Comprehensive Observation Services — what U.S. hospitals charge
APC 8011 · Hospital outpatient visit · 2,753 U.S. hospitals publish a price
Cheapest quarter
under $14,217
Typical charge
$19,434
Dearest quarter
over $28,603
Actually paid
$2,591
The middle U.S. hospital bills $19,434 for Comprehensive Observation Services. The dearest hospitals charge about 3.8x what the cheapest do for the same coded work. Medicare actually paid about $2,591 per case.
These are charges, not quotes. What you pay depends on your insurance and your own case. The figures matter because the charge is where an uninsured or out-of-network bill starts.
Comprehensive Observation Services cost by state
The middle charge in each state where at least three hospitals publish a price, cheapest first.
| State | Hospitals | Typical charge | Range |
|---|---|---|---|
| Massachusetts | 51 | $11,007 | $6,550 – $33,282 |
| Alabama | 73 | $11,350 | $3,237 – $72,394 |
| Montana | 10 | $11,882 | $8,375 – $14,373 |
| Wyoming | 9 | $12,581 | $8,489 – $26,154 |
| Mississippi | 52 | $13,209 | $4,055 – $53,372 |
| Maine | 17 | $13,512 | $7,820 – $18,125 |
| Iowa | 31 | $13,514 | $8,749 – $27,932 |
| North Dakota | 6 | $13,601 | $13,142 – $14,643 |
| Louisiana | 64 | $13,683 | $5,042 – $34,305 |
| Michigan | 81 | $13,980 | $7,332 – $28,867 |
| West Virginia | 22 | $14,245 | $7,596 – $28,469 |
| Minnesota | 45 | $14,314 | $4,503 – $20,654 |
| Arkansas | 40 | $14,950 | $6,049 – $38,229 |
| Rhode Island | 9 | $15,264 | $12,790 – $27,276 |
| Ohio | 110 | $15,664 | $7,939 – $46,074 |
| New York | 115 | $15,706 | $6,881 – $66,163 |
| Oregon | 32 | $16,119 | $10,592 – $22,624 |
| Delaware | 6 | $16,288 | $9,759 – $19,476 |
| Idaho | 12 | $16,569 | $12,536 – $26,181 |
| Utah | 31 | $16,650 | $11,913 – $33,027 |
| Wisconsin | 61 | $16,912 | $9,336 – $30,203 |
| Kansas | 33 | $17,005 | $5,928 – $53,374 |
| Oklahoma | 61 | $17,109 | $4,285 – $46,708 |
| Missouri | 63 | $17,148 | $10,163 – $48,333 |
| Hawaii | 12 | $17,272 | $11,587 – $27,896 |
| Vermont | 5 | $17,273 | $14,233 – $19,902 |
| Nebraska | 19 | $17,748 | $10,933 – $21,823 |
| North Carolina | 78 | $17,755 | $8,095 – $35,083 |
| South Carolina | 50 | $17,794 | $11,844 – $40,010 |
| Tennessee | 73 | $17,823 | $6,499 – $53,558 |
| Pennsylvania | 122 | $18,332 | $6,644 – $58,222 |
| South Dakota | 11 | $18,399 | $7,539 – $23,502 |
| Indiana | 73 | $18,992 | $9,366 – $62,558 |
| Connecticut | 26 | $19,326 | $11,379 – $46,500 |
| New Hampshire | 13 | $19,434 | $15,493 – $43,905 |
| Kentucky | 61 | $19,750 | $7,012 – $41,432 |
| Virginia | 69 | $19,985 | $10,823 – $62,582 |
| Illinois | 113 | $20,020 | $10,694 – $38,670 |
| Georgia | 92 | $20,523 | $6,504 – $51,314 |
| Washington | 45 | $21,367 | $12,674 – $40,275 |
| New Mexico | 22 | $21,657 | $7,937 – $42,521 |
| District of Columbia | 6 | $22,746 | $14,757 – $51,494 |
| Alaska | 6 | $24,459 | $22,038 – $40,690 |
| Arizona | 54 | $25,842 | $10,480 – $84,837 |
| Texas | 233 | $26,363 | $6,057 – $235,634 |
| Florida | 166 | $28,912 | $7,061 – $77,272 |
| New Jersey | 59 | $29,179 | $6,293 – $304,001 |
| Colorado | 48 | $34,051 | $8,429 – $83,387 |
| California | 242 | $35,786 | $9,308 – $104,503 |
| Nevada | 21 | $42,306 | $13,758 – $58,658 |
Where Comprehensive Observation Services is charged least
Hospitals that performed it at least eleven times, so a single case cannot set the figure.
