If your medical bill is in the thousands, you don't have to fight it alone, a growing number of medical bill negotiation companies, advocates and negotiators will investigate the charges and negotiate on your behalf. But they don't all work the same way, and the fee structures vary enough to matter. Here's an honest, head-to-head comparison of the leading medical bill negotiation services in 2026, including our own.
Quick answer
The best medical bill negotiation service depends on how you want to pay. mediloop charges an upfront flat fee, and the Pay Per Bill fee is refunded if the bill is not reduced. That can fit when you want predictable cost rather than giving up a percentage of the reduction. Goodbill, Resolve, CareRoute and Granted charge a percentage of savings under their published terms. Dollar For provides free hospital charity-care application help rather than general negotiation.
A quick note on honesty: mediloop is one of the services in this comparison, so we have a stake in it. We've tried to describe every option fairly and accurately, including where a competitor or a free option is the better fit for your situation. Fees listed are as advertised at the time of writing and can change, so always confirm the current terms directly with each service before you sign up.
Methodology: how we selected and compared providers
We reviewed U.S. services that were accepting individual medical-bill cases online on September 1, 2026 and published enough information to compare their scope or pricing. We selected established direct-to-consumer advocates that represent the main options a patient is likely to encounter: flat-fee negotiation, contingency-fee negotiation, broad advocacy, and free charity-care assistance. We excluded general debt settlement companies, legal practices without a standard consumer service, insurance-only navigation tools, and providers whose current service terms could not be confirmed. mediloop is included because it is one of those options; the conflict-of-interest disclosure above applies to our selection and conclusions.
We compared each provider on the same four dimensions:
- Total consumer cost, including the advertised fee, percentage, cap, deposit, and any stated minimum
- Eligibility and bill scope, including minimum bill size, payment or collections status, and supported bill types
- Work performed, including provider negotiation, billing review, insurance appeals, and charity-care help
- Downside risk, including upfront charges and what the consumer owes when no savings are found
Competitor facts come from the provider's own pricing, FAQ, or service pages, not affiliate roundups. Each linked claim and table row shows the date we last checked it. “Best for” labels are editorial judgments based on those published terms, not a claim that we tested every service or independently verified its advertised outcomes. Prices and eligibility rules can change, so confirm the linked terms before enrolling.
Services compared at a glance
A side-by-side look at how the leading services price their work. Scroll horizontally on mobile to see every column.
Competitor pricing, caps, and eligibility were verified on September 1, 2026 using the official pages linked in each row. Terms can change; confirm them with the provider before enrolling.
What the fee models cost on the same savings
A flat fee stays the same when the reduction grows. A percentage fee grows with it. The examples below use mediloop's $129 Pay Per Bill fee and uncapped percentage fees so you can compare the basic models on the same result.
| Bill reduction | $129 flat fee | 10% fee | 20% fee | 25% fee | 35% fee |
|---|---|---|---|---|---|
| $1,000 | $129 | $100 | $200 | $250 | $350 |
| $5,000 | $129 | $500 | $1,000 | $1,250 | $1,750 |
| $10,000 | $129 | $1,000 | $2,000 | $2,500 | $3,500 |
Illustration only. A provider's cap, deposit, minimum fee, eligibility rules, or refund terms can change the final cost. A bill reduction is never guaranteed.
A percentage fee can turn a large reduction into a large invoice. mediloop's Pay Per Bill price is fixed upfront, and the fee is refunded if the bill is not reduced.
See Pay Per BillThe services, reviewed
mediloop, best for predictable, capped cost
mediloop offers a $49 Personalized Action Plan for people who want specialist-prepared guidance but will make the calls themselves, $129 Pay Per Bill for one supported negotiation, or $499/year for up to six household bills. It never takes a percentage of your savings. On a large reduction, that's a meaningful difference: save $8,000 and a 25% service keeps $2,000, while mediloop's fee stays $129. If a Pay Per Bill case does not reduce your bill, the full $129 fee is refunded. The Personalized Action Plan is not covered by that guarantee. A dedicated case specialist handles supported hospital, ER, surgery, ambulance, and out-of-network bills. Best for people who want to know their exact cost upfront.
