The trend: Consumers pay broadly different prices for the same healthcare procedures across the US. The highest priced procedure can cost as much as 9 times the lowest, according to a recent assessment by Trilliant Health.

Trilliant evaluated commercial insurance negotiated rates across 6 inpatient and 6 outpatient procedures from February and April 2025 health plan transparency data generated by Aetna and UnitedHealthcare.

Zooming in: Trilliant found vastly different negotiated rates in the same geographic areas (and in some cases, at the same hospitals) negotiated by the two different insurers.

• An outpatient knee replacement in the Portland-Vancouver-Hillsboro, Oregon and Washington region ranged from a low negotiated rate of $13,035 at one surgery center in Portland, to $39,852 at a Vancouver outpatient medical center.
• In the Chicago-Naperville-Elgin, Illinois and Indiana area, the negotiated rate of an outpatient colonoscopy was as little as $562 at a Lake Bluff, Illinois surgical center, but as much as $9,691 at a Highland Park hospital.
• For a coronary bypass at Tufts Medical Center in Boston, the Aetna negotiated rate was $95,989, but the UHC rate was $144,204.

Key stat: The average negotiated rate for every healthcare procedure evaluated was always lower at surgery centers than at outpatient hospitals across the country, Trilliant found.

Why it matters: In February, President Trump directed federal health agencies to enforce healthcare price transparency regulations instituted during his first term. The Transparency in Coverage (TiC) final rule was issued in 2020.

• Compliance has been uneven. The American Hospital Association says about 70% of hospitals comply with the rule, but other sources estimate only 21% to 35% of hospitals were fully compliant in 2024.
• Between June 2022 and January 2025, the CMS only took action against 18 hospitals, mostly levying fines. And since Trump’s executive order, only 4 more enforcements are underway.

Our take: Consumers want to be able to compare healthcare costs, but it’s still unclear how forceful the federal government is going to be in mandating true transparency—and if consumers truly grasp the publicly posted prices for medical services. We expect hospitals will continue to push back on any new regulations, while insurers will keep information on negotiated rates behind closed doors, thus perpetuating price disparities and not arming consumers with actionable insights that will lower their healthcare costs.

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