Question 1

Why do healthcare prices vary so much?

Accepted Answer

Hospitals, surgery centers, and doctor offices each set their own prices independently. There is no standard price for any procedure. A knee MRI can cost $400 at a freestanding imaging center and $2,500 at a hospital outpatient department — for the exact same scan. This variation exists because hospitals bundle facility fees, charge higher rates to insured patients, and use complex chargemaster pricing that bears little relation to actual costs.

Question 2

How does TrueCost calculate fair cash prices?

Accepted Answer

We start with Medicare reimbursement rates — the amount the federal government pays for each procedure, broken down by work effort (Work RVU), practice expense (PE RVU), and malpractice cost (MP RVU). We adjust for your geographic area using CMS locality data (GPCI indexes), then apply a 140% multiplier to arrive at a fair cash price. This represents what facilities can profitably accept while eliminating the billing overhead that comes with insurance claims.

Question 3

What is a CPT code?

Accepted Answer

CPT (Current Procedural Terminology) codes are 5-digit numbers maintained by the American Medical Association that identify specific medical procedures and services. For example, CPT 73721 is a knee MRI and CPT 99213 is a standard office visit. Every procedure has a CPT code, and knowing it lets you compare prices accurately across facilities. TrueCost lets you search by procedure name or CPT code.

Question 4

Is paying cash actually cheaper than using insurance?

Accepted Answer

Often, yes. Cash-pay patients skip the billing overhead that adds 15-25% to insured prices. Many facilities offer their lowest rates to cash patients because they get paid immediately with no claim denials, no collections risk, and no administrative cost. If you have a high-deductible plan and haven't met your deductible, you're already paying full price — but at the inflated insurance-negotiated rate, not the lower cash rate.

Question 5

How do I negotiate a medical bill?

Accepted Answer

Start by knowing the fair market price for your procedure — that's what TrueCost provides. Call the billing department and say: "I'm a cash-pay patient. I've researched fair market rates and Medicare pays $X for this procedure. I can pay $Y cash at time of service." Most facilities will negotiate because guaranteed payment today is worth more than chasing insurance claims for months. TrueCost gives you word-for-word scripts with real dollar amounts for your area.

Question 6

Do 80% of hospital bills really contain errors?

Accepted Answer

Multiple studies, including research by Medical Billing Advocates of America, have found that roughly 80% of hospital bills contain errors. The average overcharge is approximately $1,300. Common errors include duplicate charges, charges for services not received, incorrect quantities, and unbundling (billing separately for items that should be grouped). Always request an itemized bill and review it carefully.

Question 7

What is TrueCost and how much does it cost?

Accepted Answer

TrueCost is a healthcare pricing transparency platform. You can search any procedure, see fair cash prices by facility type and location, get negotiation scripts, upload bills for overcharge analysis, and chat with our AI cost navigator. During our beta period, all features are completely free — no credit card required.

Question 8

What data sources does TrueCost use?

Accepted Answer

We use the Medicare Physician Fee Schedule (MPFS) for baseline procedure rates, CMS Geographic Practice Cost Indexes (GPCI) for regional cost adjustments, and publicly available hospital price transparency data required by the No Surprises Act. Our pricing calculator uses 2026 RVU values and conversion factors published by CMS.

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