Goodbill, best for hospital bills and charity-care screening
Goodbill supports unpaid hospital bills that have not gone to collections, reviews them for coding errors, and screens for financial-assistance opportunities. Its official pricing page says it charges 20% of savings, capped at $1,000, with no fee when no settlement is accepted. Verified September 1, 2026. Strong choice for a large hospital bill if you're comfortable with a percentage model. For a detailed head-to-head, see our mediloop vs Goodbill comparison, or, if you're shopping beyond Goodbill, the Goodbill alternatives roundup.
Resolve, best for complex bills, including collections
Resolve assigns a dedicated advocate and works with providers and insurers, including on complex cases and bills in collections. Its published terms apply to bills of at least $5,000:a $249 deposit and 25% success fee for $5,000-$15,000 bills, or a $499 deposit and 10% success fee above $15,000. The deposit is credited to the success fee or refunded if no savings are found; minimum-fee rules can apply, and the page does not state an overall dollar cap. Verified September 1, 2026. Good for messy, high-dollar situations. For a detailed head-to-head, see our mediloop vs Resolve comparison.
CareRoute, best for working both sides of the bill
CareRoute says it works provider and insurer disputes and accepts hospital, ER, physician, imaging, lab, surgical-center, and collections bills. Its official pricing is 25% of savings, or 18% for premium app subscribers, capped at $1,000, with $0 upfront and no fee if the bill is not reduced. Verified September 1, 2026.For a detailed head-to-head, see our mediloop vs CareRoute comparison.
Granted, best for small bills with nothing upfront
Granted pairs bill-detection software with a dedicated human advocate on every case, and lists hospital, ER, lab, imaging, pharmacy and out-of-network bills as well as insurance claim denials. Its homepage states the price plainly: 10% of the amount saved, capped at $300, and free if it cannot save you money, with resolutions that it says typically take 15 to 45 days. Verified September 1, 2026. The trade-offs are per-case pricing when one episode of care produces several bills, and no published policy on ambulance bills or bills in collections. For a detailed head-to-head, see our mediloop vs Granted comparison.
Medical Cost Advocate, best for a long track record
Medical Cost Advocate says it has operated since 2002 and serves individuals, families, employers, and payer organizations. For web-direct bill negotiation, its official process page lists no upfront fee, a 35% share of savings, and no negotiation fee when it finds no savings; that page does not state a dollar cap. Verified September 1, 2026. A solid, established option if longevity matters to you. In August 2024 the company announced it had merged into Emry Health, a benefit navigation company; its web-direct pricing page is unchanged.
Dollar For, best free option (charity care only)
Dollar For is a nonprofit that helps patients check eligibility and apply for hospital charity care at no cost. It is not a general bill-negotiation service: eligibility and the available discount depend on the hospital's own financial-assistance policy, household size, income, and other policy requirements. Verified September 1, 2026.If charity care may apply, start there before paying for negotiation; we've mapped exactly where that line sits in mediloop vs Dollar For.
Flat fee vs. percentage of savings
This is the single biggest decision, so it's worth understanding the trade-off clearly.
- Percentage of savings means you pay nothing if nothing is saved, but your cost rises with your reduction. A 25% fee on a $10,000 savings is $2,500. A cap (like $1,000) limits the downside, but not every service has one, and some require a deposit.
- Flat fee means you know your cost before anyone starts. You keep all savings above the fee, which is most valuable on large reductions. The trade-off is that on a small saving the flat fee could be a higher share, which is why a money-back guarantee matters: if the bill isn't reduced, you shouldn't pay.
Rule of thumb: the larger your expected reduction, the more a flat fee works in your favor. For a deeper look at fees and when professional help pays off, see Is a medical bill advocate worth it?
How to choose the right one
If you are still deciding between an app, a bill-specific plan and a service that makes the calls, start with our guide to medical bill negotiation software for families.
- Tiny or simple bill (under ~$500)? Try it yourself first with our hospital bill negotiation guide.
- Hospital bill and possible financial-assistance eligibility? Check the hospital's policy or use Dollar For's free eligibility and application help.
- Large bill and you want a known cost? A flat-fee service like mediloop.
- Comfortable with a percentage-based fee? Compare the linked terms for Goodbill, Resolve, and CareRoute, including deposits, minimums, and caps.
- Bill already in collections or highly complex? Resolve accepts high-dollar cases and describes collections support; CareRoute also says it accepts collections bills.
