Hospital bills

Billed vs. paid: how far hospital bills are from what care costs

Updated November 11, 2026

5.0×what hospitals billed for Medicare stays, compared with what was paid

$458Bbilled in total

$91Bactually paid, by Medicare and patients

127hospitals bill 10× what they are paid, or more

A hospital bill starts from the hospital's own price list. What Medicare pays is set by a national formula, so it has little to do with that list. The gap between the two shows how far list prices have drifted from what care is paid for. It matters to anyone billed at list price: the uninsured, and patients treated outside their plan's network.

Where the bill is furthest from the payment

Capital Health Medical Center - Hopewell NJ

22.7×

Capital Health Regional Medical Center NJ

21.4×

Carepoint Health - Bayonne Medical Center NJ

17.1×

Doctors Medical Center CA

16.4×

Centennial Hills Hospital Medical Center NV

16.3×

Gadsden Regional Medical Center AL

16.0×

Summerlin Hospital Medical Center NV

15.8×

Sierra Medical Center TX

15.4×

HCA Florida South Shore Hospital FL

15.3×

Delray Medical Center FL

15.1×

Crestwood Medical Center AL

15.1×

Regional Medical Center of San Jose CA

14.9×

Baptist Health Brookwood Hospital AL

14.9×

Valley Hospital Medical Center NV

14.7×

Merit Health River Oaks MS

14.7×

Typical hospital: 4.5×

Billed compared with paid, by state

1.1×–3.4×
3.4×–4.1×
4.1×–4.5×
4.5×–5.4×
5.4×–9.1×

The stays with the biggest gap

Mini-stroke (TIA)

7.0×

Heart stent

6.6×

Heart catheterization

6.1×

Heart stent, with major complications or 4+ stents

6.1×

Chest pain

6.0×

Heart attack, with complications

5.8×

High blood pressure

5.8×

Heart procedure through a catheter (e.g. ablation, valve clip)

5.7×

Stroke, with complications or clot-busting drug

5.7×

Hip replacement after a hip fracture

5.6×

Breathing problem needing a ventilator (up to 4 days)

5.6×

Hip or thigh bone surgery (not replacement), with complications

5.5×

All stays: 5.0×

The 50 hospitals with the widest gap (those with 500 or more Medicare stays)

