Data on Both Urban and Rural Hospitals

Prices, Costs, and Payments at Urban and Rural Hospitals

This table provides information on how hospitals’ charges (i.e., prices) for their services compare to the costs of delivering those services, and the percentage of the charges that hospitals are actually paid. The table includes data for both urban and rural hospitals that were operating in 2021 if they reported the amounts they were paid for their services on their Medicare Cost Reports. (Some hospitals, such as hospitals operated by the Indian Health Service and by Kaiser Permanente, report the costs of delivering services at the hospital, but do not report the amount of revenue received for the hospital’s services.)

The table can be sorted by clicking the arrows next to each column heading. The data can be restricted to a specific state or hospital or to hospitals within a specific range of expenses or the values of other variables using the filtering boxes.

The data in the four final columns represent the average of the most recent three fiscal years at the hospital for which Medicare Cost Reports were available:

It is important to recognize that this ratio is an average across all of the hospital’s services, and the amount a hospital charges for any individual service may be a higher or lower percentage of the cost of that service than this average amount. The ratio will be influenced more heavily by services with higher costs and by services that are delivered more frequently.

In most cases, the amount the hospital is paid for a service is different than the amount the hospital charges. Medicare pays hospitals based on a fee schedule or based on the hospital’s average cost of delivering the service, regardless of the amount the hospital charges. Most health insurance plans have contracts with the hospital enabling them to pay less than the hospital’s standard charge (this is commonly referred to as a “discount” or “contractual adjustment” on the charge). In contrast, a hospital can require a patient to pay the full charge if the patient does not have insurance, and if a patient’s insurance plan does not have a contract with the hospital, either the patient or their insurance plan may have to pay the full charge.

What ultimately matters for the hospital’s solvency is not what the hospital charges, but how the amounts the hospital is paid compare to what it costs the hospital to deliver services. These comparisons are shown for rural hospitals in the tables on Payer Mix and Margins and Sources of Profits and Losses. However, the amount the hospital charges for its services does matter to patients who do not have insurance, since high charges for services can prevent them from receiving needed services or cause them serious financial problems.

Additional details on the methodology used to calculate the measures are available in the Methodology section.