Step 3 of 5 — Pricing
What this should cost
Every line compared to the CMS-published median negotiated rate. These are the numbers hospitals are legally required to disclose — and the numbers you can cite when you dispute.
Total billed$2842as submitted by the hospital
CMS-anchored total$543median negotiated rate across all lines
Overcharge ratio81%portion of bill above CMS rates
Line-by-line comparison
Source transparency
Every “should cost” figure below is anchored to a CMS data source — click the badge to see the underlying file. Anything labeled Official · CMS is derived from hospital-published negotiated rate files or the CMS fee schedule.
| Code | Service | Billed | Should Cost | Difference | Flag / Source |
|---|---|---|---|---|---|
| 99285 | Emergency Dept Visit – High Complexity | $1200.00 | $420.00 | +$780.00 | Upcoded ComplexityOfficial · CMS Hospital Price Transparency · CPT 99285 |
| 80053 | Comprehensive Metabolic Panel | $310.00 | $18.00 | +$292.00 | Improper UnbundlingOfficial · CMS OPPS Addendum B · CMP Bundling Policy |
| J1885 | Ketorolac Tromethamine 15 mg Injection (Toradol) | $280.00 | $4.50 | +$275.50 | Excessive PriceOfficial · CMS ASP Drug Pricing File Q1 2026 · J1885 |
| 71046 | Chest X-Ray, 2 Views | $420.00 | $52.00 | +$368.00 | |
| 36415 | Routine Venipuncture (Blood Draw) | $95.00 | $10.00 | +$85.00 | Excessive PriceOfficial · CMS Clinical Lab Fee Schedule · CPT 36415 |
| 36415 | Routine Venipuncture (Blood Draw) | $95.00 | $10.00 | +$85.00 | Duplicate ChargeOfficial · CMS Clinical Lab Fee Schedule · CPT 36415 |
| 99000 | Handling / Conveyance of Specimen | $75.00 | $0.00 | +$75.00 | Improper UnbundlingOfficial · CMS NCCI Edits · Bundled Add-On Codes |
| 93000 | Electrocardiogram (ECG) with Interpretation | $367.00 | $28.00 | +$339.00 | |
| Total | $2842.00 | $542.50 | +$2299.50 | Sample · Illustrative · CMS sources linked per row | |