Market Rates: Providers also take into account the prevailing market rates for similar services in their geographic area. This helps ensure their charges are competitive and align with what other practices are charging.

Regulatory Guidelines: Certain procedures may have specific guidelines or limits set by regulatory bodies or insurance companies that impact how charges are determined. The Centers for Medicare & Medicaid Services (CMS) fee schedule plays a significant role in determining healthcare costs and charges. The CMS fee schedule establishes standardized payment rates for various medical services and procedures. Many healthcare providers and private insurers use the CMS fee schedule as a benchmark, impacting overall healthcare costs.

Cost of Services: Healthcare providers consider the costs associated with delivering the service, including overhead expenses like staff salaries, facility costs, equipment, and supplies.