在俄克拉荷马州首府以北约6英里、77号公路沿线的Surgery Center of Oklahoma（SCO），其核心特点是价格透明。中心为100多种常见手术公布固定价格，并通常在手术前支付完成。示例价格包括：膝关节置换17,679美元、胃旁路手术18,750美元、子宫切除9,190美元、鼻窦手术5,900美元、扁桃体切除3,875美元。约150名医生在此执业，但极少接触大型商业保险患者；常见患者包括高免赔额保险者、失去Medicaid资格者、以及通过基督教医疗费用分担组织或自筹资金的患者。该模式通常比附近医院收费低得多，并避免事后追加费用。
美国医疗体系长期假定治疗前无法确定价格，从而形成复杂计费结构。一次15分钟门诊可能因年龄、健康状况、问题类型和地点等变量采用不同编码。即便结果相当的医院，完全相同手术费用差异可达300%。网络覆盖差异也会显著改变费用：同一名外科医生在凤凰城周三进行的手术可能收费20万美元，而在斯科茨代尔周五进行的同一手术仅约5万美元，降幅达75%。SCO创始人G. Keith Smith于2009年公开价格以推动竞争，他举例称现金价格下MRI约750美元、心脏直视手术约34,000美元、脑肿瘤手术约41,000美元。
SCO模式逐渐被雇主和地方政府采用。俄克拉荷马县目前将接近三分之二医疗支出导向像SCO这样费用可预测的机构；在地方政府和小企业医疗成本十年上涨超过60%的背景下，该县增速仅为其一半。手术占美国医疗支出的四分之一以上，约1.5万亿美元，因此成为价格改革的关键领域。该中心与多个支付方合作，包括覆盖15万多个家庭的基督教医疗费用分担组织。当地县政府为2000多名受益人承担100%费用；到2025年合同扩展至8万名州雇员和退休人员以及35万名成员。约三分之一患者来自州外。
About six miles north of the Oklahoma state capitol along Route 77, the Surgery Center of Oklahoma (SCO) distinguishes itself through price transparency. The center publishes flat prices for more than 100 common procedures, typically paid before surgery. Examples include $17,679 for a knee replacement, $18,750 for gastric bypass, $9,190 for hysterectomy, $5,900 for sinus surgery, and $3,875 for tonsillectomy. Roughly 150 physicians practice there, but few patients carry major commercial insurance; common groups include high-deductible policyholders, people removed from Medicaid, and patients funded by Christian cost-sharing ministries or personal payment. The model often costs far less than nearby hospitals and eliminates surprise billing.
The U.S. health-care system has long assumed prices cannot be set before treatment, producing complex billing structures. Even a 15-minute office visit may receive different codes depending on age, health status, issue type, and location. Identical surgeries at hospitals with comparable outcomes can produce bills differing by as much as 300%. Network status can also shift costs dramatically: the same surgeon might charge $200,000 for a Wednesday procedure in downtown Phoenix but about $50,000 for the same operation on Friday in Scottsdale, a 75% reduction. SCO co-founder G. Keith Smith posted prices online in 2009 to trigger competition, citing examples such as a $750 MRI, $34,000 open-heart surgery, and $41,000 brain tumor surgery.
The SCO model has increasingly been adopted by employers and local governments. Oklahoma County now directs nearly two-thirds of its health-care spending to providers with predictable fees like SCO; while local government and small-business medical costs rose more than 60% over a decade, the county’s increase was about half that rate. Surgery represents more than one-quarter of U.S. health spending, roughly $1.5 trillion annually, making it a key testing ground for pricing reform. The center partners with multiple payers, including a Christian cost-sharing group covering more than 150,000 families. The county guarantees 100% coverage for over 2,000 beneficiaries; by 2025 contracts extended to 80,000 state employees and retirees and 350,000 ministry members. About one-third of patients travel from out of state.