Problem and audiences

What a hospital gets paid for a given scan or delivery, by each insurer, has been public by federal rule since January 1, 2021. Since January 1, 2026 the files must state each negotiated rate in dollars where it was negotiated in dollars, and where it is a percentage or a formula must add the median and the 10th and 90th percentile of what the insurer actually paid, with an attestation signed by a senior officer; enforcement began April 1, 2026. Insurers have published their negotiated rates for every in-network provider since July 2022. Nobody has turned either into something an Essex County parent can read.

The national tools cover hospitals in aggregate. None of them shows a freestanding imaging center next to the hospital department two miles away that charges several times more for the same scan with the same insurer. New Jersey has no all-payer claims database and no state price tool.

Unverified

The dates above are drawn from the schools ledger's services page, which cites CMS fact sheets. They are restated here without re-checking the primary sources; see Research.

Why Essex County, why now

The schools ledger established why local prices matter: the Brown University CAHPR memo of September 4, 2025 puts Essex hospitals at 175% to 349% of Medicare for outpatient care, and the district's health plan premium is the contested number in the 2026 teacher contract. The ledger's services page proposes a yearly local price table as the next piece of record-keeping. This site is that table and the pipeline behind it.

Audiences, in order

1. Residents choosing where to get care they already know they need. An MRI, a colonoscopy, a birth, a child's broken arm. They mostly cannot choose their insurer, only the facility, so the site compares facilities under the insurer they have.
2. The people negotiating health benefits locally. The district and its unions, the township, local employers, and the eventual health membership sketched on the services page. They need the yearly county table and a percent-of-Medicare figure per facility.
3. Neighboring towns and counties that want the same thing. The pipeline treats Essex as configuration, not as a hard-coded scope, so a second county is a second configuration file.

What success looks like

For each of about one hundred common procedures, a page showing what each Essex hospital and, later, each freestanding center is paid by each insurer, the cash price, and Medicare's rate for the same thing, with the file date and a link to the row in the source file. A yearly county price table the schools ledger can cite. Every figure reproducible from the raw public files by anyone who clones the repository.

What this is not

Not a plan-shopping tool. Not a provider rating. Not advice. A record of prices and where they came from.

Open

• Confirm the regulatory dates and cites against CMS primary sources (45 CFR Part 180; 45 CFR 147.210 to 147.212).
• Decide how to present prices for an audience that mostly has one insurer through work and can choose only the facility: facility-first navigation, or procedure-first with an insurer filter.