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Western Health Advantage
Western Health Advantage is a health insurer. They report 180 insurance plans covering 3.9K providers across 7.4K billing codes.
Source: public Transparency in Coverage filesRefreshed monthly, latest August 202611 monthly releases tracked
Monthly release
180
Plans
XX% vs prior month
3.9K
Providers (NPIs)
XX% vs prior month
3.2K
Tax IDs
XX% vs prior month
7.4K
Billing codes
XX% vs prior month
140K
Rate rows
XX% vs prior month
August 2026 release
What's in Western Health Advantage's data
A profile of the machine-readable files Western Health Advantage publishes, after PayerPrice parses and normalizes them.
Billing code types
Distinct codes and rate rows by code system
CodesRows
- CPT5.1K73K52%
- RC23029K21%
- MS-DRG42023K16%
- HCPCS1.7K15K11%
- CDT47<0.1%
Billing class
Professional vs. institutional rate rows
- Institutional85K61%
- Professional54K39%
Negotiation arrangement
How each rate is expressed
- Negotiated140K100%
Plan identifiers
HIOS IDs mark individual and small-group plans; EINs mark employer plans
- HIOS ID8749%
- EIN9251%
Providers by type
Distinct NPIs by entity type
- Organization (Type 2)2.5K65%
- Individual (Type 1)1.3K35%
Tax IDs by type
How provider groups are identified
- EIN3.2K100%
Top states
States with the most providers in network
- California3.5K
- Texas32
- Nevada30
- New York28
- Florida24
- Oregon23
Top specialties
Provider taxonomies with the most NPIs
- Marriage & Family Therapist500
- Psychiatry Physician200
- Optometrist180
- Clinical Social Worker180
- General Acute Care Hospital140
- Clinical Psychologist120
These are the files. Want the rates inside them?
Look up Western Health Advantage'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 |
|---|---|---|---|---|---|
| August 2026 | 180 | 3.9K | 3.2K | 7.4K | 140K |
| February 2026 | 180 | 3.5K | 3K | 7.4K | 140K |
| December 2025 | 190 | 3.3K | 2.9K | 7.2K | 130K |
| November 2025 | — | — | — | — | |
| October 2025 | — | — | — | — |
Data quality scorecard
6/6Good
This payer meets all 6 data quality criteria — their transparency files are comprehensive and well-structured.
Evaluated on the August 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
Western Health Advantage'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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Pull negotiated rates, providers and benchmarks into your own products and pipelines.
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Snowflake & Databricks
Query the full normalized dataset with SQL or PySpark, shared directly into your warehouse.
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MCP server
Ask Claude, Cursor or your own agents questions like "What does Western Health Advantage pay for CPT 99213 near me?"
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Frequently asked questions
About Western Health Advantage's price transparency data.
What price transparency data does Western Health Advantage publish?
Western Health Advantage's August 2026 Transparency in Coverage files list 180 plans, 3.9K providers (NPIs), 3.2K tax IDs and 7.4K billing codes, for 140K negotiated rate rows in total.
Which states does Western Health Advantage's network cover?
Western Health Advantage's files include providers in 43 states. The states with the most in-network providers are California, Texas, Nevada, New York, Florida.
How often is Western Health Advantage's data updated?
Payers must post updated machine-readable files every month. PayerPrice processes Western Health Advantage's files monthly; the latest processed release is August 2026, and 11 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 Western Health Advantage's negotiated rates?
Start a free PayerPrice trial to search Western Health Advantage'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.