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Price data · Updated monthly

Price Transparency Data & Tools:
Explore real negotiated healthcare rates.

Hospitals and health insurers publish negotiated rates, cash prices, and gross charges under federal price transparency rules. Use the explorer below to review the available rates, providers, and plans.

Explore the dataData last updated · August 2026
10B+
Negotiated rates tracked across every commercial MRF
170+
Payers with parsed rate data, refreshed monthly
789K+
Health plans tracked nationwide
3M+
Providers (NPIs) with rate data
01Data explorer

Price Transparency Data Explorer

Pick a specialty or procedure code. See, in one screen, how much published rate data exists nationally and review published negotiated rates for the codes you select.

PayerPrice · Data ExplorerExample query
Free. No login required to see sample rates.
Primary CareUnitedHealthcareEXAMPLE
Returned in 0.42s
National average rates · 6 codes shown
Sorted by claim volume
CPTDescriptionAvg (National)Medicare% of Mcr
99214
Office visit
established, moderate complexity
$124.63$128.1697%
99213
Office visit
established, low-moderate
$86.29$90.8895%
99203
Office visit
new patient, low complexity
$120.29$111.51108%
99204
Office visit
new patient, moderate
$181.92$167.10109%
Unlock provider-level rates.See exactly what UnitedHealthcare pays each NPI — plus full plan & contract detail.
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Payers
UnitedHealthcare
of 4 major commercial payers
Health plans tracked
23Kplans
incl. self-funded ASO
Providers with rate data
2.3MNPIs
unique billing providers
Negotiated rates on file
3.2Brates
contract × NPI × code
Data freshness
May 2026
refreshed monthly
Data Coverage Scorecard
6/6 — Good
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
Data drawn from 23K health plans across 1 payers with rates current through May 2026. The rate panel above shows national averages for Primary Care.
What this means
The national average negotiated rate for 99214 (office visit) across major commercial payers is $124.63 — 97% of the Medicare benchmark. Knowing where your contracted rate sits relative to this benchmark is the starting point for every credible primary care contract negotiation.
02The basics

What is price transparency data, and where does it come from?

Price transparency data is the set of negotiated rates, cash prices, and gross charges that hospitals and health insurers are federally required to publish in machine-readable files (MRFs). It exists because two CMS rules require these prices and rates to be made public.

Rule 01
Hospital Price Transparency Rule
Hospitals publish their standard charges.
Effective · January 1, 2021

Hospitals must publish standard charges in a machine-readable file, plus a consumer display of at least 300 shoppable services. The rule covers gross charges, payer-specific negotiated rates, the discounted cash price, and minimum/maximum negotiated rates by payer.

  • Payer-specific negotiated rates by service
  • Discounted cash price for self-pay
  • De-identified min & max negotiated rates
Rule 02
Transparency in Coverage Rule
Health plans publish negotiated rates.
Effective · July 1, 2022

Insurers and group health plans must publish in-network negotiated rates and out-of-network allowed amounts for every covered item and service, by provider. Files are updated monthly and apply to most commercial and self-funded plans.

  • In-network rates by NPI & procedure code
  • Out-of-network allowed amounts
  • Prescription drug rates (where applicable)
04Common provider use cases

How finance and contracting teams use price transparency data

Published rate data can support fee schedule review, benchmarking, underpayment analysis, and contract negotiations. The examples below show where teams often start.

Fee schedule lookup

Look up a payer fee schedule by code without working through a payer portal, then export the results for analysis.

View fee schedules

Rate benchmarking

Compare your rates with published rates from the same payer for the same procedure codes in your market.

Benchmark a contract

Underpayment detection

Compare remittance data with contracted rates to identify claims that may have been underpaid and need review.

Identify underpayments

Payer contract negotiation

Prepare a code-level rate request using published market data instead of relying only on general inflation figures.

Negotiation playbook
Code by codemarket comparison
Start with your highest-volume codes and compare your contracted rates with published rates from the same payer and market. This gives you a specific, reviewable basis for a negotiation request.
Check Market Rates
05Frequently asked

Common questions about price transparency data and tools.

Price transparency data is the set of negotiated rates, cash prices, and gross charges that hospitals and health insurers are federally required to publish in machine-readable files. Two CMS rules created it: the Hospital Price Transparency Rule (2021), which covers hospital charges, and the Transparency in Coverage Rule (2022), which covers insurer in-network rates and out-of-network allowed amounts.
Price transparency tools include government databases, consumer price estimators, file aggregators, research resources, and rate-intelligence platforms. They serve different users and may focus on consumer estimates, raw file access, research, or contract-rate analysis.
From machine-readable files (MRFs) that hospitals and insurers post on their own websites, refreshed monthly. The files contain negotiated rates by procedure code (CPT, HCPCS, MS-DRG, etc.), by provider (NPI), and by health plan. CMS defines the schema; payers and hospitals publish on their own infrastructure, which is why finding and reconciling the files is itself a workload.
The raw machine-readable files are public and free to download. Working with them still requires storage, parsing, normalization, and quality checks. PayerPrice and similar platforms charge for the processed, searchable data rather than access to the public files themselves.
The Hospital Price Transparency Rule (effective January 2021) requires hospitals to publish their standard charges, including payer-specific negotiated rates, in a machine-readable file plus a consumer display of 300+ shoppable services. The Transparency in Coverage Rule (effective July 2022) requires health insurers and group health plans to publish in-network negotiated rates and out-of-network allowed amounts. One covers the seller of care; the other covers the buyer.
Accuracy and completeness vary by payer and hospital. Files can contain formatting errors, incomplete records, or inconsistent field values. Using the data reliably requires schema validation, completeness checks, and ongoing monitoring as new files are published.
Common uses include fee schedule lookup, rate benchmarking, underpayment review, payer contract negotiation, out-of-network repricing, and market context for a reported QPA. Each use case depends on matching the relevant payer, plan, provider, and service code.
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Popular price transparency lookups

Browse common searches, then open a rate page for more detail.
By Procedure Code
By Payer
By Specialty & Market