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States Procedures Methodology Search
National price data · 2,002 hospitals

New patient office visit (30-44 min) cost

What a new patient office visit (30-44 min) costs across the U.S. — and the fair price to aim for.

Pillar 1 · The BaseRate™ CompositeHow 1.00× Fair BaseRate Works: Raw price averages unfairly penalize hospitals in high-wage cities or trauma centers treating sicker patients. We adjust for local CMS hospital wage levels and patient complexity first. A 1.00× score means right at the fair price average, 0.85× means 15% cheaper than fair market, and 1.30× means 30% above fair market.Near Fair BaseRate Benchmark
1.00×vs. Fair Market Price
Position vs. 1.00× Fair PriceRight at U.S. Average (0%) 1.00× (center of the bar) is the U.S. fair price average after accounting for local hospital wages and patient complexity. Left of center (<1.00×) is below fair price; right of center (>1.00×) is above fair price.

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

Pillar 2 · VeriRate™ Data TrustHow VeriRate™ (0–100) Works: Hospitals are legally required to publish machine-readable price files, but some bury fake $0.01 numbers or omit cash discounts. VeriRate audits each file across 5 checks (hover any badge below to see what it tests).86/100 · Verified
86/100Hover Any Check Below to See How Prices Were Audited
File Completeness90Provenance (File Completeness): Checks whether the hospital published a complete, up-to-date machine-readable price file with valid CPT and MS-DRG billing codes instead of leaving blanks.
Price Logic88Coherence (Price Logic): Checks whether the hospital’s numbers make basic sense — e.g., self-pay cash price is lower than gross list price, with no fake $0.01 or $999,999 placeholder numbers.
Peer Alignment86Concordance (Peer Alignment): Checks whether reported prices sit in a realistic range compared to Medicare and nearby hospitals rather than wild 100× unit errors.
Clean Billing83Regularity (Clean Billing): Checks whether rates are structured consistently across procedures without erratic statistical spikes or hidden unbundled facility fees.
Real Cash Discount84Cash Honesty (Real Cash Discount): Checks whether the hospital offers a genuine self-pay cash discount that beats or matches commercial insurance rates instead of billing full sticker price.
Pillar 3 · Clinical Quality & ER SpeedChecks whether higher hospital prices actually buy better clinical quality — combining CMS Star Ratings, hospital safety scores, and emergency room wait times.Regional Value Leader
CMS Star RatingNot RatedOfficial CMS Overall Hospital Quality Star Rating (1 to 5 stars) summarizing mortality, safety of care, readmissions, and patient experience.
Safety ScoreNot ScoredComposite patient safety score (0–100) derived from CMS hospital-acquired infection rates (CLABSI, CAUTI, MRSA, C. diff), surgical complications, and HCAHPS surveys.
Typical ER WaitNo ER DataMedian minutes patients spent in the emergency department before leaving from the visit, as reported to CMS Timely and Effective Care.

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

Behavioral Pricing FingerprintUpper-Quartile Spread · +75% Tail Jump

Wide Procedure Spread · Upper-Quartile Skew Pricer

This hospital prices routine shoppable procedures at 2.0× Medicare (median 1.03× Fair BaseRate) while upper-quartile commercial rates jump +75% to 1.80× Fair BaseRate. Self-pay cash discounts and comparing specific CPT procedure codes before scheduling yield the strongest savings.

#77 of 101 in LA · 75th State Percentile#2,203 of 3,385 in U.S. · 65th National Percentile
Advantage

Where They're Good (Patient & Payer Edge)

  • Bottom-quartile procedures (Q25) price at 0.93× the peer BaseRate benchmark
  • Self-pay cash beats commercial insurance on 0% of shoppable procedures (50/100 Cash Honesty)
  • CMS clinical safety score (72/100 safety score) with 84% patient recommendation
  • Binding Good Faith Estimate rights under 45 CFR § 149.610 protect self-pay patients before scheduling
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.
  • Commercial insurance median sits at 1.03× Fair BaseRate (2.0× Medicare), so insured patients should always compare the self-pay cash price before paying.
  • Upper-quartile procedures (Q75 1.80×) jump +75% above the median procedure ratio (Q50 1.03×)
  • Unnegotiated chargemaster list prices average 5.6× Medicare (20¢ true HCRIS cost per $1 gross)
Front-Door ShoppableElective / Imaging
2.0× Medicare

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

Back-Door Captive & ER0.50× Divergence
1.0× Medicare

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

Quantile Tail Spread+75% Upper Tail
Q25 0.93× · Q50 1.03× · Q75 1.80×

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
2.0× MedicareGood
Outpatient Surgery & ORBack-Door Captive
0.8× MedicareGood
Diagnostic Imaging (CT/MRI)Front-Door Shoppable
1.6× MedicareGood
Back-Door Captive ER VisitsBack-Door Captive
2.9× MedicareFair
Inpatient Lab & PathologyBack-Door Captive
2.7× MedicareFair
Specialty & Infusion Drugs (J-Codes)Back-Door Captive
2.3× MedicareFair
Self-Pay Cash Honesty & 501(r)Integrity & Outcomes
0% Cash Edge · 50/100Elevated
CMS Clinical Safety & Star ValueIntegrity & Outcomes
3 CMS · 72/100Fair
National Geographic Price Intelligence · 50-State + DC/PR Cartogram

