About ClearPrices
ClearPrices makes healthcare pricing data accessible and understandable for everyone. We believe that price transparency is essential to a functional healthcare market.
Our Mission
Healthcare costs in America are notoriously opaque. Patients often have no idea what a procedure will cost until they receive the bill. ClearPrices aims to change that by providing clear, data-driven insights into what healthcare actually costs.
Data Source
All data on ClearPrices comes from the CMS Medicare Provider Utilization and Payment Data for calendar year 2023. This is public data released by the Centers for Medicare & Medicaid Services (CMS) as part of their commitment to transparency.
The dataset includes:
- 3,316 medical procedures (HCPCS codes)
- Over 1.26 million healthcare providers
- 104 medical specialties
- 1.47 billion individual services
Methodology
We aggregate provider-level Medicare data to calculate national and state-level averages for each procedure. Key metrics include:
- Average Charge: What providers submit as their price (the "sticker price")
- Average Allowed Amount: What Medicare determines is the reasonable cost
- Average Payment: What Medicare actually pays (after patient responsibility)
- Markup Ratio: The ratio of charge to allowed amount
Important Caveats
- Medicare prices are not the same as private insurance prices. Private insurers negotiate their own rates.
- Geographic adjustments mean the same procedure costs different amounts in different states.
- Some high markups reflect billing anomalies rather than actual overpricing.
- This data covers Medicare fee-for-service only, not Medicare Advantage or other programs.
About TheDataProject.ai
ClearPrices is part of TheDataProject.ai, a portfolio of data-driven websites that make public records accessible and useful. We believe that public data should be easy to explore, not buried in government databases.