Check the bill before you pay it.
Hospital list prices are often several times what anyone actually pays. CutMyBill Medical gives your AI assistant the real benchmark for each line, the billing errors to look for, the federal protections that may apply, and the words to say. You make the calls. It is free and it keeps none of what you save.
| Line | Billed | Medicare pays | Multiple |
|---|---|---|---|
| Emergency room visit, high complexityLevel 4 of 5. Ask what in the record supports it. | $3,180.00 | $544.54 | 5.8x |
| CT scan of the abdomen and pelvis, with contrastAn independent imaging center charges a fraction of this. | $6,450.00 | $440.27 | 15x |
| IV fluids, first hourOne bag of saline and an hour in a chair. | $787.00 | $217.31 | 3.6x |
| Blood test: complete blood count (CBC)Medicare pays a flat national rate for this test. | $148.00 | $7.77 | 19x |
| Total | $10,565.00 | $1,209.89 | 8.7x |
The billed amounts are an example. The Medicare figures are real: national 2026 rates for a hospital, facility and doctor combined, from the CMS files listed below. Private insurers typically pay hospitals two to three times the Medicare rate.
What it does, in order
- Gets the itemized bill. The first bill is almost never itemized. The connector writes the request and asks for the account to be held.
- Screens for surprise billing protection. Emergency care, and out of network doctors at an in network hospital, are covered by the federal No Surprises Act. So is a bill $400 or more above a good faith estimate, if you are uninsured.
- Checks the lines for errors. Duplicates, quantities that look too high, top visit levels, panel tests billed twice, lump charges, and a balance higher than your insurer's statement says you owe.
- Prices the big lines. What Medicare pays in your state, what insurers typically pay, and the multiple you were charged.
- Checks financial assistance first. Nonprofit hospitals must have a policy, and it usually beats any discount offered on the phone. Your assistant does the income math on its side. Your income is never sent here.
- Gives you the playbook. Who to call, what each person can approve, a script with your numbers in it, and the traps.
- Checks the offer. Before you say yes: the math, interest, medical credit cards, pressure deadlines, and whether it is in writing.
- Tracks the clock. Assistance windows, dispute windows and payment plan terms go on a private list so nothing lapses.
Two rules the connector repeats: do not pay the first bill, and do not ignore it either. And never put a medical bill on a credit card. It stops being medical debt the moment you do.
What Medicare pays
National 2026 rates for 51 common services. The connector adjusts the doctor's part to your state. "Hospital, all in" is the hospital's facility payment plus the doctor's fee.
Emergency room 4
| Service | Office or independent | Hospital, all in |
|---|---|---|
| Emergency room visit, low complexity | n/a | $197.29 |
| Emergency room visit, moderate complexity | n/a | $348.36 |
| Emergency room visit, high complexity | n/a | $544.54 |
| Emergency room visit, highest complexity | n/a | $779.78 |
An ER visit usually produces two bills: one from the hospital (the facility fee) and one from the emergency physician group. Scans, labs and drugs are billed on top of the visit level. The visit level (1 to 5) is the hospital's judgment, and the two highest levels are the ones most often questioned.
Office and clinic visits 4
| Service | Office or independent | Hospital, all in |
|---|---|---|
| Office visit, new patient, moderate | $177.36 | $252.92 |
| Office visit, established patient, moderate | $135.61 | $220.52 |
| Office visit, established patient, short | $95.19 | $193.47 |
| Office visit, established patient, high complexity | $192.39 | $261.61 |
When a clinic is owned by a hospital, the visit can carry a separate hospital 'facility fee' on top of the doctor's fee. The hospital figure here includes what Medicare pays for that facility fee.
