When a baby is about to arrive, every minute counts. Yet when Jen Villa of Salinas, California, was in labor, she and her partner drove 45 minutes in the middle of the night, bypassing nearby hospitals to reach one they could afford.

For years, the price of hospital care has been hidden from patients, companies and taxpayers who get the bills — and that secrecy has made a hospital visit in some places prohibitively expensive. It has also fostered disparities, forcing people to pay far more depending on where they go.

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The US devotes more resources to health care than any other country, with patients, employers, and government health programs spending $4.5 trillion last year. Hospitals get the biggest share by far, taking in more than three times what Americans spend at the pharmacy on prescription drugs. Rising hospital prices have helped make health insurance more costly.

Federal rules put in place in 2021 require hospitals to make their prices public so consumers can compare them and know ahead of time how much going to one will cost. While many hospitals have been slow to comply, the emerging picture has revealed imbalances that leave patients like Villa weighing saving money against being seen by a preferred doctor or at facilities closer to home.