Federal rules compelling hospitals to disclose their prices can empower Pennsylvania patients to save thousands of dollars when getting medical procedures, according to a new study by health advocates in the commonwealth.
But inconsistencies, hidden costs and confusion about insurance make it challenging and at times impossible for many patients to shop around, the study by the Pennsylvania Health Access Network asserts.
“Patients need price information to make informed decisions about their care, but too often they can’t get a clear answer about what they’ll actually pay,” Antoinette Kraus, PHAN’s executive director, said in an April 8 statement.
The new PHAN review marks five years since the federal government began compelling hospitals to publish price information about medical procedures, with the idea that patients could compare facilities and prepare for the bills they might face. This ability is only growing in importance as health care costs climb and millions of Americans go into debt to pay for treatment.
About a third of Pennsylvania respondents in one 2023 survey said they had taken on debt, dipped into their savings or sacrificed basic needs because of their medical bills.
In the past several years, PHAN has published reports examining whether the commonwealth’s hospitals are complying with the new transparency requirements. In 2025, they found that 10% of these facilities were still not posting pricing information.
However, this year, the group focused on what a patient might experience when trying to track down the most affordable health care and the barriers that might stop them from making an informed choice.
The Hospital and Healthsystem Association of Pennsylvania said their members are complying with transparency requirements and doing their best to stay on top of shifting federal rules.
“While hospitals post their prices, variations in patients’ specific insurance plans, health status, and treatment needs are difficult to factor into upfront estimates,” Jolene Calla, the organization’s vice president for finance and legal affairs, said in a prepared statement. “Hospital financial offices work directly with patients and their families to understand their specific costs, connect with coverage, and access financial assistance, if needed.”
Cost data can yield savings but is often spotty
The price transparency measures do make it possible for consumers to find lower-cost care for some procedures, with potential savings totaling hundreds, thousands or even tens of thousands of dollars, PHAN found.
However, in checking hospital websites for information on common procedures, the researchers said they couldn’t find it about a quarter of the time.
Federal laws also give health facilities flexibility in the way they post this information, and some choose to display procedures by a five-digit code rather than their name. While these codes are common, patients might not always be familiar with the numeric system or which digits correspond to the service they need, according to the advocates.
Prices don’t always appear accurate
Hospitals are required to provide pricing information online in a downloadable file and via an online search tool, but PHAN found that the two sources often list different prices for the same procedures. In 21 cases identified by the researchers, the cost difference totaled $15,000 or more.
And it wasn’t always clear what was reflected in these prices, making it harder for consumers to do an apples-to-apples comparison from one health system to another, according to the report.
Some sites included physician charges while other prices only reflected hospital charges, and in some cases it was impossible to tell, the reviewers said. The amounts also did not incorporate facility fees, which are charged separately and might not be covered by a patient’s insurance plan, they said.
Insurance adds another layer of complication
For people with health insurance, the hospital websites might not always have enough information to make an educated decision, according to the PHAN report. Shopping around can be important even for people who do have insurance, since a growing number are on high-deductible plans that don’t always cover the cost of a smaller procedure, the researchers noted.
But the online search tool might not, for instance, tell a patient what price their insurance negotiated for a particular health service from a hospital or what a customer’s out-of-pocket costs might be, the PHAN report said.
Sometimes, the websites require consumers to enter information about their own insurance copays and deductibles, details they could have trouble locating.
In some cases, it might actually be cheaper for a patient to pay cash for a procedure rather than going through their insurance, but consumers might not have the information they need to make that judgment call, according to the report.
