Understanding Healthcare Prices
A guide to reading hospital pricing data and making informed decisions.
Types of Prices
Cash Price
The amount a hospital charges patients who pay out-of-pocket without insurance. This is often significantly lower than the gross charge and can sometimes be the best deal available, especially for common procedures.
Negotiated Rate
The price your insurance company has agreed to pay the hospital for a specific procedure. This varies by insurer -- the same procedure at the same hospital can have very different negotiated rates depending on whether you have Aetna, Blue Cross, UnitedHealthcare, or another plan. Your out-of-pocket cost (copay, coinsurance, deductible) is calculated based on this rate.
Gross Charge
The hospital's "sticker price" or list price. Think of this like the MSRP on a car -- almost nobody actually pays this amount. Insurance companies negotiate lower rates, and even cash patients typically pay less. It's useful mainly as a reference point.
Out-of-Pocket Cost
What you actually pay after your insurance contributes its share. This depends on your specific plan's deductible, copay, and coinsurance structure. The prices shown on Panopticare are the amounts hospitals and insurers agree on -- your personal cost may be lower or higher depending on your plan.
What is Hospital Price Transparency?
Since January 2021, the federal government requires all hospitals in the United States to publish their prices for medical services in a machine-readable format. This includes gross charges, discounted cash prices, and negotiated rates with every insurance plan they contract with.
Panopticare collects these publicly available files from hospital websites, processes them using intelligent parsing and medical terminology matching, and presents them in a searchable, consumer-friendly format.
How We Source Data
Our data pipeline automatically discovers hospital price transparency files from hospital websites, parses formats including CSV, Excel, and JSON, normalizes inconsistent naming conventions across hospitals, and matches procedures to standard CPT codes using semantic search technology.
Each hospital file is scored for quality and completeness. You may see quality badges (Gold, Silver, Bronze) on search results indicating how comprehensive the hospital's pricing data is.
Important Disclaimer
Prices shown are from hospital-published data and are estimates only. Your actual cost may vary based on your specific insurance plan, the complexity of your treatment, additional services required, and other factors.
Always contact your insurance company and the hospital directly for a personalized cost estimate before scheduling a procedure. This tool is intended for informational and comparison purposes only and should not be used as a substitute for professional financial or medical advice.
About the Project
Panopticare is an open-source healthcare price transparency project. Our goal is to make hospital pricing data genuinely useful for patients — not just industry insiders. While most price transparency tools serve enterprise customers, Panopticare is built from the ground up for consumers.
Our Methodology
- Data sources: We process Machine-Readable Files (MRFs) that hospitals are required to publish under the CMS Hospital Price Transparency Rule, along with Payer Transparency in Coverage (TiC) files from insurers like Blue Cross Blue Shield, Cigna, and Centene/Ambetter.
- Procedure matching: We use a CPT-anchored registry of 15,000+ procedures with semantic search (FAISS) to accurately match hospital-specific descriptions to standardized procedure codes.
- Price verification: Where both hospital MRF and payer TiC data exist for the same procedure, we cross-reference them and flag any discrepancies. Prices are marked as "verified" (within 10% agreement), "disputed" (over 10% divergence), or "estimated" (single source).
- Quality scoring: Each hospital's data is scored for completeness. Gold, Silver, and Bronze badges indicate the breadth and depth of pricing data available.
Coverage
Panopticare currently covers 100+ hospitals across Illinois, Indiana, Michigan, and Ohio with 70+ million price records and 1.3+ million payer TiC rates. We are actively expanding coverage to additional states and hospitals.
Open Source
Panopticare's entire data pipeline, API, and frontend are open-source. This means our methodology is fully transparent and can be independently verified. We believe healthcare pricing tools should be as transparent as the data they present.