In New York City, the share of hospital list prices above 260% of Medicare is higher than any statewide figure this series has measured in seven states. In Buffalo it is lower than any. New York City and Buffalo sit 370 miles apart under one law and one reporting rule, yet a gap of 46 points separates their prices.
The share of published hospital list prices that sit above 260% of the corresponding Medicare rate, the line Indiana wrote into law, in New York City and in Buffalo. Statewide, across 73,473 benchmarkable prices from 18 hospitals, the figure is 69.2%.
New York's hospitals publish, under the federal Hospital Price Transparency rule, a list price for every service they bill. This report compares those published list prices, across 18 hospital files from 11 systems, with what Medicare pays for the same procedure in 2026. The threshold is 260% of Medicare, the affordability line Indiana wrote into law for hospital contracts with employers. The instrument is identical to the one used in the first six reports.
Of 73,473 published prices that could be matched to a 2026 Medicare rate, 50,858 sit above the line. That is 69.2%, the second lowest share in the series, above only Michigan. At 200% of Medicare the share is 80.2%. Move the line up to 300% of Medicare and 63.6% of prices are still above it. Nearly two-thirds of New York's published list prices are more than triple what Medicare pays. Excluding extreme prices from the population changes the figure by two tenths of a point.
The statewide figure is an average of two markets that do not resemble each other. Ten hospitals in the New York City metro run at 94.3%. This is the highest figure measured anywhere in the series, above Texas and above New Jersey. Three hospitals in Buffalo run at 48.6%, the lowest in the series, below Michigan's statewide figure. Buffalo's files are large and account for 46% of every price in this report, which is why the state average lands where it does.
| State | Report | Share of list prices above 260% of Medicare | Benchmarkable prices |
|---|---|---|---|
| Texas | No. 3 | 94.1% | 263,835 |
| New Jersey | No. 6 | 93.8% | 196,545 |
| Indiana | No. 1 | 90.6% | 119,990 |
| Ohio | No. 2 | 89.9% | 267,083 |
| North Carolina | No. 5 | 85.1% | 158,652 |
| New York | No. 7 | 69.2% | 73,473 |
| Michigan | No. 4 | 62.8% | 275,013 |
New York is measured on a roster of the state's large systems, not a census of its hospitals. The roster is listed in the Methodology.
In New Jersey, every system was above 86% and the three regions of the state sat within 1.6 points of each other. New York is the opposite case. Sorted by share above the line, the 18 files separate into two groups with almost no overlap.
| Metro | Hospitals | Benchmarkable prices | Share above 260% |
|---|---|---|---|
| New York City metro | 10 | 26,419 | 94.3% |
| Rochester | 1 | 2,508 | 92.7% |
| Syracuse | 1 | 4,209 | 75.1% |
| Albany (Troy) | 1 | 4,835 | 54.6% |
| Buffalo | 3 | 33,901 | 48.6% |
| Rockland County (Nyack) and Oneonta | 2 | 1,601 | 84.4% |
New York City metro: the five boroughs, Westchester and Nassau. Rockland County is shown separately. The NYC and Buffalo figures are 45.7 points apart.
Downstate, every file is at or above 94% except one Manhattan hospital at 88.0%: Northwell, Montefiore, NewYork-Presbyterian and NYU Langone each have between 94% and 100% of their list prices above the line. Upstate, Rochester Regional at 92.7% sits with the downstate group. Then the figures step down: Kaleida Health 83.4%, SUNY Upstate 75.1%, Bassett 74.5%, Trinity Health's Albany-area hospital 54.6%, and the two Catholic Health System hospitals in Buffalo at 42.2% and 40.8%.
The Catholic Health System pair is the lowest full system measured in the seven states, lower than any system in Michigan. The two files carry 28,180 benchmarkable prices between them, 38% of the state total, and they share about two-thirds of their prices because they use one system chargemaster. This makes them the largest publisher in New York. Measured without the second Catholic file, the statewide figure is 75.9%. Measured with the two duplicate NYU Langone campuses removed, it is 67.2%. The headline stays at 69.2%, measured as published. The two checks, 67.2% and 75.9%, mark how far the statewide figure moves depending on how duplicate files are counted.
In 2026, Medicare pays $106.81 for a CT scan of the head without contrast (CPT 70450). Seventeen of the 18 hospitals in this report publish it. Each hospital's price here is its highest full-service list price for the code, lowest to highest:
Lowest: $611 at Unity Hospital in Rochester, 5.7 times Medicare.
Highest: $5,143 at Upstate University Hospital in Syracuse, 48.2 times Medicare.
The ten New York City hospitals price it between $1,800 and $4,868, 17 to 46 times Medicare. The two Buffalo systems sit at $823 and $852.
There is no cheap hospital for this scan in New York, only less expensive ones. The lowest hospital price in the state for this scan is 5.7 times Medicare. The highest is 48 times. The scan is one of the routine outpatient services the Fair Pricing Act would cap at 150% of Medicare, or about $160. The lowest full price in New York is nearly four times that cap.
A second exhibit, inside one system. Medicare pays $106.81 for a complete abdominal ultrasound (CPT 76700). One Manhattan-based system publishes it at $1,283 at its flagship, $1,460 at a second campus, and $6,198 at a third, 40 miles north. That's 58 times Medicare and the highest published price for the study in the state. The same ultrasound costs 4.8 times as much at one of the system's hospitals as at another. Across all 17 hospitals that publish it, the ultrasound runs from $571 in Rochester to $6,198, and the lowest hospital price for it is 5.3 times Medicare.