Scans and imaging 12
| Service | Office or independent | Hospital, all in |
|---|---|---|
| MRI of the brain, without contrast | $195.40 | $311.57 |
| MRI of the lower back, without contrast | $191.72 | $312.24 |
| MRI of a knee or other leg joint, without contrast | $204.41 | $306.56 |
| CT scan of the head, without contrast | $106.55 | $146.22 |
| CT scan of the abdomen and pelvis, with contrast | $300.27 | $440.27 |
| CT scan of the chest, without contrast | $132.60 | $156.24 |
| Chest X-ray, two views | $33.07 | $98.93 |
| Ankle X-ray, three views | $37.07 | $97.26 |
| Ultrasound of the abdomen, complete | $114.23 | $144.22 |
| Pregnancy ultrasound, after the first trimester | $135.94 | $153.91 |
| Echocardiogram (heart ultrasound), complete | $196.73 | $625.72 |
| Screening mammogram, both breasts | $126.26 | $126.26 |
The same scan usually costs far less at an independent imaging center than in a hospital. A hospital scan produces a facility charge plus a separate radiologist reading fee.
Heart, sleep and allergy tests 3
| Service | Office or independent | Hospital, all in |
|---|---|---|
| EKG (electrocardiogram) with reading | $15.36 | $68.62 |
| Overnight sleep study in a lab | $673.70 | $996.92 |
| Allergy skin prick test, per allergen | $3.67 | $3.67 |
In a hospital the test and the doctor's reading are often billed separately. Allergy skin tests are billed per allergen, so a panel of 40 allergens is 40 units.
Lab work 7
| Service | Office or independent | Hospital, all in |
|---|---|---|
| Blood test: complete blood count (CBC) | $7.77 | $7.77 |
| Blood test: comprehensive metabolic panel | $10.56 | $10.56 |
| Blood test: basic metabolic panel | $8.46 | $8.46 |
| Blood test: cholesterol (lipid) panel | $13.39 | $13.39 |
| Blood test: thyroid (TSH) | $16.80 | $16.80 |
| Blood test: hemoglobin A1c | $9.71 | $9.71 |
| Urine test (urinalysis with microscopy) | $3.17 | $3.17 |
Medicare pays labs a flat national rate. Hospital lab charges are often many times that rate, and independent labs' cash prices are often close to it. No reliable published figure exists for what private insurers pay for labs, so no insurer range is shown.
Scopes and minor procedures 7
| Service | Office or independent | Hospital, all in |
|---|---|---|
| Colonoscopy, diagnostic | $378.10 | $1,114.77 |
| Colonoscopy with biopsy | $479.97 | $1,400.25 |
| Upper endoscopy (EGD) with biopsy | $418.85 | $1,050.21 |
| Stitches, simple wound up to 2.5 cm | $113.90 | $249.07 |
| IV fluids, first hour | $33.40 | $217.31 |
| Knee arthroscopy with meniscus repair or removal | n/a | $3,858.58 |
| Colonoscopy with polyp removal (snare) | $500.01 | $1,446.01 |
A hospital procedure produces a facility charge, a separate doctor's fee, and often separate anesthesia and pathology bills that are not included here. The same procedure in an ambulatory surgery center is usually cheaper.
Therapy 1
| Service | Office or independent | Hospital, all in |
|---|---|---|
| Physical therapy exercise, one 15 minute unit | $29.06 | $29.06 |
Billed in 15 minute units. A one hour session is usually three or four units, sometimes of different types.
Childbirth 2
| Service | Office or independent | Hospital, all in |
|---|---|---|
| Childbirth, vaginal delivery: the doctor's global fee (prenatal, delivery, postpartum) | n/a | $2,214.48 |
| Childbirth, cesarean: the doctor's global fee (prenatal, delivery, postpartum) | n/a | $2,473.34 |
This is the doctor's global fee only. The hospital's own charge for the delivery stay is billed separately and is not benchmarked in this version, because Medicare pays hospitals for inpatient stays under a different system.
Surgery 5
| Service | Office or independent | Hospital, all in |
|---|---|---|
| Cataract surgery with lens implant, one eye | n/a | $2,820.41 |
| Inguinal hernia repair, open, adult | n/a | $4,165.98 |
| Gallbladder removal, laparoscopic | n/a | $6,808.42 |
| Appendix removal, laparoscopic | n/a | $6,754.64 |
| Tonsillectomy, age 12 and older | n/a | $3,618.74 |
A surgery produces at least three bills: the facility, the surgeon, and the anesthesiologist. The hospital figure here is the facility payment plus the surgeon's fee. Anesthesia is billed separately and is not included. The same operation in an ambulatory surgery center is paid at a lower facility rate.
