Every hospital in America is required by federal law to publish its real prices.
Almost no one has ever opened them. That’s the problem we exist to fix.
Since January 1, 2021, the Hospital Price Transparency Rule (45 CFR Part 180) has required every U.S. hospital to post its actual prices — including the rates it negotiates with every insurer — in a public, machine-readable file. The law made the data public. It didn’t make it usable. We do.
See what the law requires ↓Two obligations, applying to every licensed hospital — critical-access and rural hospitals included.
1. The machine-readable file (MRF)
A single public file listing the hospital’s standard charges for every item and service, in five forms:
- Gross charge (the chargemaster “sticker price”)
- Discounted cash price (what a self-pay patient is offered)
- Payer-specific negotiated charge (the real rate, named insurer by named insurer)
- De-identified minimum and de-identified maximum negotiated charges (two separate requirements, not one)
The file must be free to access — no login, no personal information, no fees — and follow a CMS-standardized naming convention.
2. The consumer view
A consumer-friendly display of at least 300 “shoppable services” (procedures you can schedule in advance), or a price-estimator tool in its place.
cms-hpt.txt at every hospital’s web rootThe rule has tightened in every cycle since 2019 — from “publish something” to “publish real, standardized, attested prices.”
The ceilings are real. The enforcement record is thin.
The penalty process is graduated: a warning notice, then a corrective-action plan, then civil monetary penalties published on CMS’s website. The ceilings are real — up to ~$5,900 per day for a large hospital — but the enforcement record is thin: in the rule’s first five years, CMS has fined 28 hospitals, out of more than six thousand covered. The largest single penalty issued to date: $871,122.
Meanwhile, independent audits dispute how many hospitals actually comply. Patient Rights Advocate’s semi-annual reviews put full compliance around a third of hospitals sampled; CMS publishes no comparable rate of its own, and the GAO has told CMS it “needs more information” on whether the published files are complete and accurate at all.
The law made the prices public. Enforcement didn’t make them findable, comparable, or trustworthy. That gap is where we work.
A short list — and it’s the whole list.
Federally owned hospitals (VA, Department of Defense), Indian Health Service and tribal facilities, and state forensic hospitals that treat exclusively court-committed patients. That’s the whole list — there is no exemption for critical-access, rural, psychiatric, or state-owned hospitals generally. (Ambulatory surgery centers and other non-hospital facilities fall outside the rule because they aren’t licensed as hospitals.)
The Transparency in Coverage rule requires insurers to publish their negotiated rates — different regulation, different party, different files. ClearPrice’s hospital data comes from hospital MRFs under the Hospital Price Transparency Rule; when we reference insurer-published data we say so explicitly.
The law made two promises. Machines got theirs. We built the other one.
The law made two promises. Machines got theirs — the files. Consumers were promised something better: a usable, plain-language display of at least 300 shoppable services from every hospital. What arrived is thousands of separate hospital websites, each presenting prices its own way — none of them comparable to the next. ClearPrice was founded to keep that promise the way it should have been kept: the consumer-friendly display the law imagined, built once, for every hospital at once, from the files themselves. Here is exactly how — and what we don’t do.
1. Find
We discover and validate every hospital’s MRF, including the cms-hpt.txt pointer the law requires
2. Read
We parse each file — a wide range of formats and vendor layouts persists in the wild, despite the template mandate — into one normalized structure: payer names normalized, schemas validated, corrupt and templated files flagged rather than trusted
3. Verify
Every hospital is scored daily against 10 requirements drawn from the rule: the file is published and machine-readable, in a CMS-approved format, discoverable via cms-hpt.txt, contains all five charge types (each checked separately), and re-checked as current within the last twelve months
4. Show
Verified rates power every exhibit, search result, and download on this site, each with an as-of date and a citable source
The full regulation contains 29 administrative and technical requirements. We score the 10 that determine whether a hospital’s price data is real, complete, and current — the five charge types, publication, machine-readability, and freshness. We don’t score administrative elements like the attestation statement or the consumer-display presentation — a signed attestation doesn’t help a patient if the file behind it is missing or unreadable. We grade the file — the data — not the hospital’s full compliance posture. When we grade, that’s exactly what the grade means — nothing more, and nothing less.
Every number on this site traces to a file a hospital was legally required to publish — and when a hospital doesn’t publish, or publishes something unreadable, we track that too. See the exhibits → · Download the CSVs →
A law only helps if someone does the work of making it legible.