Prices shown are each hospital's highest full-service list price for the code; component-only lines (professional or technical only) are excluded. The lowest full-service line at or above Medicare anywhere in the state is $366 for the CT scan and $217 for the ultrasound, both at one Albany-area hospital. Two below-Medicare Kaleida lines ($66 and $105) are in the data and are treated as sub-lines, not prices.
For inpatient care, hospitals publish the rates they have negotiated with each insurer for each diagnosis-related group, measured here against each hospital's own wage-adjusted Medicare payment. Fifteen of the 18 files carry usable MS-DRG rates; the three NYU Langone files publish inpatient rates only under a different grouping (APR-DRG) and are measured on outpatient prices alone.
| Measure (inpatient, MS-DRG, per-hospital wage-adjusted Medicare) | Median, multiple of Medicare | Share above 260% | Hospitals |
|---|---|---|---|
| SCAN, California, negotiated (case rate) | 1.12x | 0.0% | 3 |
| New York, lowest negotiated rate per DRG, any payer | 1.08x | 0.0% | 15 |
| New York, highest negotiated rate per DRG, any payer | 3.69x | 59.9% | 15 |
| New York, published inpatient list price | 2.60x | 49.9% | 3 |
At the floor, New York's hospitals accept a median of 1.08 times Medicare for an inpatient stay, within four points of SCAN, the California Medicare Advantage plan used as the control in this series since Report No. 5. That median includes all fifteen hospitals. At twelve of the fifteen, the floor sits between 0.9 and 1.6 times Medicare, and the other three are described in the Limits note below. At the ceiling, the same hospitals charge a median of 3.69 times Medicare for the same stays, about three and a half times the floor. The lowest rate and the highest rate belong to different insurers at the same hospital. Nobody pays the range. Each payer pays its own number.
The payer names behind the floor were read from each hospital's published file. At twelve of the fifteen hospitals, the payer producing the lowest negotiated rate on most diagnosis groups is a Medicare Advantage plan: Aetna, Anthem, Excellus, HealthFirst, Fidelis and Independent Health among them. The affordable inpatient rate exists at every one of these hospitals. It is the rate the hospital has agreed to with a Medicare Advantage plan.
Three hospitals in New York publish an inpatient list price. Of the 15 inpatient files, 12 disclose inpatient rates only as negotiated amounts and publish no list (gross) charge for any DRG. The three that do are the two Catholic Health System hospitals in Buffalo and one rural hospital upstate, and their median inpatient list price is 2.60 times Medicare. That figure describes three modestly priced hospitals, not the state. None of the large downstate systems publishes an inpatient list price.
Limits. Three hospitals show a floor well below Medicare, set by commercial or government contract lines whose basis is not stated in the file and which do not scale with the diagnosis group. They are included in the 1.08 median and excluded from the range and payer descriptions above. Payer classifications are from the published payer strings.
Every hospital in this report has attested under federal rule that its price file is accurate and complete. The files were read as published. Several patterns in them are findings in their own right for anyone relying on the disclosures:
The Fair Pricing Act would set a ceiling of 150% of Medicare on routine outpatient services at New York's large systems, exempting safety-net and public hospitals. This report measures those systems' published prices against a ceiling of 260%, and finds 94% of New York City's prices above it. The gap between what the bill proposes and what the files show is not a matter of degree. A CT scan the bill would price at about $160 is published between $1,800 and $4,868 by the ten New York City hospitals in this report, and the lowest hospital price in the state is $611.
The State of New York buys hospital care for its own employees through the New York State Health Insurance Program, one of the largest public employer health plans in the country. New York City is one of the largest hospital markets in the country. Its list prices, on the hospitals' own attested files, sit above the Indiana line more often than any statewide figure this series has measured.
Instrument. The instrument is identical to Reports No. 1 through 6: each published list price compared with the higher of the 2026 Medicare non-facility and facility rates for that code, threshold 260%. A price is benchmarkable where the Medicare rate exceeds $1. The 0.1x to 100x trim is reported as a robustness check and does not enter the headline.
Roster. 18 hospital price files from 11 systems, chosen as the state's large systems and its major upstate hospitals, not a census: NewYork-Presbyterian (Hospital, Queens, Hudson Valley), Montefiore (Medical Center, New Rochelle, Nyack), NYU Langone (Tisch, Brooklyn, Long Island), Mount Sinai Morningside, Northwell Staten Island University Hospital, Kaleida Health, Catholic Health System (Sisters of Charity, Mount St. Mary's), Rochester Regional Unity Hospital, SUNY Upstate University Hospital, Trinity Health Samaritan Hospital, Bassett A.O. Fox Hospital. NewYork-Presbyterian Brooklyn Methodist is published inside the NewYork-Presbyterian Hospital file and is counted there. All 18 files were loaded in September 2026 on the same instrument as Reports No. 1 through 6. Metro assignment is by county.
Inpatient. Inpatient rates are the negotiated MS-DRG rates at 15 hospitals, each measured against that hospital's own wage-adjusted FY2026 Medicare payment. New York's files label their APR-DRG rows, so those were excluded cleanly. One Manhattan hospital is benchmarked under the Medicare provider number it held under a former name. Insurer names at the floor were read from each hospital's file. Minimum and maximum negotiated rates come from different payer rows and are never cited as a paired spread.
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.