#	Hospital	City	State	Billed ÷ paid	Billed	Paid	Medicare stays
1	Capital Health Medical Center - Hopewell	Pennington	NJ	22.7×	$520.8M	$23.0M	1,447
2	Capital Health Regional Medical Center	Trenton	NJ	21.4×	$516.5M	$24.2M	1,109
3	Carepoint Health - Bayonne Medical Center	Bayonne	NJ	17.1×	$155.2M	$9.1M	502
4	Doctors Medical Center	Modesto	CA	16.4×	$1.0B	$61.2M	2,691
5	Centennial Hills Hospital Medical Center	Las Vegas	NV	16.3×	$530.8M	$32.5M	2,334
6	Gadsden Regional Medical Center	Gadsden	AL	16.0×	$156.5M	$9.8M	1,047
7	Summerlin Hospital Medical Center	Las Vegas	NV	15.8×	$484.1M	$30.7M	2,373
8	Sierra Medical Center	El Paso	TX	15.4×	$170.9M	$11.1M	766
9	HCA Florida South Shore Hospital	Sun City Center	FL	15.3×	$208.8M	$13.6M	1,474
10	Delray Medical Center	Delray Beach	FL	15.1×	$1.1B	$72.8M	6,127
11	Crestwood Medical Center	Huntsville	AL	15.1×	$224.7M	$14.9M	1,440
12	Regional Medical Center of San Jose	San Jose	CA	14.9×	$419.3M	$28.2M	1,352
13	Baptist Health Brookwood Hospital	Birmingham	AL	14.9×	$206.7M	$13.9M	906
14	Valley Hospital Medical Center	Las Vegas	NV	14.7×	$364.9M	$24.9M	1,498
15	Merit Health River Oaks	Flowood	MS	14.7×	$150.8M	$10.3M	726
16	Henderson Hospital	Henderson	NV	14.6×	$517.7M	$35.4M	2,641
17	HCA Florida Fawcett Hospital	Port Charlotte	FL	14.6×	$523.7M	$35.9M	2,966
18	Cjw Medical Center	Richmond	VA	14.6×	$1.6B	$110.3M	7,790
19	Ucla West Valley Medical Center	West Hills	CA	14.4×	$498.1M	$34.7M	2,078
20	HCA Florida Pasadena Hospital a Part of HCA Florid	Saint Petersburg	FL	14.1×	$82.0M	$5.8M	536
21	Good Samaritan Hospital	San Jose	CA	14.0×	$1.1B	$79.0M	3,755
22	St Joseph's Hospital	Tucson	AZ	14.0×	$267.5M	$19.0M	1,201
23	Medical City Plano	Plano	TX	13.9×	$1.5B	$106.7M	5,131
24	San Ramon Regional Medical Center	San Ramon	CA	13.8×	$184.7M	$13.4M	731
25	Palm Beach Gardens Medical Center	Palm Beach Gardens	FL	13.8×	$405.0M	$29.4M	2,309
26	Good Samaritan Medical Center	West Palm Beach	FL	13.7×	$242.3M	$17.7M	1,421
27	HCA-Healthone Dba Swedish Medical Center	Englewood	CO	13.6×	$736.2M	$54.2M	2,698
28	Uci Health - Los Alamitos	Los Alamitos	CA	13.5×	$314.1M	$23.3M	1,537
29	Sunrise Hospital and Medical Center	Las Vegas	NV	13.5×	$1.3B	$94.7M	4,766
30	Western Arizona Regional Medical Center	Bullhead City	AZ	13.4×	$124.5M	$9.3M	782
31	Newton Medical Center	Newton	NJ	13.4×	$351.5M	$26.3M	2,387
32	Grandview Medical Center	Birmingham	AL	13.4×	$717.9M	$53.7M	4,006
33	Spring Valley Hospital Medical Center	Las Vegas	NV	13.3×	$485.0M	$36.4M	1,998
34	Medical City Dallas Hospital	Dallas	TX	13.3×	$1.1B	$83.5M	3,586
35	Alliancehealth Durant	Durant	OK	13.3×	$168.6M	$12.7M	1,367
36	HCA Houston Healthcare Kingwood	Kingwood	TX	13.3×	$1.1B	$83.0M	5,097
37	Vhs Harlingen Hospital Company LLC	Harlingen	TX	13.1×	$223.8M	$17.1M	1,220
38	HCA Healthone Rose	Denver	CO	13.0×	$148.3M	$11.4M	822
39	HCA Florida Orange Park Hospital	Orange Park	FL	13.0×	$552.5M	$42.6M	2,628
40	South Texas Health System	Edinburg	TX	13.0×	$369.9M	$28.5M	1,762
41	HCA Florida Fort Walton-Destin Hospital	Fort Walton Beach	FL	13.0×	$529.3M	$40.8M	3,042
42	Los Robles Hospital & Medical Center	Thousand Oaks	CA	12.8×	$1.3B	$102.1M	5,061
43	Henrico Doctors' Hospital	Richmond	VA	12.8×	$839.0M	$65.5M	4,668
44	HCA Florida Mercy Hospital	Plantation	FL	12.8×	$123.0M	$9.6M	705
45	Emanuel Medical Center	Turlock	CA	12.7×	$300.9M	$23.6M	1,394
46	Nacogdoches Medical Center	Nacogdoches	TX	12.6×	$102.6M	$8.2M	742
47	Desert Regional Medical Center	Palm Springs	CA	12.4×	$593.4M	$47.8M	2,127
48	National Park Medical Center	Hot Springs	AR	12.4×	$116.8M	$9.4M	759
49	Medical City Fort Worth	Fort Worth	TX	12.4×	$537.9M	$43.3M	2,144
50	The Hospitals of Providence - East Campus	El Paso	TX	12.4×	$125.7M	$10.1M	738

What a wide gap does and doesn't mean. It does not mean the hospital is paid more: Medicare pays by formula. It means the list price is high, which is what uninsured and out-of-network patients are billed from. Ask for the cash price and for financial assistance.

Sources: CMS, Medicare Inpatient Hospitals by Provider and Service: each hospital's average charge and average total payment, weighted by its number of stays. "Paid" is Medicare plus the patient's share. How the numbers work.