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Aetna Group family

Payer price transparency data

Meritain Health

Meritain Health is a health insurer, part of the Aetna Group family. They report 18K insurance plans covering 2.5M providers across 94K billing codes.

Source: public Transparency in Coverage filesRefreshed monthly, latest September 202619 monthly releases tracked

Monthly release

18K

Plans

XX% vs prior month

2.5M

Providers (NPIs)

XX% vs prior month

500K

Tax IDs

XX% vs prior month

94K

Billing codes

XX% vs prior month

1.4B

Rate rows

XX% vs prior month

September 2026 release

What's in Meritain Health's data

A profile of the machine-readable files Meritain Health publishes, after PayerPrice parses and normalizes them.

Billing code types

Distinct codes and rate rows by code system

CodesRows
  • CPT12K970M68%
  • HCPCS8.2K400M28%
  • CDT86043M3.0%
  • LOCAL32K5.1M0.4%
  • MS-DRG8001.6M0.1%
  • RC5501.1M<0.1%
  • ICD38K320K<0.1%
  • CSTM-ALL159K<0.1%
  • HIPPS1.7K20K<0.1%
  • APC27010K<0.1%

Billing class

Professional vs. institutional rate rows

  • Institutional1.1B80%
  • Professional290M20%

Negotiation arrangement

How each rate is expressed

  • Negotiated1.2B85%
  • Fee Schedule160M11%
  • Percentage30M2.1%
  • Derived17M1.2%
  • Per Diem4.9M0.3%

Plan identifiers

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

  • EIN18K100%

Providers by type

Distinct NPIs by entity type

  • Individual (Type 1)2.2M85%
  • Organization (Type 2)370K15%

Tax IDs by type

How provider groups are identified

  • EIN470K93%
  • NPI (Individual)36K7.2%
  • NPI (Organization)330<0.1%

Top states

States with the most providers in network

  • California210K
  • Texas180K
  • New York170K
  • Florida160K
  • Pennsylvania120K
  • Illinois100K

Top specialties

Provider taxonomies with the most NPIs

  • Family Nurse Practitioner150K
  • Clinical Social Worker150K
  • Family Medicine Physician120K
  • Physician Assistant110K
  • Internal Medicine Physician110K
  • Mental Health Counselor93K

These are the files. Want the rates inside them?

Look up Meritain Health'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 202618K2.5M500K94K1.4B
August 202617K2.5M500K120K1.4B
July 202618K2.5M500K120K1.9B
June 2026————
May 2026————

Data quality scorecard

5/6Good

This payer scores 5/6 on data quality (Good). Areas that don't meet the threshold: hios plan.

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

    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

Meritain Health'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 Meritain Health's rates by code, provider or market and export the results. No setup required.

Start free trial
API

REST API

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

Explore the API
SQL

Snowflake & Databricks

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

See data sharing
AI

MCP server

Ask Claude, Cursor or your own agents questions like "What does Meritain Health pay for CPT 99213 near me?"

Read the MCP docs
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Frequently asked questions

About Meritain Health's price transparency data.

What price transparency data does Meritain Health publish?

Meritain Health's September 2026 Transparency in Coverage files list 18K plans, 2.5M providers (NPIs), 500K tax IDs and 94K billing codes, for 1.4B negotiated rate rows in total.

Which states does Meritain Health's network cover?

Meritain Health'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 Meritain Health's data updated?

Payers must post updated machine-readable files every month. PayerPrice processes Meritain Health'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 Meritain Health's negotiated rates?

Start a free PayerPrice trial to search Meritain Health'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.