An honest answer to the question, How much will it cost? is what most people seeking price transparency in health care tend to be after. Yet, what health care costs you or your family, or even being given an opportunity to assess whether you can afford services, is not how price transparency in health care is defined by even the most dedicated, knowledgeable advocates. A 2014 report from a landmark task force of the Healthcare Financial Management Association, for example, states that what all patients deserve from health care price transparency is “accurate price estimates from a reliable source.” If this is the best definition of price transparency that a well-intentioned, well-informed task force suggests the American public can expect, one might reasonably suspect that, without dramatic reforms to financial structures of US health care, an honest answer to the question, How much will it cost? might not even be possible in many cases. This theme issue investigates why this problem matters clinically and ethically to every stakeholder, rich or poor, in the US health care system.