Presbyterian Health Plan
Last updated: March 2026
Presbyterian Health Plan is a health insurer. They report 1 insurance plans covering 22K providers across 3.5K billing codes.
Data Version
Price Transparency Machine-Readable Files Snapshot
Overview
1
Plans
XX% vs prev22K
Providers (NPIs)
XX% vs prev2.5K
Tax IDs
XX% vs prev3.5K
Billing Codes
XX% vs prev180K
Data Rows
XX% vs prevGeographic Coverage
Top states by provider count:
Data Breakdown
Plans Type (HIOS vs EIN)
EIN | 1 |
NPIs
Individual | 19K |
Group | 2.8K |
Tax IDs
EIN | 2.5K |
Billing Code Type
| Codes | Rows | |
|---|---|---|
CPT | 2.5K | 160K |
HCPCS | 950 | 26K |
MS-DRG | 39 | 1.1K |
ADA | 28 | 900 |
Billing Class
| Rows | |
|---|---|
Institutional | 100K |
Professional | 83K |
Negotiated Type
| Rows | |
|---|---|
Negotiated | 130K |
Percentage | 50K |
Top States by # NPIs
New Mexico | 10K |
Texas | 3.4K |
Colorado | 2.9K |
Arizona | 670 |
California | 560 |
Top Taxonomies by # NPIs
Family Nurse Practitioner | 1.7K |
Family Medicine Physician | 1.6K |
Diagnostic Radiology Physician | 1.3K |
Certified Registered Nurse Anesthetist | 1.1K |
Internal Medicine Physician | 1K |
Want to explore Presbyterian Health Plan's actual negotiated rates?
See code-level rates by provider, specialty, and geography.
Historical Metrics
| Month | Plans | NPIs | Tax IDs | Billing Codes | Data Rows |
|---|---|---|---|---|---|
March 2026 | 1 | 22K | 2.5K | 3.5K | 180K |
February 2026 | 2 | 23K | 2.4K | 3.6K | 190K |
January 2026 | — | — | — | — | |
September 2025 | — | — | — | — | |
August 2025 | — | — | — | — |
Show all 10 months
Data Coverage Scorecard
This payer scores 3/6 on data quality (Acceptable). 3 criteria did not meet the threshold.
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
10% or more 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
Methodology
The scorecard evaluates each payer's monthly price transparency data against six quality criteria:
If 5–6 criteria pass, the overall rating is Good.
If 3–4 criteria pass, the rating is Acceptable.
If 0–2 criteria pass, the rating is Poor.
Behavioral, RX, and other specialty networks may not pass all criteria but can still contain complete and usable data.