Where do these prices come from?

Every dollar value comes from a hospital's own published machine-readable file (MRF), required under 45 CFR §180.50. We do not model, estimate, or crowdsource any prices.

What is the percentile band?

We compute each Colorado hospital's median commercial negotiated rate for the procedure, then take the 25th-to-75th percentile across those hospital medians. The headline 'Colorado median' is the 50th percentile of the same distribution. We use median-of-hospital-medians (not row-weighted) so a single MRF with thousands of plan/payer permutations doesn't dominate the band.

Are Medicare and Medicaid rates included?

No. Headline medians, percentile bands, and the workspace 'vs CO median' ratio exclude Medicare, Medicaid, Tricare, VA, and Workers' Comp — those are statutory fee-schedule floors that would distort what a commercially-insured Coloradan actually pays. Government-payer rates are still in the per-hospital downloadable Parquet for analysts.

What does the percentile bar mean?

It's the hospital's percentile rank among Colorado hospitals' commercial negotiated medians for that procedure. 0% = the cheapest CO hospital reporting; 100% = the most expensive. Ties are split evenly. Hospitals appear only when at least two CO hospitals report a median for the same code.

Are these prices a quote?

No. They are aggregates from regulatory filings, not pre-authorisations or estimates of what an individual patient will be billed. Your actual bill depends on plan, deductible, and clinical circumstances.

How often is the data refreshed?

We re-scan every quarter. Hospitals republishing MRFs in between cycles get picked up at the next refresh.

Why are some hospitals missing?

They either don't publish a CMS-mandated MRF, or publish in a format we don't yet parse — most commonly ZIP archives or non-UTF-8 CSVs. Our parser support is expanding each cycle.

How we build these prices

By Ashwin Pingali Updated June 1, 2026 6 min read

ClearPrice Health takes the raw machine-readable files (MRFs) hospitals are required to publish under 45 CFR §180.50 and turns them into clean, comparable price displays. Here’s exactly what that pipeline does.

Sources

Every price you see comes from a hospital’s own published MRF. We don’t add modeled prices, crowdsourced reports, or anything we couldn’t point a regulator at. The MRFs come in four CMS formats — csv_tall, csv_wide, json_v1, and json_v2/v3. We parse each one, normalise to a single canonical schema, and store the result as partitioned Parquet keyed by (state, code_prefix).

What you see on a procedure page

Filter to the procedure

We pick rows matching the procedure code (CPT, HCPCS, MS-DRG, APC, etc.) and the state. Modifiers are preserved.

Compute each hospital's median

For every Colorado hospital that publishes a negotiated rate, we take the median across that hospital's commercial payers. Government payers (Medicare, Medicaid, Tricare, VA, Workers' Comp) are excluded — those are fee-schedule floors set by statute and would distort the headline.

Compute the percentile band from hospital medians

The hero band — for example $276 to $4,907 — is the 25th to 75th percentile of the per-hospital medians from step 2. The 'Colorado median' is the 50th percentile of the same distribution. Median-of-hospital-medians (not row-weighted) keeps a single chatty MRF from dominating.

Median cash and gross

Cash and gross charges are reported once per (hospital, code, setting) — they're hospital-wide, not payer-specific. We deduplicate at ingest time, then take the median across hospitals for the headline.

Per-hospital ranking

Each hospital's percentile bar shows its rank within the Colorado distribution of hospital medians. 0% (teal) = cheapest hospital reporting; 100% (coral) = most expensive. Each hospital's own 25th–75th payer-band is shown for context.

What we deliberately don’t do

·No modeled prices. If a hospital didn’t publish a rate, it’s not on the page.
·No paid placements. We don’t take money to elevate any hospital.
·No quotes. These are aggregates, not pre-authorisations or estimates of what you’ll be billed.
· No crowdsourcing. Patient-reported bills are noisy in ways that hide real signal.

Caveats and known limits

Real MRFs are messy. Some hospitals publish ZIP-archived files our parser doesn’t yet open; some publish JSON with stray non-UTF-8 bytes; some omit Type-2 NPIs we’d ideally use to link to NPPES taxonomy data. When a hospital’s data is incomplete or unparseable, we omit them rather than guess. The list of currently-omitted Colorado hospitals is shrinking with every ingest cycle.

Payer coverage

The payers index and per-payer pages are derived onlyfrom each hospital’s published MRF. If a payer doesn’t appear in a hospital’s file, that does not mean the hospital doesn’t accept the payer — the MRF may not require disclosure of every contract, may be incomplete, or may report the payer under a different name. We invite corrections from hospitals and payers and refresh quarterly.

Refresh cadence

We re-scan every quarter. If a hospital republishes an MRF in between, the next quarterly cycle picks it up. The pages/manifest.json file at the root of our data bundle is the source of truth for what was indexed and when.

CPT® and code-set licensing

The CPT code numbers shown on this site are derived from the public hospital price-transparency disclosures hospitals are required to publish under 45 CFR §180.50. Procedure descriptions on ClearPrice Health are original, plain-English explanations written by the ClearPrice Health editorial team for consumer use; they are notthe AMA’s official CPT long descriptors. No fee schedules, basic units, relative values, or related listings are included in CPT. The AMA does not directly or indirectly practice medicine or dispense medical services, and assumes no liability for data contained or not contained on this site.

MS-DRG, APC, and HCPCS Level II codes are maintained by the U.S. Centers for Medicare & Medicaid Services and are in the public domain. If you are the AMA or its licensing representative and have a concern about this site’s use of CPT codes, please email clear-price-corrections@geninspired.com and we will respond promptly.

Open questions, contributions

ClearPrice Health is published by Generative Inspired. Methodology questions, data corrections, and reproducibility requests are welcome — see the footer for contact details.