Understanding the cost of healthcare before receiving treatment can help patients make informed decisions and avoid unexpected medical bills. To help Americans with that process, the federal Hospital Price Transparency Rule was introduced in 2021 to push for more transparency. However, while changes have been made over the past five years, a September 2026 report highlighted an important issue: although hospitals are improving their compliance, many patients still struggle to find clear, usable prices.
Progress in Hospital Price Transparency
Federal rules now require hospitals to publish pricing information online in a machine-readable file and provide consumer-friendly pricing information for services patients can schedule in advance. These requirements are intended to help consumers compare hospitals and estimate the cost of care before making healthcare decisions. According to a report from PatientRightsAdvocate.org, data found that 49.4% of the 2,000 hospitals recently reviewed fully complied with federal price transparency requirements. This represents a significant improvement from 21.1% in the organization’s previous report.
Why Finding Actual Prices Remains Difficult
Despite this progress, transparency does not always mean clarity. The report found that only 18% of hospitals reviewed published dollar-and-cents prices for at least half of the items and services in their pricing files. “CMS has made progress enforcing its hospital transparency rules, but this report shows that most hospitals still owe patients clear, usable dollars-and-cents prices they can look up before receiving care,” said Cynthia Fisher, founder and chair of PatientRightsAdvocate.org. “Too many patients are still being denied the real, upfront prices they need to shop for affordable care and protect themselves from overcharges.”
One major barrier to publishing dollar-and-cents prices is due to the fact that for many hospitals, calculating pricing involves using complicated formulas, algorithms, and percentages which often “require access to additional information” to establish the final cost of a service. The report also found that 23% of hospitals reviewed used algorithms that did not provide enough information for the public to calculate the dollar amount. As a result, patients may encounter pricing information online without being able to determine what they are likely to pay, which is both unfair and frustrating for many seeking health services. However, there was some positive news: approximately 98.9% of hospitals provided the required information for 300 shoppable services through a consumer-friendly display, a price estimator, or both.
What This Means for Patients
Clear pricing allows patients to compare providers, ask informed questions about potential costs, and ultimately chose the best healthcare services for them. However, posted prices may not represent a patient’s final out-of-pocket expense, which can depend on insurance coverage, deductibles, and the services received. Regardless of what pricing calculators estimate, patients should contact hospitals and insurance providers directly to request personalized estimates and clarify which services and fees are included.
Solidarity is Committed to Affordable Care For Members
At Solidarity HealthShare, we are committed to providing our Members with affordable healthcare with no hidden costs. In order to keep our costs competitive and affordable, we employ a Reference-Based Pricing model based on Medicare reimbursement rates. This approach ensures providers are paid fairly while keeping eligible medical expenses as low as possible.
To offer our Members additional access to savings, we provide a Solidarity Care Card that offers discounts on dental and vision care. For more information about joining the Solidarity community, please contact our Member Care team today at 737-SHARING or check prices online.