Healthcare Pricing Transparency Tool
CenturyGoal has collected files from hospitals that are now all required to make publicly available, their gross charges (as found in the hospital’s chargemaster), payer-specific negotiated charges, discounted cash prices, and de-identified minimum and maximum negotiated charges for all items and services they provide through a single online machine-readable file.
The data that CenturyGoal has made available is the negotiated rate between the hospital and each heath insurance plan. We have attempted to select the correct negotiated price from each hospital file. If you believe that we have selected the incorrect price in any instances, please email us at info@centurygoal.com.
| Facility # | Facility Name | Facility Address | Price Data Located (Y/N) | Price Data Usable (Y/N) | Source |
|---|
Search Tool for Healthcare Pricing
CenturyGoal has developed a database of all hospital files and provides the search engine below for anyone to search the data. We have included the payer-specific negotiated charges in this database so that the focus is on what is actually paid for each procedure per the contract rates that the hospital has with each healthcare insurance company (“payer”).
Of the approximate ______ hospitals in the US, we were able to locate files for ______ hospitals and determined that ______ of these hospitals provided usable data. Searches are available in two steps below: (1) select the state and county to see a list of all hospitals in the county and which hospitals provided usable data; and (2) select the procedure code for that state/county to see the list of negotiated prices by payer for each procedure code.
This data was collected during the months of June and July 2023. Therefore, it is important to understand that some of the data may have changed since then and now. It should also be understood that there may now be more hospitals providing usable data now than stated in the paragraph above. We have provided a link in Search #1 below for each facility indicating where we retrieved the data during the months of June and July 2023. We intend to collect files from all hospitals and provide updated data at that time in 2024.
Hospital Pricing Search Tool Directions
Search #1:
Select the State and County to see a list of hospitals in that county and which hospitals provided usable Price Transparency data when it was collected during the summer of 2023.
Search #2:
Select the State, County, and Procedure Code to see a list of contract prices for each hospital in that county including the price negotiated with each of their payers.
CenturyGoal is delighted to discuss price transparency and share information on how to get more access to price data. Please email info@centurygoal.com to set up a discussion.
Request More Information
CenturyGoal is delighted to discuss price transparency and share information on how to get more access to price data. Please fill out the form below to set up a discussion:
Rules Overview
Issued by the Centers for Medicare and Medicaid Services (CMS)
Hospital Price Transparency
Require hospitals to make publicly available, their gross charges (as found in the hospital’s chargemaster), payer-specific negotiated charges, discounted cash prices, and de-identified minimum and maximum negotiated charges for all items and services they provide through a single online machine-readable file that is updated at least once annually.
Publish Annually
Hospitals are required to publish:
- Consumers Online Tool – make payer-negotiated rates for common services available to consumers on an online tool, and for all services in a machine-readable file
- Standard Charges – Hospitals are required to make public its standard charges for the items and services it provides
- Payer Negotiated Charges – Hospitals are required to make public the Payer-specific negotiated charge – means the charge that a hospital has negotiated with a third-party payer for an item or service
Transparency in Coverage
Requires plans and issuers to disclose in-network provider negotiated rates, historical out-of-network allowed amounts, and drug pricing information through three machine-readable files posted on an internet website, thereby allowing the public to have access to health coverage information that can be used to understand health care pricing and potentially dampen the rise in health care spending.
Publish Monthly
Health insurers are required to disclose pricing for covered services and items:
- Rates with Providers – Rates they have negotiated with participating providers for all covered services and items, as well as the allowed and billed amounts for out-of-network providers
- Self-Service Cost Sharing Tool for Participants – disclose to participants, beneficiaries, or enrollees upon request, through a self-service tool, cost-sharing information for a covered item or service from a particular provider or providers
- Machine Readable Files – disclose pricing information through three machine-readable files (500 items specified by CMS after 1-01-23 and all items after 1-01-24) including:
- Payment rates negotiated between plans or issuers and providers for all covered items and services
- Amounts a plan or issuer allowed, as well as associated billed charges, for covered items or services furnished by out-of-network providers during a specified time period
- Pricing information for prescription drugs to reduce the complexity and burden of prescription drug information
- The Transparency in Coverage final rules require plans and issuers to make available the machine- readable files on their websites
