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Sentara Health Plans (Optima Health)
Sentara Health Plans (Optima Health) is a health insurer. They report 5.1K insurance plans covering 100K providers across 21K billing codes.
Source: public Transparency in Coverage filesRefreshed monthly, latest September 202615 monthly releases tracked
Monthly release
5.1K
Plans
100K
Providers (NPIs)
XX% vs prior month
17K
Tax IDs
21K
Billing codes
XX% vs prior month
270M
Rate rows
September 2026 release
What's in Sentara Health Plans (Optima Health)'s data
A profile of the machine-readable files Sentara Health Plans (Optima Health) publishes, after PayerPrice parses and normalizes them.
Billing code types
Distinct codes and rate rows by code system
CodesRows
- CPT12K190M70%
- HCPCS7.6K73M27%
- CDT7007.9M2.9%
- RC560370K0.1%
- MS-DRG950280K0.1%
- NDC133.8K<0.1%
- CSTM-ALL186<0.1%
Billing class
Professional vs. institutional rate rows
- Institutional140M50%
- Professional140M50%
Negotiation arrangement
How each rate is expressed
- Fee Schedule270M99%
- Percentage3.5M1.3%
- Per Diem310K0.1%
Plan identifiers
HIOS IDs mark individual and small-group plans; EINs mark employer plans
- HIOS ID3907.6%
- EIN4.7K92%
Providers by type
Distinct NPIs by entity type
- Individual (Type 1)100K96%
- Organization (Type 2)3.7K3.6%
Tax IDs by type
How provider groups are identified
- EIN17K100%
Top states
States with the most providers in network
- Virginia45K
- North Carolina11K
- Maryland7.9K
- Florida4.6K
- Tennessee4K
- Pennsylvania3K
Top specialties
Provider taxonomies with the most NPIs
- Family Nurse Practitioner6.7K
- Diagnostic Radiology Physician6.1K
- Physician Assistant5.6K
- Family Medicine Physician5.3K
- Internal Medicine Physician5.1K
- Emergency Medicine Physician4.8K
These are the files. Want the rates inside them?
Look up Sentara Health Plans (Optima 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.
| Month | Plans | NPIs | Tax IDs | Billing codes | Rate rows |
|---|---|---|---|---|---|
| September 2026 | 5.1K | 100K | 17K | 21K | 270M |
| August 2026 | 5.1K | 100K | 17K | 21K | 270M |
| July 2026 | 2.6K | 100K | 17K | 21K | 270M |
| 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
Sentara Health Plans (Optima 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.
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Frequently asked questions
About Sentara Health Plans (Optima Health)'s price transparency data.
What price transparency data does Sentara Health Plans (Optima Health) publish?
Sentara Health Plans (Optima Health)'s September 2026 Transparency in Coverage files list 5.1K plans, 100K providers (NPIs), 17K tax IDs and 21K billing codes, for 270M negotiated rate rows in total.
Which states does Sentara Health Plans (Optima Health)'s network cover?
Sentara Health Plans (Optima Health)'s files include providers in 51 states. The states with the most in-network providers are Virginia, North Carolina, Maryland, Florida, Tennessee.
How often is Sentara Health Plans (Optima Health)'s data updated?
Payers must post updated machine-readable files every month. PayerPrice processes Sentara Health Plans (Optima Health)'s files monthly; the latest processed release is September 2026, and 15 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 Sentara Health Plans (Optima Health)'s negotiated rates?
Start a free PayerPrice trial to search Sentara Health Plans (Optima 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.