44% of US Hospitals Charge 5x What Medicare Pays. We Graded All 3,093.
Healthcare pricing in America is broken. Hospitals charge wildly different amounts for the same procedures, markups are irrational, and patients have almost no way to know what something costs before they get the bill. We built ClearPrices.org to change that — using real Medicare data, not estimates.
What We Found
The Price Chaos Problem
A knee replacement costs $1,374 under Medicare — but hospitals charge an average of $7,874. That's a 5.7x markup. And it gets worse: the same knee replacement costs $899 in Alabama but $2,641 in Mississippi. Same procedure, same outcome, wildly different prices.
We scored every major procedure on what we call the Price Chaos Index — measuring how irrational pricing is across states. The most chaotic procedures show price swings of 500%+ for identical services. This isn't driven by cost differences. It's a market failure.
Hospital Fairness Grades
We graded all 3,093 US hospitals on a simple metric: how much do they charge compared to what Medicare pays? The results:
- Grade A (under 2x markup): 232 hospitals (7.5%)
- Grade B (2-3x): 399 hospitals (12.9%)
- Grade C (3-4x): 546 hospitals (17.6%)
- Grade D (4-5x): 555 hospitals (17.9%)
- Grade F (over 5x): 1,361 hospitals (44.0%)
Nearly half of all hospitals in America charge more than 5x what Medicare pays. If you're uninsured, you're often billed the full chargemaster price — the same inflated number that insurance companies negotiate down by 50-90%.
Fraud Detection Built In
We didn't stop at pricing. ClearPrices includes a fraud analysis suite that applies statistical methods to Medicare billing data:
- Benford's Law analysis on submitted charges — detecting anomalous digit distributions
- Upcoding detection — flagging states/specialties with abnormal billing complexity
- Volume outliers — providers billing impossibly high patient volumes
- 83,000 excluded providers cross-referenced against billing data
What You Can Do With It
All free. No login. No ads. No paywall. Built with public CMS data — 9.6 million provider claims from 2023.
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