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Payer price transparency data

Oscar

Oscar is a health insurer. They report 30 insurance plans covering 680K providers across 23K billing codes.

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

Monthly release

30

Plans

XX% vs prior month

680K

Providers (NPIs)

XX% vs prior month

190K

Tax IDs

XX% vs prior month

23K

Billing codes

XX% vs prior month

43M

Rate rows

XX% vs prior month

September 2026 release

What's in Oscar's data

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

Billing code types

Distinct codes and rate rows by code system

CodesRows
  • CPT13K38M88%
  • HCPCS9.2K5.2M12%
  • RC18088K0.2%
  • CDT87024K<0.1%
  • MS-DRG93.4K<0.1%
  • CSTM-ALL11<0.1%

Billing class

Professional vs. institutional rate rows

  • Professional42M98%
  • Institutional1M2.3%
  • Both1<0.1%

Negotiation arrangement

How each rate is expressed

  • Negotiated23M55%
  • Fee Schedule19M45%
  • Percentage16K<0.1%

Plan identifiers

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

  • HIOS ID30100%

Providers by type

Distinct NPIs by entity type

  • Individual (Type 1)660K97%
  • Organization (Type 2)20K3.0%

Tax IDs by type

How provider groups are identified

  • EIN160K84%
  • NPI (Individual)30K16%
  • NPI (Organization)5<0.1%

Top states

States with the most providers in network

  • Texas62K
  • Florida56K
  • California50K
  • New York46K
  • Pennsylvania29K
  • Ohio28K

Top specialties

Provider taxonomies with the most NPIs

  • Clinical Social Worker120K
  • Mental Health Counselor76K
  • Professional Counselor70K
  • Psychiatric/Mental Health Nurse Practitioner40K
  • Behavior Analyst33K
  • Marriage & Family Therapist32K

These are the files. Want the rates inside them?

Look up Oscar'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 202630680K190K23K43M
August 202631690K190K25K99M
July 202630700K190K25K96M
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

Oscar'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 Oscar'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 Oscar pay for CPT 99213 near me?"

Read the MCP docs
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Blue Cross Blue Shield (BCBS)47
Centene Group7
Cigna Healthcare1
Dean Health Plan Group2
United Healthcare1
Other79

Frequently asked questions

About Oscar's price transparency data.

What price transparency data does Oscar publish?

Oscar's September 2026 Transparency in Coverage files list 30 plans, 680K providers (NPIs), 190K tax IDs and 23K billing codes, for 43M negotiated rate rows in total.

Which states does Oscar's network cover?

Oscar's files include providers in 51 states. The states with the most in-network providers are Texas, Florida, California, New York, Pennsylvania.

How often is Oscar's data updated?

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

Start a free PayerPrice trial to search Oscar'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.