{"uid":"cap_o1pPyOQJ8EcYaSN1MD0so","slug":"hospital-price-lookup-629646f8","name":"hospital-price-lookup","description":"Negotiated, gross and cash prices a hospital publishes for a procedure code, plus fused CMS Care Compare quality. Streams the slice of the hospital's own machine-readable file for one billing code and cites the file's hospital name, date and version. Informational, not a quote.","url":"https://payai.agentstools.dev/price/hospital","method":"GET","headers":{},"bodySchema":{"type":"object","$schema":"https://json-schema.org/draft/2020-12/schema","required":["input"],"properties":{"input":{"type":"object","required":["type","method"],"properties":{"type":{"type":"string","const":"http"},"method":{"enum":["GET","HEAD","DELETE"],"type":"string"},"queryParams":{"type":"object","required":["code"],"properties":{"ccn":{"type":"string","description":"Optional 6-digit CMS Certification Number to fuse Care Compare quality"},"code":{"type":"string","description":"Procedure billing code to look up, e.g. 27447"},"payer":{"type":"string","description":"Optional payer or plan name substring to filter the returned negotiated rates"},"domain":{"type":"string","description":"Hospital domain to auto-discover the MRF instead of mrf_url"},"mrf_url":{"type":"string","description":"The hospital machine-readable-file URL (from /price/discover)"},"code_type":{"type":"array","items":{"enum":["CPT","HCPCS","MS-DRG","DRG","APC","NDC","ICD-10","CDM","local"],"type":"string"},"description":"Optional billing-code system(s) to constrain the match"}}}},"additionalProperties":false},"output":{"type":"object","required":["type"],"properties":{"type":{"type":"string"},"example":{"type":"object"}}}}},"responseSchema":null,"example":null,"exampleRequest":null,"tags":["x402"],"displayCostAmount":"0.04","displayCostAsset":"USDC","priceDynamic":false,"priceHint":null,"priceStatus":"priced","priceSource":"probe","requiresHandshake":false,"reviewCount":0,"rating":{"score":"0.00","successRate":"0.00","reviews":0,"stars":null,"state":"unrated"},"availabilityStatus":"unknown","priceObserved":null,"sessionDeposit":null,"pricing":{"kind":"static","summary":"$0.04/call","primary":{"kind":"static","protocol":"x402","network":"base","amountUsd":"0.04","per":"call","confidence":"exact"},"accepted":[{"kind":"static","protocol":"x402","network":"base","amountUsd":"0.04","per":"call","confidence":"exact"}]},"paymentMethods":[{"uid":"pm_DFY3wOrSYn8xp0rTvbcpC","protocol":"x402","methodType":"crypto","chain":"base","mode":"charge","costAmount":"0.04","costPer":"request","priority":0,"asset":"0x833589fCD6eDb6E08f4c7C32D4f71b54bdA02913","unit":"request","depositMicros":null,"planRef":null}],"brandName":null,"brandSlug":null,"brandBaseUrl":null,"brandDocsUrl":null,"whatItDoes":"Retrieves negotiated, gross, and cash prices a hospital publishes for a given procedure billing code, fused with CMS Care Compare quality data, streamed from the hospital's machine-readable file.","exampleAgentPrompt":"What does St. Mary's Hospital charge for a total knee replacement — CPT code 27447 — including their negotiated rate with Blue Cross and their cash price? Pull it from their machine-readable file at stmarys.org and include CMS quality scores if you can find their CCN.","exampleUseCases":[{"title":"Pre-surgery cost estimate for patient","prompt":"My doctor wants me to get a hip replacement, CPT code 27130, at University of Chicago Medical Center — can you pull what they charge gross, cash, and what Aetna's negotiated rate is from their price transparency file?"},{"title":"Insurance plan price comparison","prompt":"I'm trying to figure out what Cedars-Sinai charges UnitedHealthcare vs cash for a colonoscopy, HCPCS code 45378 — can you look that up from their machine-readable file?"},{"title":"Hospital quality-adjusted price research","prompt":"Before I choose a hospital for cardiac bypass surgery, MS-DRG 231, can you get me the published prices from Houston Methodist along with their CMS Care Compare quality rating? Their CCN is 450358."}],"resultDescription":"A structured slice of the hospital's machine-readable pricing file for the requested billing code, including gross charge, negotiated rates (optionally filtered by payer), and cash/discounted price. Also includes hospital name, MRF file date and version for citation, and optionally fused CMS Care Compare quality metrics when a CCN is supplied. Response is informational, not a binding quote.","failureModes":["Billing code not found in MRF — no matching entry returned","MRF URL unreachable or malformed — file fetch fails","Hospital domain MRF auto-discovery fails — no MRF link found on site","Payer filter returns zero matching negotiated rates","CCN not recognized by CMS Care Compare — quality data omitted","Rate-limiting or timeouts when streaming large MRF files","Invalid or unsupported code_type enum value"],"whenToPreferThis":"Use this endpoint when you need to retrieve actual hospital-published transparency prices for a specific procedure code from a specific hospital's CMS-mandated machine-readable file, optionally enriched with quality data. Prefer this over generic insurance cost estimators when you need sourced, citable pricing from the hospital's own disclosure. Best when you have the MRF URL (from a discovery step) or the hospital's domain and a known billing code.","instructions":null,"reviewSummary":null,"reviewSummaryHighlights":null,"reviewSummaryConcerns":null,"reviewSummaryGeneratedAt":null,"activationCount":0,"lastUsedAt":null,"lastSuccessfullyRanAt":null,"lastHealthCheckAt":"2026-09-15T18:53:15.264Z","isFirstParty":false}