Whatever you choose, confirm three things before signing: the exact fee, whether there's a cap or deposit, and what happens if they can't reduce the bill.
When mediloop may not be the right fit
- You may qualify for hospital financial assistance. Check the hospital's policy or use Dollar For's free application help before paying for negotiation.
- The bill is small or straightforward. If the balance is under about $500, requesting an itemized bill and calling the billing office yourself may be more economical.
- The bill is already in collections or needs a complex insurance appeal. Confirm mediloop can accept the case before paying, and compare services that explicitly publish collections or insurer-dispute support.
- You prefer a contingency fee. A percentage model can fit if you would rather avoid an upfront fee and accept giving up part of any reduction.
Frequently asked questions
What is the best medical bill negotiation service?
There's no single winner for everyone. Choose a flat-fee service when you want a predictable, capped cost; choose a percentage service when you'd rather pay nothing unless they win; and start with a free charity-care nonprofit if you may qualify based on income.
Is there a service that negotiates medical bills for you?
Yes. Several companies negotiate medical bills on your behalf, and they fall into three camps. mediloop negotiates hospital, ER, surgery, ambulance, and out-of-network bills for a flat fee with a money-back guarantee. Goodbill, Resolve, CareRoute and Granted do the same work for a percentage of what they save you, under the terms linked in the table above. And Dollar For is a free nonprofit that handles hospital charity-care applications rather than negotiation. Whichever camp fits, confirm the fee, the eligibility rules, and what you owe if no savings are found before you hand over the bill.
How much do medical bill negotiation services charge?
Pricing usually takes one of three forms: a flat fee, a percentage of the reduction, or free charity-care assistance. Percentage services may also have deposits, minimum fees, or dollar caps. Compare the full terms, not just the headline rate.
Do medical bill negotiation services take a percentage of the savings?
Many do, but not all. Goodbill, Resolve, CareRoute, Granted, and Medical Cost Advocate publish percentage-based pricing, while mediloop uses flat prices and Dollar For provides free charity-care application help. Check the official terms linked in the table because prices and eligibility can change.
Are these services worth it?
It depends on the bill, the likely relief path, and the full fee. Start with free routes such as correcting billing errors and checking hospital financial assistance. Paid help may be worth considering when the balance is large or complex, you have exhausted the free options, or you want someone else to handle the work.
Will using a service hurt my credit?
No. Negotiating or disputing a bill doesn't affect your credit. (Medical debt reporting rules also changed in 2025, see does medical debt affect your credit score.)
About mediloop
mediloop (mediloop.ai) is a specialist-led medical bill review and negotiation service for people in the United States. Customers create an account and upload the bill and an explanation of benefits, if available. The $49 Personalized Action Plan is a specialist-prepared, self-directed plan for one bill and is posted to the customer's account within 24 hours after complete intake. For customers who want help with the calls, Pay Per Bill is $129 and the Annual Plan is $499 for up to six household bills. Prices are flat, never a percentage of savings. The $129 Pay Per Bill fee is refunded if the bill is not reduced; the Personalized Action Plan is not covered by that guarantee. mediloop is an independent US company and is not connected to other businesses that use a similar name.
Sources
- FTC, Debt relief services and the Telemarketing Sales Rule
A debt relief provider may not collect any fee until it has settled or renegotiated at least one debt, the customer has approved the agreement, and the customer has made a payment under it. Front-loading fees is illegal.
- FTC, How to get out of debt
A debt settlement company cannot collect its fees before it settles your debt, and demands for upfront payment or guaranteed results are named as signs of a scam.
- Patient Advocate Certification Board, BCPA eligibility
To sit the Board Certified Patient Advocate exam a candidate needs two letters of recommendation, a self-assessment, and either a bachelor's degree or documented equivalent advocacy experience.
- Duffy, Frasco and Trish, JAMA Health Forum, August 2024
Of adults who received a bill they disputed or could not afford, 61.5% contacted the billing office; among those, 25.7% had the bill corrected, 15.2% got a price reduction and 8.1% got financial assistance. Nationally representative survey of 1,135 adults, 2023.
Sources last checked 1 September 2026. Medical billing rules change, so if you spot something out of date, tell us and we will correct it.
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