What Hospitals Actually Charge: Cleveland Clinic vs Houston Methodist, From Their Own Price Files
We parsed the federally required price-transparency files of Cleveland Clinic and Houston Methodist. Gross charges, cash prices, and median insurer-negotiated rates for 16 common services — including a lab test with a 100x gap between list price and what insurers pay.
Since 2021, federal law (45 CFR §180) has required every U.S. hospital to publish a machine-readable file listing its standard charges: the “gross” chargemaster price, the discounted cash price, and the rates it actually negotiated with each insurance plan. Almost nobody reads these files — they are enormous, messy, and buried. We built a pipeline that does read them, and this page compares what two major U.S. hospitals — Cleveland Clinic Main Campus and Houston Methodist Hospital — say they charge for the same common services. Every number below comes from the hospitals' own published files.
Key Findings
- The “list price” is fiction in both directions. Houston Methodist's median negotiated rate for a diagnostic colonoscopy ($1,038 gross) is $2,017.86 — insurers pay almost double the list price. For a comprehensive metabolic panel it lists $1,145 — and insurers pay a median of $11.46, a 100× gap.
- Both hospitals apply a flat self-pay discount: Cleveland Clinic's cash price is uniformly 35% off gross; Houston Methodist's is 50% off. The discount is automatic pricing policy, not charity — and often still far above what insurers pay.
- Same procedure, different city, opposite winner. A CT of the head is cheaper at Houston Methodist ($143.36 median negotiated vs $308.28 at Cleveland Clinic), but a diagnostic colonoscopy is half the price at Cleveland Clinic ($983.93 vs $2,017.86).
- The cash price can beat your insurance. At Houston Methodist, paying cash for an MRI of the knee ($1,230) costs more than the median insurer rate ($327.18) — but at both hospitals there are services where self-pay beats a high-deductible plan's negotiated rate.
Cleveland Clinic vs Houston Methodist: Prices for 16 Common Procedures
The table shows, for each CPT code, the hospital's published gross charge, its discounted cash (self-pay) price, and the median of the rates it negotiated with insurance plans, taken from each hospital's official price-transparency file (outpatient setting). A dash means the hospital's file doesn't publish that value — we never estimate.
| Service (CPT) | Cleveland Clinic | Houston Methodist | ||||
|---|---|---|---|---|---|---|
| Gross | Cash | Insurer median | Gross | Cash | Insurer median | |
| Office visit, new patient (level 3) (99203) | $139 | $90.35 | $94.87 | $544 | $272 | $241.74 |
| Office visit, established patient (level 3) (99213) | $150 | $97.50 | $75.39 | $409 | $204.50 | $161.93 |
| Comprehensive metabolic panel (80053) | $73 | $47.45 | $34.24 | $1,145 | $572.50 | $11.46 |
| Complete blood count (CBC) (85025) | $54 | $35.10 | $25.78 | $305 | $152.50 | $12.67 |
| TSH thyroid test (84443) | $116 | $75.40 | $52.63 | $21 | $10.50 | $27.38 |
| Blood draw (36415) | $63 | $40.95 | $24 | $59 | $29.50 | $9.99 |
| Chest X-ray (2 views) (71046) | $608 | $395.20 | $194.56 | $1,250 | $625 | $95.58 |
| CT scan, head (without contrast) (70450) | $734 | $477.10 | $308.28 | $2,240 | $1,120 | $143.36 |
| CT scan, abdomen/pelvis (with contrast) (74177) | $2,464 | $1,601.60 | $807.73 | $4,724 | $2,362 | $478.38 |
| MRI brain (with & without contrast) (70553) | $2,464 | $1,601.60 | $852.62 | $3,231 | $1,615.50 | $478.38 |
| MRI knee (without contrast) (73721) | $1,668 | $1,084.20 | $549.86 | $2,460 | $1,230 | $327.18 |
| Abdominal ultrasound, complete (76700) | $734 | $477.10 | $277.21 | $1,979 | $989.50 | $204.79 |
| Screening mammogram (77067) | $609 | $395.85 | $258.79 | $665 | $332.50 | $113.27 |
| Colonoscopy, diagnostic (45378) | $4,194 | $2,726.10 | $983.93 | $1,038 | $519 | $2,017.86 |
| Upper GI endoscopy with biopsy (43239) | $4,313 | $2,803.45 | $883.82 | $810 | $405 | $1,968.02 |
| Knee arthroscopy with meniscectomy (29881) | $3,093 | $2,010.45 | $1,511.40 | — | — | $4,173.50 |
Sources: each hospital's CMS-required machine-readable file (v3.0.0), Cleveland Clinic dated 2026-06-16, Houston Methodist dated 2026-04-01; retrieved 2026-07-27. Outpatient setting. “Insurer median” is the median of the payer-specific negotiated dollar rates in the file; the number of plans behind each median varies by service (from 1 to 975).
