Every US hospital is required to publish a machine-readable file listing its standard charges, including the discounted price it gives patients who pay cash. Almost nobody outside the industry has opened one. It is a large spreadsheet with an ugly name, and it contains the number a billing representative will not say out loud.
What the file is and why it exists
Under the federal hospital price transparency rule, hospitals must post a comprehensive machine-readable file of standard charges for all items and services, updated at least annually and available without a login, an account, or any obligation to identify yourself. The file has to include the gross charge, the discounted cash price, payer-specific negotiated rates, and de-identified minimum and maximum negotiated rates.
The column that matters to you is the discounted cash price. That is the hospital publishing, in its own file, what it charges a patient paying out of pocket for a specific service. You are not asking for a favor when you cite it. You are quoting the institution to itself.
Finding the file
Hospitals rarely link it from anywhere a patient would look. Three approaches, in order of speed:
- Search the hospital domain directly. Query a search engine for the hospital name plus the phrase standard charges or price transparency. The compliance page is usually titled something close to that.
- Check the site footer. Price transparency links are frequently buried alongside privacy and nondiscrimination notices rather than in patient-facing navigation.
- Look for a file name pattern. Files are commonly named with the hospital's tax identification number, the legal entity name, and the word standardcharges, ending in .csv or .json.
Many hospitals also publish a separate consumer-friendly price estimator for common shoppable services. Use it if it exists, but treat the full file as the source of truth, because the estimator often quietly excludes categories.
Opening a file that fights back
These files are large. A mid-size hospital's file can run to hundreds of thousands of rows, which is enough to make a spreadsheet application struggle or refuse outright.
If the file will not open
- CSV that crashes your spreadsheet: import it rather than opening it, and filter on the code column before loading everything, or open it in a plain text editor and search for the code you care about.
- JSON: use a browser-based JSON viewer, or simply open the file in a text editor and use find. You are looking for one code, not a full analysis.
- Nothing works: email the hospital's price transparency contact and ask for the discounted cash price for a specific code in writing. The obligation to publish implies an obligation to be reachable about it.
You need the code, not the procedure name
Searching for the word colonoscopy in a hospital file returns dozens of rows, because the file describes billing lines rather than patient experiences. Search by code instead. CPT and HCPCS codes identify professional and outpatient procedures, DRG codes identify inpatient stays, and revenue codes identify departments.
Get the code from your physician's office before you go looking. Ask which CPT code will be billed for the planned procedure, and whether more than one is expected. Our guide to reading an itemized bill covers the code types in more detail.
Reading it without fooling yourself
Three traps catch first-time readers.
One code is not one bill. A surgical episode generates a facility line, a professional line, an anesthesia line, and often pathology. The file gives you the hospital's charges, and typically not the independent physician group's. The number you find is real, and it is partial.
The cash price is not always the best price. The discounted cash price is what this hospital publishes. A freestanding ambulatory surgery center across town may publish a package price well below it, since surgery centers charge on average 60 to 80 percent less than hospital outpatient departments for the identical procedure. The file tells you what this building costs, not whether you should be in it.
Published does not mean automatically applied. If the file lists a discounted cash price, you still have to invoke it. Print the row, send it to billing, and ask for that price in writing. See the self-pay discount ask for the wording.
One more reason to pull the file yourself
The gap between the gross charge column and the discounted cash column is the clearest evidence you will ever see that the first number was never a real price. Seeing a $3,412 charge and a $614 cash price sitting on the same row, published by the same institution, changes how the negotiation feels. You are no longer asking for mercy. You are pointing at a number the hospital wrote down.
It also tells you when to stop negotiating. If the published cash price is $614 and billing has offered you $700, you are close enough that further argument is not worth your afternoon. If billing quotes you $2,400, you have documentation that the institution says otherwise.
What to do with the number once you have it
Bring it to the estimate conversation rather than the bill conversation. A patient who emails billing with the hospital's own published cash price for CPT 70551 attached is having a different conversation than a patient asking whether there is any kind of discount available. The file converts a negotiation into a reconciliation.
Then compare it against a second site of service and, for elective procedures, against an international cash price. That is the full comparison set, and the file is one of the three inputs.
The comparison the file cannot give you
A machine-readable file tells you what one American hospital charges a cash patient. It cannot tell you whether that number is competitive against the wider market, because the wider market for elective care now includes accredited hospitals abroad that publish package prices as a matter of ordinary commercial practice.
If you have pulled a cash price out of a hospital file and want a second number to hold it against, we can give you a typical Colombia range for the same procedure, itemized the same way. We are in Medellin and see the clinics in person.
Straight answers
Is the machine-readable file the same as a price estimator?
No. The estimator is a consumer-facing tool covering selected shoppable services. The machine-readable file is the comprehensive list of standard charges, including the discounted cash price, and it is the more complete source even though it is harder to read.
Do I have to identify myself to download it?
No. The file is required to be accessible without a login, an account, or any personal information. If a hospital is gating it behind a form, that is worth noting in any complaint you file, and worth going around by emailing the price transparency contact directly.
What if the hospital has not posted one?
Noncompliance still happens, and CMS accepts complaints. In the meantime, do not stall: request the discounted cash price in writing from patient financial services, and price the procedure at an ambulatory surgery center in parallel.
Will the hospital honor the published cash price?
In most cases yes, if you ask before service and reference the specific code and file. Print or screenshot the row, since files are updated and your evidence should be dated. If the hospital declines to honor its own published price, ask for the refusal in writing.
Which code should I search for?
Ask the ordering physician's office which CPT or HCPCS code will be billed. For an inpatient stay, ask for the expected DRG instead. Searching by procedure name returns too many rows to interpret.
Does the file show what my insurance would pay?
It shows payer-specific negotiated rates and de-identified minimum and maximum negotiated rates, so you can see the range plans pay. For a cash patient that is useful context, because it shows how far the chargemaster sits above what anyone actually pays.
How to read the numbers on this page. Every dollar figure here is a typical 2026 range compiled from published provider pricing, transparent-price surgery centers, and government data. None of it is a quote, and none of it is a guarantee. Your bill depends on your case, your provider, and your state. Get a current itemized estimate in writing before you budget against anything you read here.
Not legal or medical advice. This is consumer education about billing rules and patient rights, written for people paying cash. It is not legal advice, and it is not a substitute for a licensed clinician. If you are considering care in Colombia, verify any physician on the Colombian government's ReTHUS registry and confirm accreditation at the hospital level before you commit to anything.
Disclosure. Cash Medical is operated by Scout Theory LLC. We may receive referral compensation from providers we connect patients with. It never changes the price you are quoted, and it never decides what we publish. Questions: andy@colombiamedical.co.