How much does a Hospital observation (per hour) typically cost in the United States?

Across 1,020 U.S. hospitals in 48 states, the modeled national fair BaseRate for Hospital observation (per hour) is $80, with most hospital negotiated prices falling between $31 and $298.

Why do hospital prices for Hospital observation (per hour) vary across facilities?

Commercial rates are negotiated individually between hospital systems and insurers, creating wide local dispersion even within the same metro area. Comparing facility-specific cash and in-network rates before scheduling care helps avoid overpaying.

National price data · 1,020 hospitals

Hospital observation (per hour) cost

What a hospital observation (per hour) costs across the U.S. — and the fair price to aim for.

Near Fair BaseRate Benchmark

1.00×vs. Fair Market Price

Typical commercial prices here match the fair market benchmark (1.00×) after accounting for local nurse/doctor wages and patient complexity.

86/100 · Verified

86/100Hover Any Check Below to See How Prices Were Audited

File Completeness90

Price Logic88

Peer Alignment86

Clean Billing83

Real Cash Discount84

Regional Value Leader

Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.

Behavioral Pricing FingerprintLow Shoppable & Low Captive

Uniform Value Leader

Mosaic Life Care at St Joseph maintains disciplined commercial pricing across both elective shoppable care (0.7× Medicare) and captive emergency/ancillary departments (1.0× Medicare). Patients and health plans benefit from predictable, below-benchmark rates (0.76× Fair BaseRate) without hidden ancillary cross-subsidization.

#1 of 79 in MO · 1st State Percentile#202 of 3,385 in U.S. · 5th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Elective shoppable care is priced 24% below peer Fair BaseRate (0.76×)
Self-pay cash beats commercial insurance on 40% of shoppable procedures (91/100 Cash Honesty)
4-Star CMS clinical rating with 64% patient recommendation (63/100 safety score)
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (41.4% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Even at low-cost facilities (1.00× Fair BaseRate), out-of-network or unnegotiated chargemaster bills can exceed commercial medians — confirm in-network status or request a self-pay cash quote up front.
Captive ER (1.3×) & laboratory (1.5×) services average 1.43× higher multiples than routine shoppable care (0.7×)
Upper-quartile procedures (Q75 0.93×) jump +26% above the median procedure ratio (Q50 0.74×)
Consolidated metro market (HHI 9,977) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

0.7× Medicare

Pre-scheduled outpatient procedures where patients can comparison-shop.

Back-Door Captive & ER1.43× Divergence

1.0× Medicare

Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.

Quantile Tail Spread+26% Upper Tail

Q25 0.50× · Q50 0.74× · Q75 0.93×

Detects median-gaming when upper-quartile codes spike above the p50 median.

Select any lens to inspect department markups, federal cost accounting, or insurer discounts.

Department & Integrity Multiples (vs. CMS Medicare Cost Anchor) Green ≤1.3× · Teal 1.3–1.8× · Amber 1.8–2.5× · Rose >2.5×

Front-Door Shoppable CareFront-Door Shoppable

0.7× MedicareGood

Outpatient Surgery & ORBack-Door Captive

0.5× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

1.3× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

1.3× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

1.5× MedicareGood

Specialty & Infusion Drugs (J-Codes)Back-Door Captive

1.1× MedicareGood

Self-Pay Cash Honesty & 501(r)Integrity & Outcomes

40% Cash Edge · 91/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

4 CMS · 63/100Elevated

National Geographic Price Intelligence · 50-State + DC/PR Cartogram

National State Price Index Heatmap · Hospital observation (per hour)

State commercial price index vs. U.S. median (1.00×) and average Medicare multiple across all 53 priced states & territories

<0.93× Below Fair Price 0.93–1.05× Near Average 1.05–1.18× Elevated >1.18× High-Cost State

AK1.15× 1.8× Med ME0.73× 1.5× Med WA1.00× 1.5× Med ID1.02× 1.6× Med MT1.20× 1.5× Med ND0.67× 2.4× Med MN0.92× 1.6× Med WI0.66× 2.0× Med MI0.79× 1.1× Med VT0.69× 1.3× Med NH0.48× 1.9× Med OR1.20× 1.5× Med NV0.43× 1.7× Med WY0.85× 1.0× Med SD0.92× 1.8× Med IA0.41× 1.7× Med IL0.97× 1.5× Med IN1.10× 1.4× Med OH2.69× 1.4× Med PA2.69× 1.3× Med NY0.90× 1.4× Med MA1.09× 1.9× Med CA1.84× 1.5× Med UT1.26× 2.2× Med CO1.21× 1.9× Med NE0.51× 2.5× Med MO0.76× 1.4× Med KY0.73× 1.7× Med WV0.72× 1.5× Med VA1.91× 1.7× Med MD1.20× 1.2× Med NJ3.50× 1.7× Med CT1.00× 1.3× Med AZ1.31× 1.5× Med NM1.40× 2.0× Med KS0.73× 1.8× Med AR0.59× 1.4× Med TN1.17× 1.3× Med NC0.86× 1.6× Med SC0.60× 1.4× Med DE1.15× 2.3× Med DC1.31× 1.9× Med RI3.50× 1.6× Med OK0.72× 1.7× Med LA0.49× 1.4× Med MS0.87× 1.3× Med AL0.92× 1.1× Med GA2.47× 1.6× Med HI1.09× 1.3× Med TX1.06× 1.8× Med FL1.16× 2.1× Med PR0.77× 1.1× Med