How to Read These Three Prices
- Gross charge (the “chargemaster” price) is the sticker price. Almost nobody pays it — but it is the number that appears on many bills before adjustments, and it anchors out-of-network and uninsured billing. Read our hospital price transparency guide for how these lists work.
- Discounted cash price is what the hospital offers if you pay without insurance. Both hospitals here apply it as a flat percentage of gross — 35% off at Cleveland Clinic, 50% off at Houston Methodist — which means it inherits every distortion of the chargemaster.
- Negotiated rate is what an insurance plan actually pays. It varies plan to plan (that's why we show the median), and your cost-sharing is computed from your plan's specific rate, not from the median.
What This Means for Your Bill
If you are uninsured or on a high-deductible plan, these files are negotiating leverage. When a hospital bills you $1,145 for a metabolic panel that it accepts $11.46for from a typical insurer, “I'd like to pay what insurers pay” is a reasonable, documented ask. Hospitals' own financial assistance policies (Cleveland Clinic's here and Houston Methodist's here) add a second lever on top.
When you upload a bill to Health Bill Central from a hospital whose price file we've loaded, your analysis now shows the hospital's own posted rates next to each line item — the same numbers in this post, matched to your actual charges.
Methodology
We downloaded each hospital's machine-readable file from the location published in its federally required cms-hpt.txt discovery file (Cleveland Clinic's transparency page, Houston Methodist's). Both files use the CMS v3.0.0 template. For each CPT code we take the outpatient rows, use the file's published gross and discounted-cash values, and compute the median of the payer-specific negotiated dollar rates. Rates published only as percentages or algorithms, and the v3 “estimated allowed amount” percentiles, are excluded — they describe different quantities. Numbers are exactly as published; where a file omits a value we show a dash rather than estimating. This comparison will expand as we load more hospitals' files.
Content is for informational purposes only and does not constitute financial, legal, or medical advice. Consult a qualified professional for advice specific to your situation.
Frequently Asked Questions
Where do these hospital prices come from?
Directly from each hospital's own machine-readable standard-charges file, which federal law (45 CFR §180) requires every U.S. hospital to publish. We parsed the official files Cleveland Clinic and Houston Methodist link from their price-transparency pages — no estimates or third-party data.
Will I pay the negotiated median shown here?
No. The median summarizes the rates the hospital negotiated across many insurance plans. Your plan pays its own specific rate, and your share depends on your deductible and coinsurance. Use the median as context for whether a charge is unusually high, and as leverage when negotiating a self-pay bill.
Why would an insurer's rate be higher than the hospital's list price?
It happens — Houston Methodist's median negotiated rate for a diagnostic colonoscopy is nearly double its gross charge. Negotiated rates reflect bargaining power, bundled contracts, and payer mix, not the list price. That's exactly why comparing all three numbers matters.
Can I use these files to negotiate my bill?
Yes. If you're uninsured or facing a large out-of-network charge, citing the hospital's own published cash price or typical negotiated rate is a documented, reasonable basis for asking for a lower price. Pair it with the hospital's financial assistance policy for the strongest case.
How much does a CT scan cost at Cleveland Clinic or Houston Methodist?
Per their own price files, a CT of the head without contrast (CPT 70450) lists at $734 at Cleveland Clinic Main Campus ($477 cash, $308 median insurer rate) and $2,240 at Houston Methodist Hospital ($1,120 cash, $143 median insurer rate). The full comparison table above covers MRIs, colonoscopies, lab work, and office visits.
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