In a nationwide examination of commercial prices for transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR), we observed substantial markups and variability across hospitals, payers, and plan types—including differences exceeding $90,000 among insurers. Higher prices did not consistently correlate with better clinical outcomes, suggesting that factors beyond quality of care drive these pricing differences. These findings underscore the need for greater transparency and further investigation into how pricing structures and market forces affect both cost and quality of care.