| Hospital | Charged | Actually paid |
|---|---|---|
|
Lake Martin Community Hospital
Dadeville, AL |
$3,237 | $2,188 |
|
Beacham Memorial Hospital
Magnolia, MS |
$4,055 | $2,235 |
|
Bibb Medical Center
Centreville, AL |
$4,220 | $2,285 |
|
Harper County Community Hospital
Buffalo, OK |
$4,285 | $2,440 |
|
Jackson Medical Center
Jackson, AL |
$4,346 | $2,215 |
|
Essentia Health Duluth
Duluth, MN |
$4,503 | $1,835 |
|
Hale County Hospital
Greensboro, AL |
$4,719 | $2,328 |
|
Yalobusha General Hospital
Water Valley, MS |
$4,841 | $2,235 |
|
Oklahoma Surgical Hospital, Llc
Tulsa, OK |
$4,938 | $2,223 |
|
Leonard J Chabert Medical Center
Houma, LA |
$5,042 | $2,247 |
|
Elkview General Hospital
Hobart, OK |
$5,849 | $2,489 |
|
Mercy Hospital, Inc
Moundridge, KS |
$5,928 | $2,453 |
Where it is charged most
Hospitals that performed it at least eleven times, so a single case cannot set the figure.
| Hospital | Charged | Actually paid |
|---|---|---|
|
Heights University Hospital
Jersey City, NJ |
$304,001 | $3,020 |
|
Brushy Creek Family Hospital Llc
Round Rock, TX |
$235,634 | $2,346 |
|
Cleveland Emergency Hospital
Humble, TX |
$225,815 | $2,489 |
|
Carepoint Health-Hoboken University Medical Center
Hoboken, NJ |
$224,188 | $3,072 |
|
Carepoint Health - Bayonne Medical Center
Bayonne, NJ |
$223,858 | $3,115 |
|
The Woodlands Specialty Hospital
Spring, TX |
$125,966 | $2,489 |
|
Capital Health Regional Medical Center
Trenton, NJ |
$106,318 | $2,855 |
|
San Ramon Regional Medical Center
San Ramon, CA |
$104,503 | $3,774 |
|
Regional Medical Center Of San Jose
San Jose, CA |
$102,210 | $3,855 |
|
Capital Health Medical Center - Hopewell
Pennington, NJ |
$100,832 | $2,828 |
|
Good Samaritan Hospital
San Jose, CA |
$96,714 | $3,819 |
|
Altus Lumberton Hospital
Lumberton, TX |
$94,235 | $2,336 |
Questions people ask
What do U.S. hospitals charge for Comprehensive Observation Services?
Across 2,753 U.S. hospitals, the middle charge for Comprehensive Observation Services is $19,434. Half of hospitals charge less than that and half charge more. The cheapest quarter charge under $14,217 and the dearest quarter over $28,603.
Why do hospitals charge such different amounts for the same procedure?
Because a hospital charge is a list price it sets itself, not a regulated rate. For Comprehensive Observation Services, the hospitals in the dearest tenth charge about 3.8x what the cheapest tenth charge for the same coded work. Insurers negotiate their own rates from those lists, which is why the charge and what is actually paid can be very far apart.
Is that what I would actually pay?
No. $2,591 is roughly what Medicare actually paid per case, against an average charge of $24,060. If you have insurance, your plan pays a negotiated rate and you pay your deductible and coinsurance. If you are uninsured or out of network, the hospital's charge is where your bill starts — which is why the gap matters. Ask for a written good-faith estimate before treatment.
What this code covers
CMS records this work as APC 8011: “Comprehensive Observation Services”. An APC covers one outpatient visit for that level of service — you go home the same day.