A new report released by the Rand Corporation finds large hospital systems in Indiana are generally paid higher prices and hospital prices vary widely, particularly for outpatient services. The report found larger hospital systems are charging up to three times what they charge Medicare for the same procedure. Prices paid for outpatient care vary widely from system to system and from hospital to hospital. There is significant variation in hospital outpatient prices within systems. Within three large systems, the flagship facility is at or near the top of the price range within that system, while other, smaller hospitals within those systems tend to be paid lower outpatient prices.