Medical & Data Disclaimers

1. Not a Medical Device

2. No Medical Advice

3. AI Interpretation Limitations

ClearCost uses artificial intelligence (Claude by Anthropic) to translate plain-language descriptions of healthcare services into standardized billing codes (CPT, HCPCS, MS-DRG). This translation process is an approximation.

The billing codes your provider ultimately uses may differ from those identified by ClearCost based on clinical findings made at the time of service, the specific technique or approach used, the provider's clinical judgment, or other factors that cannot be known in advance.

AI-generated code interpretations should always be verified with your healthcare provider or their billing department before making financial decisions based on price estimates from this site.

4. Price Data Limitations

Prices displayed on ClearCost are sourced from hospital Machine Readable Files (MRFs) published pursuant to the CMS Hospital Price Transparency Rule (45 C.F.R. § 180). These files represent hospitals' published standard charges.

Prices shown may not reflect:

• Negotiated rates specific to your insurance plan
• Your actual out-of-pocket cost after deductibles, copays, or coinsurance
• Additional facility fees, supply charges, or equipment costs
• Updates made after the hospital last published its MRF
• Services bundled with or required alongside the procedure

All prices are estimates for informational purposes only. Actual charges will be determined by your provider at the time of service.

5. Professional Fees

Many hospital charges shown on ClearCost are facility fees only — the portion billed by the hospital for use of its facilities, equipment, and support staff. Where a hospital labels a charge as a facility fee or a professional (doctor's) fee, ClearCost says so next to the price.

Professional fees — charged separately by the individual clinicians who perform or interpret your care, such as the surgeon, radiologist, anesthesiologist, or pathologist — are billed independently and do not appear in hospital MRFs. These fees are not included in the prices shown unless otherwise noted.

Your total cost for a procedure will typically include both a facility component and one or more professional fee components. Where professional fee estimates are available, ClearCost will indicate this separately.

Estimated totals. For some procedures ClearCost shows an estimated total that adds up the services commonly billed together with the procedure (for example imaging, lab work or anesthesia). These totals are modeled, not a package price published by the hospital. Each line uses that hospital's own published price for the service. When the hospital publishes no cash price for a line, ClearCost converts its insured or list price into an estimated cash price and labels that line with lower confidence. Lines with no published price are listed as missing rather than filled in from other hospitals. You may not need every service included, and you may need services that are not.

Hospital stays. Some surgery is billed as a hospital stay under a single MS-DRG code. Where ClearCost shows a hospital-stay price, it is the hospital's published price for an uncomplicated stay; stays with complications can cost substantially more.

An estimated total is general information, not a quote, a bill or a Good Faith Estimate. Ask the provider for a written Good Faith Estimate before you schedule care.

6. Billing Code Accuracy

Medical billing codes (CPT codes maintained by the American Medical Association, HCPCS codes maintained by CMS, and MS-DRG codes) are standardized nationally, but their application varies considerably in practice.

The same procedure may be billed under different codes depending on the clinical circumstances, anatomical approach, complexity level, provider type, facility type, or payer requirements. ClearCost's code interpretation is based on the description you provide and may not match the code your provider selects after clinical evaluation.

ClearCost does not guarantee that the codes displayed represent the codes that will be used for your specific encounter. Always confirm billing codes with your provider prior to service.

7. Insurance & Coverage

ClearCost currently displays self-pay and cash prices from hospital MRFs. These are the rates hospitals publish for patients without insurance or those paying out of pocket, and are not insurance-specific negotiated rates.

Your actual out-of-pocket cost if you have insurance will depend on your specific plan design, including your deductible, copay, coinsurance, annual out-of-pocket maximum, and network status of the provider. Coverage for a procedure may also depend on prior authorization, medical necessity determination, or other plan requirements.

Always verify coverage, prior authorization requirements, and estimated costs directly with your insurance provider before scheduling a procedure.