▸ DATA STUDY · 2025 EDITION

Hospital Markups

The median U.S. hospital marks up its charges 1.8× over actual costs. Across 7,389 hospitals with complete Medicare cost reports (through FY2025), gross charges far exceed what care actually costs to deliver. Below: the hospitals with the highest markups nationally, and how markups break down by state. Updated annually.

1.8×
MEDIAN MARKUP (CHARGES ÷ COSTS)
28.8×
HIGHEST MARKUP
7,389
HOSPITALS ANALYZED
▸ STATES WITH THE HIGHEST MARKUPS

Average hospital markup — top 12 states

Florida4.9×Nevada3.6×Alabama3.3×Tennessee3.2×Texas3.2×South Carolina3.2×Georgia2.9×Arizona2.8×Virginia2.7×California2.7×Mississippi2.7×Pennsylvania2.7×
▸ HIGHEST MARKUPS NATIONALLY

The 50 hospitals with the highest charge-to-cost ratios

Ranked by markup (total charges ÷ total costs). Limited to hospitals with more than $10.0M in total costs.

#HospitalLocationMarkupTotal chargesTotal costs
1WESTERN ARIZONA REGIONAL MEDICAL CENBULLHEAD CITY, AZ28.8×$1.57B$54.6M
2CLEVELAND EMERGENCY HOSPITALCLEVELAND, TX24.0×$1.29B$53.8M
3ST. LUCIE MEDICAL CENTERPORT ST. LUCIE, FL23.8×$2.73B$114.9M
4WOMANS HOSPITAL OF TEXASHOUSTON, TX22.1×$1.54B$69.5M
5LAS PALMAS MEDICAL CENTEREL PASO, TX20.4×$6.70B$328.3M
6TWIN CITIES HOSPITALNICEVILLE, FL19.8×$914.1M$46.1M
7VALLEY REGIONAL MEDICAL CENTERBROWNSVILLE, TX19.7×$2.62B$133.2M
8HCA FLORIDA BRANDON HOSPITALBRANDON, FL19.1×$5.83B$304.8M
9OAK HILL HOSPITALSPRING HILL, FL18.2×$4.26B$234.7M
10RAULERSON HOSPITALOKEECHOBEE, FL18.1×$736.9M$40.7M
11KENDALL REGIONAL MEDICAL CENTERMIAMI, FL18.0×$5.65B$313.4M
12FORT WALTON BEACH MEDICAL CTRFORT WALTON BEACH, FL17.3×$3.94B$227.2M
13GADSDEN REGIONAL MEDICAL CENTERGADSDEN, AL17.3×$2.83B$163.7M
14NORTH OKALOOSA MEDICAL CENTERCRESTVIEW, FL16.6×$1.36B$81.8M
15HCA FLORIDA BAYONET POINT HOSPITALHUDSON, FL16.4×$4.35B$265.2M
16SOUTH BALDWIN REGIONAL MEDICAL CENTEFOLEY, AL16.2×$2.03B$125.6M
17MEDICAL CENTER ENTERPRISEENTERPRISE, AL16.1×$978.8M$60.7M
18WESTSIDE REGIONAL MEDICAL CENTERPLANTATION, FL16.1×$3.35B$207.9M
19MEMORIAL HOSPITAL OF JACKSONVILLEJACKSONVILLE, FL16.1×$4.71B$292.7M
20CRESTWOOD MEDICAL CENTERHUNTSVILLE, AL15.1×$3.66B$242.4M
21HCA FLORIDA WOODMONT HOSPITALTAMARAC, FL15.0×$1.79B$119.6M
22HCA FLORIDA PALMS WEST HOSPITALLOXAHATCHEE, FL14.9×$2.40B$161.1M
23ENGLEWOOD COMMUNITY HOSPITALENGLEWOOD, FL14.9×$1.02B$68.2M
24GRANDVIEW MEDICAL CENTERBIRMINGHAM, AL14.9×$9.08B$611.1M
25ALLIANCEHEALTH DURANTDURANT, OK14.8×$1.26B$84.8M
26POINCIANA MEDICAL CENTERKISSIMMMEE, FL14.5×$1.38B$94.9M
