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

Three public numbers help most when you question a medical bill: the hospital's financial assistance income limit, what the hospital actually accepts for the service (its cash price and insurer rates), and the Medicare rate for the same service. All three are free to look up. This page shows where each one is and what to write down.

When you question a medical bill, three numbers help more than anything else. Start with the bill: upload it and BillFighter reads the provider, the charges, and the billing codes, and shows which letter fits. The three numbers come from public websites. This page shows you where to find each one, step by step, what it tells you about your bill, and why to keep it with your case.

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."

What it tells you

If your household earns less than the limit, you are likely inside the hospital's own policy. That is worth knowing before you apply. BillFighter's Charity Care Application letter asks the hospital for the application and the policy, cites Section 501(r), and asks that collection pause while it is reviewed; you fill in the hospital's form with your income and household size. Read: How to apply for charity care.

Where to find it

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 it is not online, you can ask for it in writing. The hospital must give you a free paper copy of the policy and the application when you ask. BillFighter's Charity Care Application letter asks for both.

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.

What it tells you

If the hospital accepts $900 from an insurer for the same service, then a $4,000 bill to you is an amount worth questioning. That is the comparison to keep with your case: the bill against what the hospital already accepts. BillFighter's Settlement Offer letter offers a lump sum as full and final payment and asks for the agreement in writing before you pay. It does not look up prices; the amount you offer is yours to set, and you read the letter before you sign it. The numbers you found here are what you compare the bill against; what you offer, if anything, is your call.

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.

What it tells you

Medicare's rate is a public, set payment for the same service. Comparing the bill to it shows how far above a known payment the charge sits. 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.

What the numbers tell you

• The income limit (Number 1) tells you whether you are likely inside the hospital's own financial assistance policy. If you are, the next step is the Charity Care Application letter.
• The cash price, the insurer rates, and the Medicare rate (Numbers 2 and 3) tell you whether the bill is above what the hospital already accepts for the same service. If it is, the next step is the Dispute Letter for the lines that are wrong, and the Settlement Offer for whatever balance survives. The amount you offer is yours to set.
• None of these go into the Request Itemized Bill letter. That letter asks for the list of charges first. You look up the numbers once you have the codes.

BillFighter's letters are written from your bill, not from these lookups. The numbers are yours to keep with the case. Write them on one page with the date and the website you used, and keep that page with your papers. Then upload the bill: the free scan shows which letter fits.

Ready to start?

Upload your bill and BillFighter shows which letter fits your situation. The scan is free. Check my bill, free →

Sources, checked on 2 September 2026

• IRS, Financial Assistance Policy requirements for nonprofit hospitals, Section 501(r)(4): https://www.irs.gov/charities-non-profits/financial-assistance-policy-and-emergency-medical-care-policy-section-501r4
• Turquoise Health, patient price search: https://turquoise.health/patients
• FAIR Health Consumer, medical and hospital costs: https://www.fairhealthconsumer.org/medical
• CMS, hospital price transparency requirements: https://www.cms.gov/priorities/key-initiatives/hospital-price-transparency/hospitals
• CMS, Physician Fee Schedule search: https://www.cms.gov/medicare/physician-fee-schedule/search
• CMS, PFS Look-Up Tool overview: https://www.cms.gov/medicare/physician-fee-schedule/search/overview