. CT abdomen and pelvis with contrast (CPT 74177): $693 / $2,059 / $5,224, max $18,323, median negotiated rate $736, across 818 hospitals. Colonoscopy (CPT 45378): $408 / $1,250 / $3,230, max $11,138, across 388 hospitals. MRI knee (CPT 73721): $581 / $1,409 / $3,592, max $10,180, across 804 hospitals. CT head without contrast (CPT 70450): $423 / $913 / $2,321, max $6,500, across 818 hospitals. Screening mammogram 3D (CPT 77067): $106 / $251 / $502, max $1,444, across 660 hospitals. Comprehensive metabolic panel (CPT 80053): $27 / $108 / $274, across 831 hospitals. RAND Corporation, Private Health Plans During 2022 Paid Hospitals 254 Percent of What Medicare Would Pay (May 2024); Whaley et al., Prices Paid to Hospitals by Private Health Plans: Findings from Round 5.1 (RAND, 2025); KFF Health News, Transparent Hospital Pricing Exposes Wild Fluctuation, Even Within Miles (brain MRI with contrast listed from $1,720 to $8,800); KFF Health News, Wide Variation in Hospital Charges for Blood Tests Called Irrational (BMJ Open study: one hospital charged $10 for a cholesterol test, another $10,169). This is general information, not medical or financial advice.