Each hospital has a unique combination of payers (insurers/government programs/employers), patients and services. Large insurers can negotiate discounted pricing contracts with hospitals that they include in their network. If a hospital serves a large portion of patients on a government health program, higher prices may be passed on the patients with private insurance since the government pays a lower portion of the charges for each case. Many times because billing systems rely on codes for services the patient received, there could be coding mistakes or older price lists mixed into the data in these complex systems.
Articles in this section
- Are hospitals that show higher prices going to give better care?
- Do you provide estimates outside of the U.S.?
- How are complications categorized (CC/MCC)?
- How are estimate costs determined?
- How do ClaraPrice estimates compare to billed charges?
- How do health complications affect the cost of surgery?
- How do I find my medical records (EHR)?
- How do I know the quality of my provider?
- How do you protect my data?
- What is a DRG?