About CostGrade

CostGrade grades what every Medicare-certified hospital in the United States charges, using the federal record and nothing else. 5,508 hospitals, 209,397 published prices, one question: is that number fair?

Why this exists

American hospitals charge wildly different amounts for identical, identically coded work. The information proving it has been public for years — CMS publishes what each hospital billed and what it was actually paid — but it ships as multi-gigabyte files full of billing codes, which is a form of secrecy all by itself.

We read those files so you do not have to, and we say plainly what they show.

What we take money for

No hospital pays us anything. There are no sponsored listings, no paid placement in any ranking, and no way to buy a better grade. We take no referral fee for sending anyone anywhere, and we do not sell leads.

The site is funded by advertising, which is why there are ad slots on these pages. An advertiser cannot influence a grade, a ranking or a word of the analysis, and none of them see anything before it is published.

What we will not build

The obvious business here is a lead-generation funnel: collect people worried about a bill, sell them to whoever pays most. That would earn well and it would destroy the only thing this site has, which is that nothing on it is bought. We are not going to build it.

What the grade is, and is not

The CostGrade measures a hospital's charges against two yardsticks: what that care is actually paid for, and what other hospitals charge for the same coded work. It is not a quality rating, and it is not a prediction of your bill. We checked whether a high markup is a proxy for good care across every U.S. hospital — it is not; markup and the CMS quality star rating barely move together at all.

Every component, weight and threshold is published in full on the methodology page, including the things we deliberately left out and why.

Getting it wrong

If a figure on this site is wrong, we want to know and we will fix it. Federal files contain errors, hospitals merge and change ownership, and our own code can have bugs. Tell us, with the hospital and the figure, and we will check it against the source.