Skin 3
| Service | Office or independent | Hospital, all in |
|---|---|---|
| Mohs skin cancer surgery, first stage | $667.02 | $1,041.99 |
| Skin biopsy, shave | $95.53 | $445.38 |
| Skin biopsy, punch | $121.25 | $453.40 |
Dermatology procedures in an office are one fee. In a hospital outpatient department the facility bills separately from the doctor. Pathology on a biopsy is a separate bill.
Infusions 2
| Service | Office or independent | Hospital, all in |
|---|---|---|
| Chemotherapy infusion, first hour | $133.27 | $337.46 |
| Chemotherapy infusion, each additional hour | $28.39 | $73.56 |
The infusion charge covers the chair time and nursing. The drug itself is billed separately, usually at a far higher amount, and is not benchmarked here.
Mental health 1
| Service | Office or independent | Hospital, all in |
|---|---|---|
| Psychotherapy, 45 minutes | $113.90 | $273.19 |
Many therapists do not take insurance and set a cash rate. In a hospital or clinic owned by a hospital, a facility fee can be added.
Sources: CMS 2026 Physician Fee Schedule Relative Value File, October release (RVU26D, released 2026-08-26), non-QPP conversion factor $33.4009, with the 2026 Geographic Practice Cost Indices (Addendum E). CMS Hospital Outpatient Prospective Payment System, Addendum B, July 2026 update. National unadjusted payment rates. A hospital's actual Medicare payment is adjusted by its local wage index. CMS 2026 Clinical Laboratory Fee Schedule, third quarter file. National rates.
For most services the connector also returns a reported cash or self-pay price range and, where published, the typical list price markup, from a research file of published price lists and price studies. Those are reported figures of various years, shown as a second reference point.
Insurer ranges used by the connector: RAND Hospital Price Transparency Study, Round 5 (2024, claims from 2020 to 2022): private plans paid hospitals about 289% of Medicare for outpatient facility services on average, with state averages from under 200% to over 300%. Congressional Budget Office (2022): commercial prices for physician services averaged about 129% of Medicare. KFF literature review (2020): about 143%. RAND Round 5: about 188% for hospital-based professional services. Hospitals say Medicare pays below their costs, which is why the insurer range is shown alongside it. A price above a benchmark is a reason to ask, not proof of anything.
The rules it works from
- No Surprises Act. In force since 2022. Ground ambulances are not covered, and the connector says so. Help desk: 1-800-985-3059.
- Hospital financial assistance, section 501(r). Nonprofit hospitals must take applications for at least 240 days from the first bill, and must check for eligibility before selling the debt, reporting it or suing.
- Debt validation. If a collector writes, you have 30 days to dispute in writing and make them prove the debt.
- Credit reports. The three bureaus currently leave off paid medical collections, medical collections under $500, and any under a year old. That is bureau policy, checked 2026-09-21, not law. The federal rule that would have removed all medical debt was struck down in July 2025.
Federal rules only in this version. Many states add their own protections on top.
Add to your assistant
CutMyBill Medical is a standard MCP connector. In an assistant that accepts custom connectors, add this address. There is no account and no login.
https://medical.cutmybill.ai/mcp
Then ask: check this hospital bill, is this ER bill fair, or help me negotiate a medical bill.
What it never sees
Your assistant reads the bill. CutMyBill Medical receives a procedure category, amounts, dates, a state and your insurance status, and rejects anything that looks like a name, a date of birth, an account number or a diagnosis code. It never sees the bill, your records or your income.
What it does not do
- It does not call anyone, log in anywhere, or speak as you.
- It does not take a percentage. Bill negotiation services commonly keep a quarter to a third of what they save you.
- It does not say what you legally owe, and it does not promise a result.
- It does not appeal insurance denials. Its sister connector Health Appeal does that.
- It does not lower recurring bills. That is CutMyBill, the connector this one grew out of: internet, wireless, TV, subscriptions and bank fees.
Questions, corrections, support
Write to hello@cutmybill.ai. If a figure or a rule is out of date, tell us and we will fix it. CutMyBill Medical is free to use under these terms, and what it stores is set out in the privacy policy.
Data 2026-09-21b.