Ohio has no hospital price benchmark law. This report borrows the strictest one enacted anywhere in the country and measures Ohio against it.
The share of more than 192,000 benchmarkable list prices published by Ohio's major hospital systems that currently sit above 260% of the corresponding Medicare rate, the line Indiana wrote into law.
Indiana's House Enrolled Act 1004 requires the state's largest nonprofit hospital systems to offer employers health care arrangements priced at or below 260% of what Medicare pays. It is the most direct hospital pricing benchmark enacted in the country. Ohio has no equivalent. No Ohio statute draws a line against Medicare, and no Ohio hospital is required to price against one.
The measurement is still possible. Ohio hospitals, like all American hospitals, have been federally required to publish their standard charges since 2021, and Ohio's own House Bill 173 layered state transparency requirements and state enforcement on top of the federal rule in 2025. Medicare's payment rates are public record. So the question this series asked of Indiana in Report No. 1 can be asked of Ohio: how far do the prices hospitals publish sit from the strictest line any legislature has drawn?
The Solomon Report measured it, using the identical instrument as Report No. 1. Across 102 hospital facilities in 17 of Ohio's major systems, the answer is further than Indiana.
Report No. 1 measured Indiana's published hospital prices against the 260% of Medicare benchmark in Indiana's own law and found 86.8% above the line. This report applies the same line to Ohio, not because Ohio is bound by it, but because it is the only price benchmark an American legislature has enacted with this level of directness, and because a common yardstick is what makes states comparable at all.
Price benchmarks tied to Medicare are spreading. Indiana's employer contracting requirement has applied to its largest systems since September 2025 and reaches independent hospitals on September 1, 2026. Oregon has operated a cap on what its state employee plans pay hospitals, with documented savings exceeding $100 million in its first two years. Vermont has adopted employer-plan price limits of its own. Whether Ohio ever draws such a line is a question for Ohioans. What this report establishes is where Ohio's published prices stand today relative to the strictest line that exists.
Ohio's own legislation to date addresses transparency rather than price levels. House Bill 173 requires hospitals to publish machine-readable files of standard charges, directs the Ohio Department of Health to monitor compliance and publish noncompliance lists, and took effect in April 2025. Those files, together with the federal requirement, are the data this report measures.
Across 102 facilities in 17 major hospital systems operating in Ohio, 93.2% of the 192,668 published list prices that can be directly benchmarked against a Medicare rate currently exceed 260% of that rate. The figure is computed conservatively: each price is compared against the higher of Medicare's applicable payment rates for the same billing code, so a price is counted as above the line only when it exceeds 260% of the most generous Medicare figure available. By the identical computation, Indiana's share was 86.8%.
The finding is not sensitive to where the line is drawn. Moving the threshold from 200% of Medicare to 300% changes the answer by less than six points: 96.4% of prices exceed 200% of Medicare, and 90.8% exceed 300%. Ohio's published prices are not clustered just above the benchmark. They sit far above it.
Nor is the finding driven by any single system. All 17 systems measured land between 74.0% and 98.4% of their benchmarkable prices above the line: seventeen separate organizations, from academic medical centers to community systems, telling one story.
A comprehensive metabolic panel, one of the most commonly ordered blood tests in American medicine, illustrates the range:
| Comprehensive metabolic panel (CPT 80053) | Price |
|---|---|
| Lowest published list price, major Ohio systems | $8.07 |
| Highest published list price, major Ohio systems | $877.00 |
| Medicare payment rate | $10.56 |
| 260% of Medicare | $27.46 |
One Ohio hospital lists this test below Medicare's own rate. Another lists it at more than 100 times the lowest price in the market, and more than 30 times the level Indiana's law contemplates.
The pattern repeats across services. The same Level 5 emergency department visit code is published at $685 by one Ohio hospital and $10,686 by another, a 15-fold difference for the identically coded service.
A published list price above 260% of Medicare violates no Ohio law, because Ohio has drawn no such line. Nor would it violate Indiana's: HEA 1004's benchmark governs the pricing of direct-to-employer arrangements in Indiana, computed under that statute's own methodology. This report makes no compliance determination about any hospital anywhere. It measures distance, not violation.
What the finding does establish is the starting point. If Ohio, or any state, ever considers a benchmark of its own, the adjustment implied is not marginal. The gap between the prices Ohio hospitals publish today and the strictest enacted standard is the dominant feature of the data.
It also establishes something simpler: this measurement required no subpoena, no special access, and no cooperation from any hospital. Any patient, employer, journalist, or legislator can ask how far a given price sits from the Medicare benchmark, because both numbers are published. A state that wants to know where its hospital prices stand can know.
Two states, one instrument. Indiana, with the strictest benchmark law in the country, publishes list prices that exceed its own line in 86.8% of benchmarkable cases. Ohio, with no benchmark law at all, exceeds that same line in 93.2% of cases, on a population of prices nearly twice as large. Whether the difference reflects the shadow a law casts before it, or simply two markets that have never been asked the question, is beyond what published prices can answer. The measurement itself is not.
The Solomon Report intends to keep measuring.
Solomon Report findings are computed from hospitals' federally required price transparency files and public Medicare fee schedules. Findings compare published hospital charges for a given billing code against Medicare's payment rates for the same code, using the higher applicable Medicare rate so that all figures are conservative. Prices published without a matchable billing code are excluded rather than estimated: of 395,376 published prices at the measured Ohio facilities, 192,668 could be directly benchmarked and constitute the population reported here. List prices are distinct from negotiated rates, including pricing arrangements governed by state benchmark statutes. This report uses the identical computation as Report No. 1, which was re-run and reproduced at the time of this analysis. The finding is robust to conservative restriction: limiting the population to prices between zero and 30 times a Medicare rate of at least $5 yields 91.9%. Quoted per-code examples exclude lines described as trauma activations, which are distinct services carried under visit codes in some hospitals' published files. To keep the focus on market-wide patterns, findings are reported in aggregate rather than by institution.
The Solomon Report is an ongoing public reporting series from Solomon Copilot that measures what public healthcare pricing data actually shows. Hospital prices and Medicare rates are public records. The Report puts them side by side.