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Three Numbers That Change a Medical Bill Dispute, and Where to Find Them

6 MIN · MAINTAINED — LAST REVIEWED JUL 2026 · FREE, NO ACCOUNT

When you question a medical bill, three numbers help more than anything else. BillFighter does not look these up for you. They come from public websites, and you can find them yourself. This page shows you where, step by step.

Every lookup on this page is free.

Before you start

Have your itemized bill in front of you. An itemized bill lists every charge on its own line. Read: How to request an itemized bill.

Write down these things from it:

  • The billing code for the service. It is a five-digit code next to each charge. It may be called a CPT code or a HCPCS code. Both are just code systems for medical services.
  • The date of the service.
  • The hospital's full name and the city.
  • Your ZIP code.

Number 1: The hospital's financial assistance income limit

What it is

Financial assistance is also called charity care. It is a hospital program that lowers or erases a bill for people who cannot afford it. Every nonprofit hospital must post a written financial assistance policy on its website. That is a federal tax rule. The policy says the most a household can earn and still get free or reduced care. That number is the income limit.

The limit is usually written as a percent of the "federal poverty level." The federal poverty level is a yearly income number the government sets for each household size. So a policy might say "free care under 200% of the federal poverty level."

Why a letter needs it

A charity care request is stronger when you can say: "Your policy gives free care to households under this limit. My household is under it." That turns a request into a match with their own rules. Read: How to apply for charity care.

Where to find it

Option A: Dollar For. Dollar For is a nonprofit that helps people apply for charity care. Its help is free.

  1. Go to dollarfor.org.
  2. Click See if you Qualify.
  3. Answer the short questions about your hospital, your household, and your income.
  4. It tells you whether you likely qualify at that hospital.

Option B: The hospital's own policy.

  1. Go to the hospital's website.
  2. In the site's search box, type financial assistance.
  3. Open the page or PDF called "Financial Assistance Policy" or "Charity Care."
  4. Look for the income table. It lists household sizes and the income limits for free care and for discounts.

If you cannot find it online, call the billing office and ask them to mail it. They must give it to you for free.

What to write down

  • The hospital's name.
  • The limit for free care (the percent of the federal poverty level, or the dollar amount for your household size).
  • The limit for discounted care.
  • The date on the policy.

Number 2: What the hospital actually accepts for the service

What it is

The amount on your bill is usually the hospital's "gross charge." That is the full list price. Insurance companies do not pay that amount. Two other numbers matter more:

  • The cash price is what the hospital charges a person who pays without using insurance.
  • The negotiated rate is the amount an insurance company has agreed to pay the hospital for the same service.

Every hospital must publish its standard charges online, including the cash price and the insurer-negotiated rates. That is a federal rule.

Why a letter needs it

If the hospital accepts $900 from an insurer for the same service, then a $4,000 bill to you is an amount worth questioning. A settlement-offer letter can point to that number and ask for a fair amount.

Where to find it

Option A: Turquoise Health patient search. Turquoise Health collects the price files hospitals publish and lets you search them.

  1. Go to turquoise.health/patients.
  2. Click Search for care.
  3. Type the name of the service, or the billing code from your bill.
  4. Enter your ZIP code.
  5. Pick your hospital from the list. Look for the cash price and the prices for different insurers.

Option B: FAIR Health Consumer. FAIR Health is a nonprofit. Its tool shows typical costs in your area, based on real claims. It is not the hospital's own price, but it shows what is normal nearby. It also works in Spanish.

  1. Go to fairhealthconsumer.org.
  2. Click Medical and Hospital Costs.
  3. Where it asks Where is your provider?, enter your ZIP code.
  4. Search for the service by name or code.
  5. Read the typical cost for your area.

Option C: The hospital's own price file. Go to the hospital's website and search for price transparency. Open the file. It can be large and hard to read. Search inside it for your billing code.

What to write down

  • The cash price for your billing code.
  • The lowest insurer rate you can find, and a typical one.
  • Which website you used, and the date.

Number 3: The Medicare rate for the service

What it is

Medicare is the federal health insurance program, mostly for people 65 and older. It pays hospitals and doctors a set amount for each service. Those amounts are public.

Why a letter needs it

Many people who negotiate a bill start from "a multiple of what Medicare pays." For example, an offer might say: "I can pay 150% of the Medicare rate for this service." The Medicare rate gives your offer a starting point that is easy to explain. It does not promise any result. The hospital can still say no.

Where to find it

For doctor services: the Medicare Physician Fee Schedule lookup.

  1. Go to the CMS Physician Fee Schedule search.
  2. The form asks for the year, the type of information, and the code. Choose the current year and choose pricing.
  3. Type the billing code from your bill.
  4. Choose your state or area, or the national amount.
  5. Run the search. Write down the payment amount shown.

If the form is confusing, the PFS Look-Up Tool overview explains each part.

For hospital services: hospital price files sometimes list Medicare as one of the payers. When you open the hospital's price file (Number 2, Option C), look for a row that says Medicare. Not every file has one. If yours does not, use the doctor-service lookup above for any doctor charges on the bill, and use the cash price and insurer rates for the hospital charges.

What to write down

  • The Medicare payment amount for your billing code.
  • Whether it came from the fee schedule or from the hospital's price file.
  • The year and the date you looked it up.

How to use the numbers

Here is where each number goes.

  • Charity care letter: the income limit (Number 1) and your household size and income. The letter says you fit the hospital's own policy.
  • Settlement-offer letter: the cash price and insurer rates (Number 2) and the Medicare rate (Number 3). The letter compares the bill to what the hospital already accepts and offers a fair amount.
  • Itemized bill letter: none of these yet. That letter asks for the list of charges first. You use the numbers once you have the codes.

Keep the numbers handy for your letter. Write them on one page with the date and the website you used. Bring that page when you call the billing office, and keep it with your case.

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Sources, checked on 2 September 2026

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