28.0 million
Americans had no health insurance in 2025, 8.3% of the population. Among adults 18 to 64, it was 11.6%.
CDC National Center for Health StatisticsOur mission
Putting patients and their dollars back in the driver's seat.
Cash Based Care is an information hub for people who pay for healthcare themselves. We show you what care costs before you walk in, and what your rights are when you pay out of pocket.
The patient isn't treated as the customer
Much of the complexity in American healthcare comes from the insurance companies sitting between patients and the people who treat them. You receive the care, but in many cases the insurer is the one treated as the customer. Insurers negotiate the prices, decide which treatments get approved, and set the rules doctors' offices have to follow.
That middle layer is expensive and slow. In a 2024 survey by the American Medical Association, physicians reported handling an average of 39 prior authorization requests a week, taking their staff about 13 hours. Meanwhile, prices stay hidden behind contracts most patients never see.
Even people with insurance increasingly pay their own way. The average deductible for single coverage at work is now $1,886, and nearly 3 in 10 covered workers are in high-deductible plans. Until that deductible is met, they're effectively paying cash, often without knowing the price ahead of time.
More people are paying their own way
A growing share of patients is skipping third-party coverage altogether, or carrying so little of it that they shop like cash buyers. The number of people looking for cash options keeps growing.
1.2 million
fewer people signed up for ACA marketplace plans for 2026 (23.1 million, down from 24.3 million) after enhanced premium subsidies expired.
HFMA, citing CMS10 million
more people are projected to be uninsured over the next decade because of recent changes to Medicaid, according to the Congressional Budget Office.
Fortune, citing CBO+83%
growth in direct primary care and concierge practices from 2018 to 2023, from 1,658 to 3,036 sites, as doctors and patients opt out of insurance billing.
Johns Hopkins Carey Business SchoolWhat Cash Based Care does about it
Shows the price before you go
We collect the cash prices clinics, imaging centers and practices publish, and put them side by side on a map, so you can compare the way you would for anything else you buy.
Explains your rights
Federal and state laws protect people who pay out of pocket, from Good Faith Estimates to caps on what hospitals can charge. Know Your State lays them out in plain language.
Shows its work
Every price links to the page where we found it. We only list providers that publish a real number or a written discount, so you can check it yourself.
What we believe
- Prices should be public. You should know what care costs before you receive it, not weeks later in the mail.
- The patient is the customer. When you pay, providers should compete for your business on price and quality.
- Information should be free. Anyone can search Cash Based Care. You don't need an account or an insurance card.
Power to the patients.
Sources
- CDC National Center for Health Statistics: U.S. Uninsured Rate Unchanged in 2025 (May 2026)
- HFMA: ACA marketplace enrollment declines as subsidies expire in 2026
- Fortune: America's uninsured rate held at 8% in 2025. That's about to change (May 2026)
- KFF: 2025 Employer Health Benefits Survey
- KFF: Health Care Debt Survey (2022)
- American Medical Association: Nearly 40 prior authorizations a week is way too many (2024 survey)
- Johns Hopkins Carey Business School: Fee-based primary care is rapidly rising in U.S. (study in Health Affairs)