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WellSense
WellSense is a health insurer. They report 14 insurance plans covering 53K providers across 140K billing codes.
Source: public Transparency in Coverage filesRefreshed monthly, latest September 20263 monthly releases tracked
Monthly release
14
Plans
53K
Providers (NPIs)
6.3K
Tax IDs
140K
Billing codes
17M
Rate rows
September 2026 release
What's in WellSense's data
A profile of the machine-readable files WellSense publishes, after PayerPrice parses and normalizes them.
Billing code types
Distinct codes and rate rows by code system
CodesRows
- CPT42K11M61%
- HCPCS92K6.3M36%
- CDT7.5K400K2.3%
Billing class
Professional vs. institutional rate rows
- Institutional17M97%
- Professional470K2.7%
Negotiation arrangement
How each rate is expressed
- Negotiated15M89%
- Fee Schedule1.8M10%
- Request Error86K0.5%
- Percentage24K0.1%
- Per Diem66<0.1%
Plan identifiers
HIOS IDs mark individual and small-group plans; EINs mark employer plans
- HIOS ID14100%
Providers by type
Distinct NPIs by entity type
- Individual (Type 1)48K91%
- Organization (Type 2)4.7K8.9%
Tax IDs by type
How provider groups are identified
- EIN5.4K86%
- NPI (Individual)90014%
- NPI (Organization)130.2%
Top states
States with the most providers in network
- Massachusetts40K
- New Hampshire5.8K
- Rhode Island1.4K
- Connecticut800
- New York680
- Florida520
Top specialties
Provider taxonomies with the most NPIs
- Internal Medicine Physician3.3K
- Physician Assistant3.1K
- Family Nurse Practitioner2.8K
- Clinical Social Worker2.5K
- Behavior Analyst2.4K
- Mental Health Counselor2.2K
These are the files. Want the rates inside them?
Look up WellSense'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 | 14 | 53K | 6.3K | 140K | 17M |
| July 2026 | 14 | 0 | 0 | 0 | 0 |
| May 2026 | 14 | 0 | 0 | 0 | 0 |
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
WellSense'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.
API
REST API
Pull negotiated rates, providers and benchmarks into your own products and pipelines.
Explore the APISQL
Snowflake & Databricks
Query the full normalized dataset with SQL or PySpark, shared directly into your warehouse.
See data sharingAI
MCP server
Ask Claude, Cursor or your own agents questions like "What does WellSense pay for CPT 99213 near me?"
Read the MCP docsBrowse all payers
Search the payer directoryAetna Group4
Blue Cross Blue Shield (BCBS)47
- Elevance (Anthem)
- BCBS Alabama
- BCBS Arizona
- BCBS Arkansas
- BCBS Florida Blue
- BCBS Idaho
- BCBS Illinois
- BCBS Kansas
- BCBS Kansas City
- BCBS Louisiana
- BCBS Massachusetts
- BCBS Michigan
- BCBS Minnesota
- BCBS Mississippi
- BCBS Montana
- BCBS Nebraska
- BCBS NewMexico
- BCBS NorthDakota
- BCBS Oklahoma
- BCBS North Carolina
- BCBS South Carolina
- BCBS Tennessee
- BCBS Texas
- BCBS Wyoming
- Blue Shield California
- Capital Blue Cross
- Capital Health Plan
- Care First
- Excellus BCBS
- Hawaii Medical Service Association
- Highmark BCBS Delaware
- Highmark BCBS Pennsylvania
- Highmark BCBS Western New York
- Highmark BCBS West Virginia
- Highmark Blue Shield Northeastern New York
- Highmark Blue Shield Pennsylvania
- Highmark Independence National Alliance
- Horizon BCBS NewJersey
- Independence Blue Cross
- Premera
- Regence BCBS Idaho
- Regence BCBS Oregon
- Regence BCBS Utah
- Regence BCBS Washington
- Wellmark
- BCBS Vermont
- BCBS Rhode Island
Cigna Healthcare1
Dean Health Plan Group2
United Healthcare1
Other79
- Triple-S Salud
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- Ameri Health
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- Baylor Scott & White Health Plan
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- OSU Health Plan
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- Physicians Health Plan
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- Priority Health
- Providence Health Plan
- Quartz
- Sanford Health Plan
- Select Health
- Texas Children's Health Plan
- The Alliance
- Trilogy Health Solutions
- Tufts Health Plan (Point32Health)
- UCare
- UHA Health Insurance
- UPMC Health Plan
- University of Utah Health Plans
- Ventura County Health Care Plan
- WellSense
- Western Health Advantage
- Yale Health
- CDPHP
- Community Health Choice
- Physicians Health Plan of Northern Indiana
- Inland Empire Health Plan
- Network Health
- Security Health Plan
- Wisconsin Physicians Group
- Group Health Cooperative of South Central Wisconsin
- Viva Health
- Magellan
- Aspirus Health Plan
- Group Health Cooperative of Eau Claire
- Sutter Health Plan
- Wellpoint
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- Others
Frequently asked questions
About WellSense's price transparency data.
What price transparency data does WellSense publish?
WellSense's September 2026 Transparency in Coverage files list 14 plans, 53K providers (NPIs), 6.3K tax IDs and 140K billing codes, for 17M negotiated rate rows in total.
Which states does WellSense's network cover?
WellSense's files include providers in 51 states. The states with the most in-network providers are Massachusetts, New Hampshire, Rhode Island, Connecticut, New York.
How often is WellSense's data updated?
Payers must post updated machine-readable files every month. PayerPrice processes WellSense's files monthly; the latest processed release is September 2026, and 3 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 WellSense's negotiated rates?
Start a free PayerPrice trial to search WellSense'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.