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Payer price transparency data

Harvard Pilgrim Health Care (Point32Health)

Harvard Pilgrim Health Care (Point32Health) is a health insurer. They report 270 insurance plans covering 2.1M providers across 18K billing codes.

Source: public Transparency in Coverage filesRefreshed monthly, latest September 202618 monthly releases tracked

Monthly release

270

Plans

XX% vs prior month

2.1M

Providers (NPIs)

XX% vs prior month

420K

Tax IDs

XX% vs prior month

18K

Billing codes

XX% vs prior month

650M

Rate rows

XX% vs prior month

September 2026 release

What's in Harvard Pilgrim Health Care (Point32Health)'s data

A profile of the machine-readable files Harvard Pilgrim Health Care (Point32Health) publishes, after PayerPrice parses and normalizes them.

Billing code types

Distinct codes and rate rows by code system

CodesRows
  • CPT11K640M99%
  • HCPCS4.4K5.9M0.9%
  • CDT490870K0.1%
  • APR-DRG1.3K100K<0.1%
  • MS-DRG77023K<0.1%
  • RC242.2K<0.1%

Billing class

Professional vs. institutional rate rows

  • Professional610M94%
  • Institutional41M6.3%

Negotiation arrangement

How each rate is expressed

  • Negotiated620M95%
  • Fee Schedule32M4.9%
  • Percentage1.5M0.2%

Plan identifiers

HIOS IDs mark individual and small-group plans; EINs mark employer plans

  • HIOS ID4015%
  • EIN23085%

Providers by type

Distinct NPIs by entity type

  • Individual (Type 1)1.8M87%
  • Organization (Type 2)290K13%

Tax IDs by type

How provider groups are identified

  • EIN380K89%
  • NPI (Individual)47K11%
  • NPI (Organization)110<0.1%

Top states

States with the most providers in network

  • California180K
  • Texas160K
  • New York140K
  • Florida130K
  • Pennsylvania97K
  • Ohio88K

Top specialties

Provider taxonomies with the most NPIs

  • Family Nurse Practitioner130K
  • Clinical Social Worker120K
  • Family Medicine Physician100K
  • Physician Assistant100K
  • Internal Medicine Physician92K
  • Mental Health Counselor78K

These are the files. Want the rates inside them?

Look up Harvard Pilgrim Health Care (Point32Health)'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.

MonthPlansNPIsTax IDsBilling codesRate rows
September 20262702.1M420K18K650M
August 20262702.2M500K20K1B
July 20265702.2M490K21K930M
June 2026————
May 2026————

Data quality scorecard

6/6Good

This payer meets all 6 data quality criteria — their transparency files are comprehensive and well-structured.

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 includes at least one HIOS-identified plan

  • Low Derived/Percentage Rates

    Less than 10% of negotiation entries are derived or percentage type

  • Standard Code Coverage

    Sufficient CPT and HCPCS code coverage with low proportion of 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

Harvard Pilgrim Health Care (Point32Health)'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.

UI

Web app

Search Harvard Pilgrim Health Care (Point32Health)'s rates by code, provider or market and export the results. No setup required.

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API

REST API

Pull negotiated rates, providers and benchmarks into your own products and pipelines.

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SQL

Snowflake & Databricks

Query the full normalized dataset with SQL or PySpark, shared directly into your warehouse.

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AI

MCP server

Ask Claude, Cursor or your own agents questions like "What does Harvard Pilgrim Health Care (Point32Health) pay for CPT 99213 near me?"

Read the MCP docs
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Frequently asked questions

About Harvard Pilgrim Health Care (Point32Health)'s price transparency data.

What price transparency data does Harvard Pilgrim Health Care (Point32Health) publish?

Harvard Pilgrim Health Care (Point32Health)'s September 2026 Transparency in Coverage files list 270 plans, 2.1M providers (NPIs), 420K tax IDs and 18K billing codes, for 650M negotiated rate rows in total.

Which states does Harvard Pilgrim Health Care (Point32Health)'s network cover?

Harvard Pilgrim Health Care (Point32Health)'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 Harvard Pilgrim Health Care (Point32Health)'s data updated?

Payers must post updated machine-readable files every month. PayerPrice processes Harvard Pilgrim Health Care (Point32Health)'s files monthly; the latest processed release is September 2026, and 18 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 Harvard Pilgrim Health Care (Point32Health)'s negotiated rates?

Start a free PayerPrice trial to search Harvard Pilgrim Health Care (Point32Health)'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.