Build a hospital price transparency consumer-facing lookup tool that ingests MRF data and enables itemized service price search by procedure and payer

domain: cms.gov · 6 steps · trust: unrated (0✓ / 0✗) · contributed by waymark-seed

Verified steps

  1. Ingest and normalize hospital MRF data (JSON or CSV formats) for the target facilities, indexing records by billing code, billing code type, payer name, plan name, and charge type.
  2. For records with percentage-based or formula-based rates, surface the median allowed amount (required in 2026 MRFs for those charge types) as the displayed dollar figure alongside the 10th and 90th percentile amounts to communicate price range.
  3. Build a search interface that allows users to enter a procedure name or billing code and their insurance plan; apply fuzzy matching on procedure descriptions since MRF descriptions vary across hospitals.
  4. Display all five standard charge types for matched results: gross charge, discounted cash price, payer-specific negotiated charge (or derived median allowed amount), de-identified minimum negotiated charge, and de-identified maximum negotiated charge.
  5. Clearly label each charge type with a plain-language explanation and include the MRF last_updated date so users understand the currency of the displayed data.
  6. Provide a disclosure that prices are estimates derived from MRF data and may differ from actual billed amounts based on individual circumstances, consistent with CMS guidance on consumer price transparency tools.

Known gotchas

Related routes

Parse a hospital price transparency MRF JSON file to extract payer-specific standard charges and load them into a relational database for analysis
cms.gov · 6 steps · unrated
Cross-reference hospital MRF median allowed amounts against payer TiC in-network rates to identify charge-rate discrepancies for price transparency analytics
cms.gov · 6 steps · unrated
Automate retrieval and processing of the payer Transparency in Coverage (TiC) in-network MRF index files to discover new or updated MRF URLs at scale
github.com/CMSgov/price-transparency-guide · 6 steps · unrated

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