IA0.41×1.7× Med NV0.43×1.7× Med NH0.48×1.9× Med LA0.49×1.4× Med NE0.51×2.5× Med AR0.59×1.4× Med SC0.60×1.4× Med WI0.66×2.0× Med ND0.67×2.4× Med VT0.69×1.3× Med OK0.72×1.7× Med WV0.72×1.5× Med KS0.73×1.8× Med KY0.73×1.7× Med ME0.73×1.5× Med MO0.76×1.4× Med PR0.77×1.1× Med MI0.79×1.1× Med WY0.85×1.0× Med NC0.86×1.6× Med MS0.87×1.3× Med NY0.90×1.4× Med AL0.92×1.1× Med MN0.92×1.6× Med SD0.92×1.8× Med IL0.97×1.5× Med CT1.00×1.3× Med WA1.00×1.5× Med ID1.02×1.6× Med TX1.06×1.8× Med HI1.09×1.3× Med MA1.09×1.9× Med IN1.10×1.4× Med AK1.15×1.8× Med DE1.15×2.3× Med FL1.16×2.1× Med TN1.17×1.3× Med MD1.20×1.2× Med MT1.20×1.5× Med OR1.20×1.5× Med CO1.21×1.9× Med UT1.26×2.2× Med AZ1.31×1.5× Med DC1.31×1.9× Med NM1.40×2.0× Med CA1.84×1.5× Med VA1.91×1.7× Med GA2.47×1.6× Med OH2.69×1.4× Med PA2.69×1.3× Med NJ3.50×1.7× Med RI3.50×1.6× Med

5 Lowest-Price States (Confounder-Isolated Value Leaders)

IA0.41×(1.7×)NV0.43×(1.7×)NH0.48×(1.9×)LA0.49×(1.4×)NE0.51×(2.5×)

5 Highest-Markup States (Strict Bill Audit Recommended)

RI3.50×(1.6×)NJ3.50×(1.7×)PA2.69×(1.3×)OH2.69×(1.4×)GA2.47×(1.6×)

The BaseRate high confidence

$80

the fair national price for a hospital observation (per hour)

typically $31–$298 across 1,020 hospitals · how we calculate it

modeled estimate · not a bill or quote

1,020

hospitals priced

states

9.6×

price spread — where shopping matters

—

vs. Medicare

Across 1,020 hospitals in 48 states, a hospital observation (per hour) has a fair BaseRate of $80 and typically costs $31–$298. The cheapest state is IA; the priciest is NJ.

Cheapest hospitals for a hospital observation (per hour)

Hospital observation (per hour) cost by state

AL $79 11 hospitals AR $51 17 hospitals AZ $113 34 hospitals CA $158 81 hospitals CO $104 12 hospitals DE $99 3 hospitals FL $100 71 hospitals GA $212 32 hospitals HI $94 6 hospitals IA $35 26 hospitals ID $88 14 hospitals IL $83 37 hospitals IN $95 30 hospitals KS $63 23 hospitals KY $63 10 hospitals LA $42 50 hospitals MA $94 9 hospitals ME $63 11 hospitals MI $68 40 hospitals MN $79 30 hospitals MO $65 24 hospitals MS $75 21 hospitals NC $74 8 hospitals ND $58 9 hospitals NE $44 23 hospitals NH $41 3 hospitals NJ $579 9 hospitals NM $120 8 hospitals NV $37 16 hospitals NY $77 31 hospitals OH $231 30 hospitals OK $62 46 hospitals OR $103 5 hospitals PA $231 19 hospitals RI $646 2 hospitals SC $52 8 hospitals SD $79 2 hospitals TN $101 31 hospitals TX $91 104 hospitals UT $108 15 hospitals VA $164 15 hospitals VT $59 6 hospitals WA $86 11 hospitals WI $57 16 hospitals WV $62 8 hospitals

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 36.3%

Audit a Bill or Quote at U.S. Hospital Benchmark (Zero PHI Required)

Fair BaseRate™ $80

Medicare Rate $46

Self-Pay Cash Request Quote

Insurer Median $86

1. Amount on Your Bill or Quote ($) Pre-filled with U.S. Hospital Benchmark’s charged/list benchmark

2. Household Annual Income ($) Screened against 2026 HHS Federal Poverty Guidelines

3. Household Size (1–8) 2026 FPL: $15,650 + $5,500 per additional person

Step 1 · 501(r) Charity Care Check 501(r) AGB Cap: $75 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $75

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (36.3% of gross = $75).

Step 2 · Cash vs. Insurance Arbitrage Request Prompt-Pay Quote

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask U.S. Hospital Benchmark's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.

Step 3 · Fair BaseRate Target +$126 Above Fair BaseRate

Negotiate Toward $80 Fair BaseRate ($46 Medicare)

Your bill ($206) is $126 above the denoised Fair BaseRate ($80) and 4.5× the $46 Medicare rate.

1-Click Factual Dispute Summary: Copy a citation-backed benchmark memo (with CMS CCN, CPT code, Medicare reference, Fair BaseRate, and 26 U.S.C. § 501(r) calculations) to paste into patient-portal messages or billing appeals.