Want higher rates for your top billing codes? PayerPrice can help.
We're partnering with the Healthcare Leaders Association of New Jersey to give members direct access to market insights on provider reimbursement rates, helping you negotiate better deals with payers.
"To succeed in healthcare, you need to understand how the system works. Legislation has made more data available. PayerPrice makes this data usable, and has become an invaluable resource to us and our clients."
Brian Kern, Partner at Acadia Professional
Did you know your fee schedule is public?
As of July 2022, commercial insurers are federally mandated to disclose what they're reimbursing every provider across the U.S., for every covered service.
WHAT YOU GET
See what every payer pays every provider — then use it to negotiate.
Every rate in your market
200+ commercial payers. Search by NPI, Tax ID, or billing code. Updated monthly.
Spot underpaid codes
Percentile positioning shows which codes are below market — and by how much.
Drill down by geography
Filter by county, metro, payer, or network to find opportunities others miss.
Compare to Medicare
Convert any rate to % of Medicare in one click — the metric payers use at the table.
PayerPrice helps you understand what rates to ask for
We analyze trillions of rates monthly, providing practice administrators with the tools to compare their reimbursement against local providers and health systems.
- Search rates by NPI, Tax ID, and CPT code
- Benchmark against local competitors
- Identify underpaid services
How PayerPrice Works
Payers publish their prices
Insurers are required to post in-network rates every month.
PayerPrice aggregates the data
We download raw machine-readable files from payers—over 100+ TB monthly.
You get clear benchmarks
Clean, searchable insights delivered through our analytics platform built for providers.
Curious how you compare to the rest of the NJ market?
Tell us your NPI and we'll email you a free benchmark.
FAQs
Common questions about PayerPrice and price transparency data.
Every rate in PayerPrice comes from the machine-readable files (MRFs) that commercial payers are required to publish under the CMS Transparency in Coverage rule. We ingest, normalize, and index these files monthly across 200+ payers and 4M+ providers. You're seeing what payers actually contracted to pay.
Data refreshes monthly, with updated rates typically available within 30 days of payer publication. We also retain historical snapshots from August 2023 onward, so you can see how rates have changed over time.
Accuracy starts at the source: payer-published filings. We handle entity matching, reporting inconsistencies, and contract structure normalization, and we tend to manage that complexity better than most. The data is only as good as what payers publish, though, and we're upfront about edge cases. During onboarding, we'll run a live data audit with your own codes so you can validate against your current contracts.
CPT, HCPCS, MS-DRG, revenue codes, NDC, and J-Codes. Payer coverage includes all four major nationals (Blue Cross, United, Cigna, Aetna) plus over 200 regional commercial plans across every state.
PayerPrice covers commercial payer rates. Medicaid, Medicare, and Medicare Advantage are not included since those fee schedules are published separately by CMS. Where a Medicare rate exists for a code, we can express commercial rates as a percentage of Medicare, which is how most contracting teams benchmark.
Yes. Insurance companies are required to publish their negotiated rates in machine-readable files under the Transparency in Coverage rule. PayerPrice processes this publicly mandated data. Providers, consultants, and attorneys across the industry already use it for contracting and dispute resolution.
We only serve providers, never payers. Your queries, benchmarks, and negotiation strategies are never visible to the other side of the table. We believe it would be a conflict of interest to serve both providers and payers.
Most incumbents serve both payers and providers, charge 3-4x more, and lock you into preset dashboards. PayerPrice gives you drag-and-drop analytics, SQL and BI access, and an API over trillions of rows, for less. A lot of our customers came from multi-tool setups and consolidated into one platform.
Pricing depends on the states and specialties you need, with monthly and one-time options available. Every subscription includes full platform access, unlimited users, and onboarding support. Book a short call and we'll put together a quote.
Sign up for a free trial to run up to 5 searches with your own codes and payers. If you want a guided walkthrough, book a call and we'll run a live data audit so you can see where your rates stand before committing to anything.
Yes. PayerPrice is SOC 2 compliant with encryption in transit and at rest. We never share your information with third parties.
Can't find what you're looking for? Contact our Support Team