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Heath Care Pricing Transparency and Consumer Rights: Standard charges

"Standard charges" in a machine-readable file

Federal regulations require hospital-based health care providers to post standard charges in a Machine-Readable File (MRF). 

These files include gross charges (AKA the full price), discounted cash prices for patients not using insurance, payer-specific negotiated charges (allowed amounts negotiated by health insurance companies), and de-identified minimum and maximum negotiated charges. Prices are listed for each and every service, test, procedure, every disposable supply, etc.   There may be further prices based on where the service took place, for example a flu test may be priced differently for an urgent care than a doctor's office. 

The database is best accessed by searching the full text (Control + F) by CPT and HCPCS code.  A single code may show up in the database dozens of times because of the necessity to state the negotiated price with every insurance company as well as entries for the gross price, self-pay price, etc.

To find the file, go to any hospital's home page and add  “/cms-hpt.txt" at the end.  For example,

Note the URL location of the standard charges, "Machine Readable File" (MRF).

location-name: Name of hospital system
source-page-url: Web address for page that contains a link to pricing data
mrf-url: Web address for machine-readable file containing price data
contact-name: Name of person designated to answer technical questions about the data file
contact-email: Email address of person designated to answer technical questions about the file

This instruction sheet for hospitals describes in plain language all the elements that should be present in the machine-readable file containing standard charges.

TIPS FOR ACCESSING A MACHINE READABLE FILE CONTAINING STANDARD CHARGES 

File can be enormous -- sometimes over 300 megabytes.  Files of this size fail to load in a browser and are too large for word processing programs. You can however open and search these files by following the suggested steps listed below.

If you attempt to open a Standard Charge file and get an error message, simply right-click on the file link and choose "Save link as..." on our computer. Then, use a software program that is able to open and display it.  For Windows users, Notepad++ works well.  For Mac users, we've heard good things about BBEdit, available from the Apple Store.

  • Adjusting the display in Windows
    If you open Standard Charges file and find one humongous word wrap without line breaks, you can adjust the way it displays in Notepad++.  First, look closely at the file and notice where the “rows” (individual records) are supposed to begin and end.  Each record is enclosed by curly brackets and between each record there is a comma.   You can use those commas to insert line breaks between each record.  
    • In the Seach menu, select Replace. 
    • Enter “,” (without the quotes) in the “Find what:” box. 
    • Enter “\n” (without the quotes) in the “Replace with:” box. 
    • Change the radio button for the Search Mode from Normal to Extended. 
    • Then click on the Replace All button.  This will convert all commas to new lines.
  • Mac users
    You may find the TextEdit app which comes shipped with your Mac a suitable application for viewing Standard Charges files.  If however your machine slows up and you get the spinning beachball, consider using BBEdit instead.  It is a free download from the Apple store.