PriceCheckMD

How it works

From opaque files to a real answer.

Insurers and hospitals are required to publish their negotiated prices. We download those files, make sense of them, and put a search box in front of the result.

1

Search for a procedure

Type a procedure name like "MRI of knee" or "colonoscopy," or enter a billing code (CPT or HCPCS) if you have one from your provider. We're rolling out broader natural-language search — for now, common procedures like MRI, CT, mammogram, and colonoscopy are recognized directly.

2

See real negotiated rates

We show you the prices insurance companies have actually agreed to pay providers for that specific procedure, sorted by cost. Each result includes the provider name, location, the insurer the rate applies to, and the billing class (professional, institutional, or facility).

3

Use it in conversation

Take what you find to the provider's billing office. Ask whether the price you'd be charged matches what their negotiated rate suggests. Ask about cash-pay options if your deductible is high. Real negotiated rates give you a defensible benchmark for that conversation.

Where the data comes from

Federal transparency rules require insurance companies and hospitals to publish their negotiated rates as machine-readable files. These files are public but enormous (sometimes hundreds of gigabytes per insurer) and structured for machines, not humans. We download, parse, validate, and index them, then update as new versions are published.

What you'll see in a result

Every search result includes:

  • The procedure description (e.g., "MRI scan of leg joint with contrast")
  • The negotiated rate in dollars, or as a percentage of billed charges when the contract is written that way
  • The provider and their city — actual people and facilities, not generic listings
  • The insurance plan the rate applies to
  • The billing class — whether the rate covers professional services, institutional/hospital services, or both

What we don't have (yet)

A few honest limits worth knowing about:

  • Coverage is currently Idaho-only with one major insurer. We're expanding gradually rather than rushing nationwide and risking data quality.
  • Cash-pay and self-pay rates from hospitals are coming, but not yet integrated. For now, we focus on insurance-paid rates.
  • Personalized "what will I owe?" requires knowing your specific deductible, copay, and coinsurance. We don't ask for those, so we can't tell you exactly. We tell you what the insurer pays — which is most of what determines your share.