The Uninsured Tax
What you pay without insurance — and how much more it is than negotiated rates.
Without insurance, patients are typically billed the full chargemaster price — an average of 5.5x what Medicare pays. For a knee replacement, that is the difference between $1,374 (Medicare) and $7,874 (chargemaster). This uninsured tax falls hardest on those least able to pay.
If you don't have insurance, you're likely paying the highest price in the building. While insurance companies negotiate rates that are a fraction of list prices, uninsured patients often receive bills based on the hospital's chargemaster — inflated prices that no insurer actually pays.
The "uninsured penalty" is the difference between what hospitals charge (what you'd see on a bill without insurance) and what Medicare considers a reasonable payment. For some procedures, uninsured patients pay 5-10x what an insured patient's plan would be billed.
This is the healthcare system's cruelest irony: the people who can least afford care pay the most for it. Below, we calculate the uninsured penalty for every major procedure.