27HENDERSON HOSPITALHENDERSON, NV14.5×$4.68B$323.0M
28SUNRISE HOSPITAL AND MEDICAL CENTERLAS VEGAS, NV14.3×$10.73B$748.1M
29TEXAS ORTHOPEDIC HOSPITAHOUSTON, TX14.3×$2.21B$154.3M
30ST. PETERSBURG GENERALSAINT PETERSBURG, FL14.2×$1.18B$82.8M
31LUMBERTON HOSPITAL LLCLUMBERTON, TX14.2×$255.1M$18.0M
32EASTERN NEW MEXICO MEDICAL CENTERROSWELL, NM14.1×$710.8M$50.6M
33MEDICAL CENTER OF TRINITYTRINITY, FL14.0×$4.21B$300.6M
34HELENE FULD MEDICAL CENTERTRENTON, NJ14.0×$6.24B$446.8M
35FLOWERS HOSPITALDOTHAN, AL14.0×$3.06B$219.1M
36MEDICAL CITY DALLASDALLAS, TX13.9×$9.26B$666.6M
37OSCEOLA REGIONAL MEDICAL CENTERKISSIMMEE, FL13.8×$4.69B$339.2M
38SUMMERLIN HOSPITAL MEDICAL CENTERLAS VEGAS, NV13.7×$5.30B$386.1M
39CLEAR LAKE REG MED CTRWEBSTER, TX13.7×$6.69B$489.4M
40HCA FL FAWCETT HOSPITALPORT CHARLOTTE, FL13.6×$3.32B$244.4M
41HCA FLORIDA GULF COAST HOSPITALPANAMA CITY, FL13.5×$3.55B$262.6M
42CONROE REGIONAL MEDICAL CENTERCONROE, TX13.4×$3.28B$244.4M
43AVENTURA HOSPITAL AND MED CTRMIAMI, FL13.4×$3.42B$255.1M
44GALESBURG COTTAGE HOSPITALGALESBURG, IL13.4×$203.7M$15.2M
45RIO GRANDE REGIONAL HOSPITALMCALLEN, TX13.4×$3.27B$244.7M
46CORPUS CHRISTI MEDICAL CENTERCORPUS CHRISTI, TX13.2×$5.26B$398.1M
47HCA FLORIDA ORANGE PARK HOSPITALORANGE PARK, FL13.2×$4.77B$361.8M
48CJW MEDICAL CENTERRICHMOND, VA13.2×$10.58B$804.3M
49LAKE CITY MEDICAL CENTERLAKE CITY, FL13.1×$1.42B$108.3M
50NORTH FLORIDA REGIONAL MED CTRGAINESVILLE, FL13.1×$6.64B$506.9M

Methodology

Markup is total gross charges divided by total costs from each hospital's most recent HCRIS cost report. Charges are list prices; few payers pay them in full, but they drive out-of-network bills and uninsured liability. We include only hospitals with more than $10.0M in total costs; state figures use the median across states with at least five qualifying hospitals. See also: hospitals operating at a loss →

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CITATION
HCRIS. (2025). Hospital Markups. Retrieved from https://hcris.io/hospital-markups
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<a href="https://hcris.io/hospital-markups" style="display:inline-block;border-left:4px solid #84cc16;padding:10px 14px;font:14px/1.4 system-ui,sans-serif;color:#0f172a;text-decoration:none;background:#f8fafc;border-radius:4px;max-width:520px"><strong>The median U.S. hospital marks up charges 1.8× over costs</strong><br>Source: HCRIS — Hospital Markups (2025)</a>
PREVIEW
The median U.S. hospital marks up charges 1.8× over costs
Source: HCRIS — Hospital Markups (2025)