What a routine office visit actually costs
Billed at five levels of complexity, and the level chosen is the single biggest driver of the price.
List price
$388
What the hospital lists the procedure at.
Cash price
$130
What the hospital charges someone paying without insurance.
Cash is
33%
of the list price. The self-pay discount, as published.
What different people pay
| The list priceWhat the hospital publishes as its gross charge | $388 |
| Paying without insuranceThe hospital's own discounted cash price | $130 |
| An insurer with a contractMedian of the rates hospitals publish per payer and plan | $169 |
The gap is the argument
A list price is close to fiction. Almost nobody pays it: Medicare does not, no insurer with a contract does, and the hospital itself will take far less from someone paying cash. It is an opening number.
If your bill for office visit is near the list price, the figures above are what you raise. Ask for the cash price by name, it is published and they are required to honour it. Then ask why you are being charged more than a contracted payer for identical work.
What these numbers are not: a quote. Prices vary by hospital, by region and by what else happens during the visit. These are medians of what hospitals published, not an average of what people were billed.
This is the most useful right almost nobody knows they have. If you were given a good faith estimate and the final bill from that provider came in $400 or more above it, you can force a review.
Your bill came in above the estimateWhere this came from
Prices published by 54 hospitals in their machine-readable files under 45 CFR 180.50, 239 of which listed a cash price for this procedure. Those hospitals are all part of one health system, so treat these as that system's published prices rather than a national average. Retrieved 2026-08-07.