National State Price Index Heatmap · New patient office visit (30-44 min)

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
AZ0.50×0.5× MedLA0.64×0.6× MedWV0.70×0.7× MedHI0.75×0.7× MedKY0.75×0.7× MedPA0.75×0.7× MedTN0.78×0.7× MedMO0.82×0.8× MedNM0.82×0.8× MedNV0.82×0.8× MedMI0.85×0.8× MedPR0.85×0.8× MedCA0.92×0.9× MedKS0.92×0.9× MedNJ0.93×0.9× MedVA0.93×0.9× MedWI0.94×0.9× MedOH0.95×0.9× MedID0.96×0.9× MedIN0.96×0.9× MedAR0.97×0.9× MedVT0.97×0.9× MedNC0.98×0.9× MedNY0.98×0.9× MedUT0.98×0.9× MedWY0.98×0.9× MedGA0.99×0.9× MedCO1.00×0.9× MedAL1.01×0.9× MedWA1.02×1.0× MedNH1.03×1.0× MedMS1.04×1.0× MedIA1.05×1.0× MedIL1.05×1.0× MedCT1.12×1.0× MedOK1.15×1.1× MedMT1.16×1.1× MedND1.16×1.1× MedSC1.16×1.1× MedDE1.17×1.1× MedMD1.18×1.1× MedME1.19×1.1× MedRI1.19×1.1× MedNE1.20×1.1× MedOR1.20×1.1× MedSD1.21×1.1× MedMA1.26×1.2× MedDC1.31×1.9× MedMN1.33×1.2× MedTX1.38×1.3× MedFL1.55×1.4× MedAK2.14×2.0× Med
5 Lowest-Price States (Confounder-Isolated Value Leaders)
AZ0.50×(0.5×)LA0.64×(0.6×)WV0.70×(0.7×)HI0.75×(0.7×)KY0.75×(0.7×)
5 Highest-Markup States (Strict Bill Audit Recommended)
AK2.14×(2.0×)FL1.55×(1.4×)TX1.38×(1.3×)MN1.33×(1.2×)DC1.31×(1.9×)
The BaseRate high confidence
$109
the fair national price for a new patient office visit (30-44 min)
typically $69–$244 across 2,002 hospitals · how we calculate it
modeled estimate · not a bill or quote
2,002
hospitals priced
51
states
3.5×
price spread — where shopping matters
0.9×
vs. Medicare

Across 2,002 hospitals in 51 states, a new patient office visit (30-44 min) has a fair BaseRate of $109 and typically costs $69–$244. The cheapest state is AZ; the priciest is AK.

Cheapest hospitals for a new patient office visit (30-44 min)

New patient office visit (30-44 min) cost by state

AK $235 6 hospitals AL $111 25 hospitals AR $107 36 hospitals AZ $55 27 hospitals CA $101 115 hospitals CO $110 40 hospitals CT $123 18 hospitals DE $129 8 hospitals FL $170 99 hospitals GA $109 39 hospitals HI $82 15 hospitals IA $116 73 hospitals ID $106 16 hospitals IL $115 81 hospitals IN $106 67 hospitals KS $101 81 hospitals KY $83 32 hospitals LA $70 57 hospitals MA $139 33 hospitals MD $130 4 hospitals ME $131 21 hospitals MI $93 70 hospitals MN $146 39 hospitals MO $90 40 hospitals MS $114 44 hospitals MT $128 12 hospitals NC $108 34 hospitals ND $128 11 hospitals NE $132 51 hospitals NH $113 6 hospitals NJ $102 40 hospitals NM $90 2 hospitals NV $90 16 hospitals NY $108 82 hospitals OH $104 64 hospitals OK $127 50 hospitals OR $132 19 hospitals PA $82 85 hospitals PR $93 2 hospitals RI $131 4 hospitals SC $128 32 hospitals SD $133 11 hospitals TN $86 55 hospitals TX $152 161 hospitals UT $108 25 hospitals VA $102 31 hospitals VT $107 10 hospitals WA $112 30 hospitals WI $103 62 hospitals WV $77 16 hospitals WY $108 5 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™ $109
Medicare Rate $63
Self-Pay Cash Request Quote
Insurer Median $110
Pre-filled with U.S. Hospital Benchmark’s charged/list benchmark
Screened against 2026 HHS Federal Poverty Guidelines
2026 FPL: $15,650 + $5,500 per additional person
Step 1 · 501(r) Charity Care Check 501(r) AGB Cap: $96 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $96

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 = $96).

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 +$155 Above Fair BaseRate

Negotiate Toward $109 Fair BaseRate ($63 Medicare)

Your bill ($264) is $155 above the denoised Fair BaseRate ($109) and 4.2× the $63 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.