Vlada
2026-09-10 · on LinkedIn ↗
In Florida, a typical hospital charges 5.9 times what its care cost. In North Dakota, 1.4 times.
In Florida, a typical hospital charges 5.9 times what its care cost. In North Dakota, 1.4 times.
Every hospital has to tell Medicare what its care actually costs to give. Put that next to the price on the bill, and the gap is the markup.
Across 6,708 hospitals the typical markup is about 3 times. But where you live moves that number more than your care does. In Florida the middle hospital charges 5.9 times its own cost. In North Dakota, Montana and Maryland, about 1.4 times. Same scan. Same stitches. Same night in a bed. What changed is the state line you were standing on.
Some of it is the rules. Maryland sets one price for every hospital and every plan, and its bills sit near the bottom. Most states let each hospital write its own number.
Be fair about what this is. It is the price on the bill, not profit. If you have insurance, your plan pays a lower rate it worked out. If you do not, the state line is part of your bill.
You did not pick the markup on your bill. The state you live in picked it for you.
- Source
- Hospital Medicare cost report (Form 2552-10), Worksheet C, as filed; Vlada mart_hospital_dept_ccr, vintage v20260728T012955Z.
- Measure
- State medians of markup, the price on the bill over what the care cost (1 divided by the cost-to-charge ratio), across 6,708 hospitals in 50 states and DC; each hospital counted once at its own Medicare cost report (Form 2552-10), Worksheet C; read September 2026. The markup is the price on the bill; an insured patient pays a lower negotiated rate.