Houston hospitals show significant pricing differences in their procedures, according to a new brief from Rice University’s Baker Institute for Public Policy. The research revisits the websites of the four largest Texas Medical Center (TMC) hospitals to assess whether they have followed federal hospital price transparency laws. The analysis focuses on the listed prices from Baylor St. Luke’s Medical Center, HCA Houston Healthcare Medical Center, Houston Methodist Hospital and Memorial Hermann-TMC.
“We found incomplete and inaccessible pricing data, extreme price variations between hospitals and omissions of high-cost procedures in the available data,” said Vivian Ho, the James A. Baker III Institute Chair in Health Economics. “Noncompliance limits people’s ability to access and compare pricing information and make informed decisions about their medical care.”
The federal hospital price transparency rules took effect January 2021 with the goal of reducing costs, minimizing price variation and ultimately curbing overall health spending. Significant challenges have remained, according to the report, and President Donald Trump issued an executive order in February 2025 to renew the push for greater transparency.
Despite the implementation of multiple price transparency policies, hospitals continue to fall short of meeting legal requirements, according to the report. While these regulations have received bipartisan support, compliance remains insufficient, the data shows.
For example, one TMC hospital negotiated a preferred provider organization (PPO) rate that was $20,000 higher than the hospital’s negotiated rate with another insurer. At HCA Houston Healthcare, Blue Cross Blue Shield Texas’ average negotiated prices for 467 outpatient procedures were nearly three times higher than those at Memorial Hermann. For United Healthcare, average prices at Baylor St. Luke’s were more than 50% higher than those at HCA.
“The new executive order underscores the need for further government action,” the report reads. “Without stronger enforcement, health care prices may continue to rise, and hospital costs will remain insulated from market competition. As demonstrated in this study, hospitals directly competing in the same local market are not providing transparent, comparable pricing.”