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Avera Health Plans
Avera Health Plans is a health insurer. They report 1 insurance plans covering 2.1M providers across 11K billing codes.
Source: public Transparency in Coverage filesRefreshed monthly, latest September 202619 monthly releases tracked
Monthly release
1
Plans
XX% vs prior month
2.1M
Providers (NPIs)
XX% vs prior month
410K
Tax IDs
XX% vs prior month
11K
Billing codes
XX% vs prior month
510M
Rate rows
XX% vs prior month
September 2026 release
What's in Avera Health Plans's data
A profile of the machine-readable files Avera Health Plans publishes, after PayerPrice parses and normalizes them.
Billing code types
Distinct codes and rate rows by code system
CodesRows
- CPT11K510M100%
Billing class
Professional vs. institutional rate rows
- Professional470M92%
- Institutional39M7.6%
Negotiation arrangement
How each rate is expressed
- Negotiated500M100%
- Percentage1.4M0.3%
Plan identifiers
HIOS IDs mark individual and small-group plans; EINs mark employer plans
- EIN1100%
Providers by type
Distinct NPIs by entity type
- Individual (Type 1)1.8M87%
- Organization (Type 2)280K13%
Tax IDs by type
How provider groups are identified
- EIN370K91%
- NPI (Individual)37K9.0%
- NPI (Organization)99<0.1%
Top states
States with the most providers in network
- California180K
- Texas160K
- New York130K
- Florida120K
- Pennsylvania96K
- Ohio88K
Top specialties
Provider taxonomies with the most NPIs
- Family Nurse Practitioner130K
- Clinical Social Worker120K
- Family Medicine Physician100K
- Physician Assistant99K
- Internal Medicine Physician91K
- Mental Health Counselor77K
These are the files. Want the rates inside them?
Look up Avera Health Plans's negotiated rates by provider, TIN, billing code and plan.
Month-over-month history
Track how network size and rate volume change with each monthly release.
| Month | Plans | NPIs | Tax IDs | Billing codes | Rate rows |
|---|---|---|---|---|---|
| September 2026 | 1 | 2.1M | 410K | 11K | 510M |
| August 2026 | 1.7K | 2.1M | 410K | 19K | 700M |
| July 2026 | 3.4K | 2.1M | 410K | 19K | 690M |
| June 2026 | — | — | — | — | |
| May 2026 | — | — | — | — |
Data quality scorecard
4/6Acceptable
This payer scores 4/6 on data quality (Acceptable). Areas that don't meet the threshold: hios plan and standard code coverage.
Evaluated on the September 2026 release.
Professional & Institutional Rates
Data includes both professional and institutional billing class rates
Valid Tax IDs
More than 80% of Tax IDs are EIN or NPI (Organization) type
HIOS Plan
Data does not include any HIOS-identified plans
Low Derived/Percentage Rates
Less than 10% of negotiation entries are derived or percentage type
Standard Code Coverage
Insufficient CPT / HCPCS code coverage, or too many LOCAL entries
Common Taxonomies
NPIs in the dataset cover at least 50 distinct provider taxonomies
How the score works
Each monthly release is checked against six criteria. 5–6 passing criteria rate Good, 3–4 rate Acceptable, and 0–2 rate Poor.
Behavioral, RX, and other specialty networks may not pass all criteria but can still contain complete and usable data.
Access the data
Avera Health Plans's negotiated rates, in the tools your team already uses
PayerPrice turns raw transparency files into one clean, normalized dataset across 180+ payers, refreshed every month. Pick how you want to work with it.
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Frequently asked questions
About Avera Health Plans's price transparency data.
What price transparency data does Avera Health Plans publish?
Avera Health Plans's September 2026 Transparency in Coverage files list 1 plans, 2.1M providers (NPIs), 410K tax IDs and 11K billing codes, for 510M negotiated rate rows in total.
Which states does Avera Health Plans's network cover?
Avera Health Plans's files include providers in 51 states. The states with the most in-network providers are California, Texas, New York, Florida, Pennsylvania.
How often is Avera Health Plans's data updated?
Payers must post updated machine-readable files every month. PayerPrice processes Avera Health Plans's files monthly; the latest processed release is September 2026, and 19 monthly releases are available.
What is the Transparency in Coverage rule?
Since July 2022, the federal Transparency in Coverage rule has required most group health plans and health insurers to publish machine-readable files of their in-network negotiated rates and out-of-network allowed amounts, updated monthly. These files are the source for the data on this page.
How can I access Avera Health Plans's negotiated rates?
Start a free PayerPrice trial to search Avera Health Plans's rates in the web app, or book a demo to get the full dataset through the REST API, SQL in Snowflake or Databricks, or AI assistants through the PayerPrice MCP server.