Many not-for-profit hospitals are facing a severe capital shortage. Their traditional sources of funding--government grants, philanthropy, and appropriations--have dramatically declined. Increasingly, these hospitals are turning to the tax-exempt bond market for their capital. It is important for the financial manager to understand the elements and the process of tax-exempt financing. One crucial element is the investment banker who handles the project's financing. This article focuses on the financing services investment banking firms provide to hospitals and explains how much these services will cost.