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Priority Health
Priority Health is a health insurer. They report 11K insurance plans covering 1.9M providers across 67K billing codes.
Source: public Transparency in Coverage filesRefreshed monthly, latest September 202618 monthly releases tracked
Monthly release
11K
Plans
1.9M
Providers (NPIs)
XX% vs prior month
380K
Tax IDs
XX% vs prior month
67K
Billing codes
XX% vs prior month
650M
Rate rows
XX% vs prior month
September 2026 release
What's in Priority Health's data
A profile of the machine-readable files Priority Health publishes, after PayerPrice parses and normalizes them.
Billing code types
Distinct codes and rate rows by code system
CodesRows
- CPT18K460M70%
- HCPCS44K160M24%
- MS-DRG89037M5.6%
- RC4702.2M0.3%
- APC800210K<0.1%
- CDT1.7K200K<0.1%
- CSTM-ALL124K<0.1%
- ICD1.6K15K<0.1%
Billing class
Professional vs. institutional rate rows
- Professional450M69%
- Institutional200M31%
Negotiation arrangement
How each rate is expressed
- Fee Schedule280M43%
- Negotiated220M34%
- Derived130M20%
- Per Diem11M1.8%
- Percentage6.5M1.0%
Plan identifiers
HIOS IDs mark individual and small-group plans; EINs mark employer plans
- HIOS ID8.9K79%
- EIN2.4K21%
Providers by type
Distinct NPIs by entity type
- Individual (Type 1)1.7M91%
- Organization (Type 2)170K9.3%
Tax IDs by type
How provider groups are identified
- EIN340K88%
- NPI (Individual)44K11%
- NPI (Organization)1.2K0.3%
Top states
States with the most providers in network
- California140K
- Texas130K
- Florida120K
- New York100K
- Pennsylvania93K
- Ohio77K
Top specialties
Provider taxonomies with the most NPIs
- Family Nurse Practitioner120K
- Family Medicine Physician96K
- Physician Assistant95K
- Internal Medicine Physician87K
- Clinical Social Worker86K
- Mental Health Counselor54K
These are the files. Want the rates inside them?
Look up Priority 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 | 11K | 1.9M | 380K | 67K | 650M |
| August 2026 | 11K | 1.9M | 380K | 67K | 720M |
| July 2026 | 11K | 1.8M | 380K | 66K | 630M |
| 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: low derived/percentage rates.
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
10% or more 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
Priority 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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MCP server
Ask Claude, Cursor or your own agents questions like "What does Priority Health pay for CPT 99213 near me?"
Read the MCP docsBrowse all payers
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Cigna Healthcare1
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Other79
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- UPMC Health Plan
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Frequently asked questions
About Priority Health's price transparency data.
What price transparency data does Priority Health publish?
Priority Health's September 2026 Transparency in Coverage files list 11K plans, 1.9M providers (NPIs), 380K tax IDs and 67K billing codes, for 650M negotiated rate rows in total.
Which states does Priority Health's network cover?
Priority Health's files include providers in 51 states. The states with the most in-network providers are California, Texas, Florida, New York, Pennsylvania.
How often is Priority Health's data updated?
Payers must post updated machine-readable files every month. PayerPrice processes Priority Health'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 Priority Health's negotiated rates?
Start a free PayerPrice trial to search Priority 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.