How much can a hospital, physician practice or records vendor legally charge for copies of medical records? Pick the state, who is asking (the patient, the patient's attorney with a signed authorization, or a subpoena), the page count and paper or electronic delivery. The calculator applies that state's statutory fee schedule, the HIPAA "reasonable, cost-based fee" rule and the $6.50 flat-fee option for electronic patient requests, shows the statute and the source, and writes a short dispute paragraph you can paste into a letter when you have been overcharged. For attorneys, legal nurse consultants, paralegals and patients.
How the state maximum is built
Dispute paragraph (paste into your letter)
Fill the bracketed fields before sending.
How to use the result
Compare the invoice to the "state maximum" figure first. That number is the most the provider or its release-of-information vendor may charge under the state statute for the format and page count you entered, before postage or sales tax where the statute allows them. Anything above it is the amount to dispute.
If the patient made the request, apply HIPAA too. Under 45 C.F.R. § 164.524(c)(4) a patient's own access request can only be billed a reasonable, cost-based fee (labor to copy, supplies, postage), and for an electronic copy the provider may instead charge a flat $6.50. When the state figure is higher than that, the HIPAA figure controls, because HIPAA pre-empts state law that gives patients less protection.
Attorney requests are different. Since Ciox Health v. Azar (D.D.C. 2020) the HIPAA fee limits do not apply to records sent to a third party on the patient's instruction; the state schedule governs. Many firms therefore have the client submit a HIPAA access request for a copy to the client (patient rate), then forward it.
Check the confidence flag and the source link. Several states adjust the schedule every year for inflation; "high" means the figure was read from the statute or the state's current fee notice, "medium" from a secondary source that quotes it, "unverified" means we could not confirm the state rule and show only the federal rule.
Send the dispute paragraph with the invoice. Address it to the records department or the vendor named on the invoice (Ciox/Datavant, MRO, Sharecare, Verisma and similar), keep a copy, and if there is no refund within 30 days consider the state attorney general's consumer-protection office or, for a patient request, an HHS Office for Civil Rights complaint.
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Sources
Each state's figure links to the statute, regulation or official fee notice it was read from. Verified dates and confidence flags are shown per state. Fee schedules change (several states index them to CPI each year), so confirm against the current statute before relying on a figure in litigation.
How much can a hospital charge for medical records?
There is no single national price. Roughly four-fifths of states cap what a provider may charge for copies of a patient's chart, usually a per-page rate that steps down after the first 20 to 100 pages, sometimes with a flat search or retrieval fee and a separate rate for electronic copies. The rest leave it to "reasonable cost". On top of the state rule, federal HIPAA law limits what a patient can be charged for their own records to a reasonable, cost-based fee, with a $6.50 flat-fee safe harbour for electronic copies, and gives the provider 30 days (one 30-day extension) to produce them. Patients cannot be charged a search or retrieval fee at all. Attorneys, insurers and courts are outside the HIPAA fee limit and pay the state schedule, which is why the same 500-page chart can cost $6.50 or several hundred dollars depending on who signs the request.