Healthcare Price Transparency Data, Natively in Your Cloud
Harness petabytes of machine-readable files directly in Snowflake, AWS, or Databricks. No ETL, no delays. Just instant access to the most comprehensive payer data available.
Available on Your Preferred Cloud Platform
The End of Data Wrangling
The scale of price transparency data is immense, often measured in petabytes. Traditional methods of downloading, storing, and processing this data are slow, expensive, and require significant engineering overhead. These challenges create a barrier to entry, preventing timely and effective analysis.
Eliminate ETL
Stop building and maintaining fragile data pipelines. Access data the moment it's published.
Reduce Infrastructure Costs
Leverage the power of your existing cloud data platform without needing massive storage servers.
Unprecedented Scale and Detail
Our platform provides direct, queryable access to a continuously growing dataset from over 140 payers, including UnitedHealthcare, Elevance (Anthem), Aetna, Cigna, and Humana. Analyze billions of negotiated rates, cash prices, and provider details to unlock powerful market insights.
Powering Critical Use Cases
From strategic planning to compliance, direct access to price transparency data can transform how your organization operates.
Market & Competitive Analysis
Benchmark your rates against competitors in any geography. Identify market leaders, uncover pricing strategies, and discover opportunities for growth.
Network Design & Optimization
Evaluate network adequacy and model the financial impact of adding or removing providers. Negotiate better contracts with data-driven insights.
Compliance & Transparency
Ensure your organization is compliant with federal price transparency regulations by leveraging the most accurate and up-to-date data available.
Data Dictionary
This section provides an interactive overview of our standardized data schema. The data is structured to be intuitive and easily joinable, allowing you to quickly perform complex analyses. Click through the tabs to explore the primary tables and their columns.
Contains the negotiated prices for covered items and services between the plan/issuer and in-network providers.
| Column | Data Type | Description |
|---|---|---|
| billing_code_type | String | Common billing code types including CPT, HCPCS, RC, MS-DRG, APR-DRG, NDC, and more. |
| billing_code | String | The code used by a plan or issuer or its in-network providers to identify health care items or services for purposes of billing, adjudicating, and paying claims for a covered item or service. |
| name | String | This is name of the item/service that is offered |
| negotiated_type | String | There are a few ways in which negotiated rates can happen. Allowed values: "negotiated", "derived", "fee schedule", "percentage", and "per diem". |
| negotiated_rate | Number | The dollar or percentage amount based on the negotiation_type |
| expiration_date | String | The date in which the agreement for the negotiated_price based on the negotiated_type ends. Date must be in an ISO 8601 format (i.e. YYYY-MM-DD). |
| service_code | Array | The CMS-maintained two-digit code that is placed on a professional claim to indicate the setting in which a service was provided. |
| billing_class | String | Allowed values: "professional", "institutional", "both" |
| billing_code_modifier | Array | An array of strings. There are certain billing code types that allow for modifiers (e.g. The CPT coding type allows for modifiers). |
| additional_information | String | The additional information text field can be used to provide context for negotiated arrangements that do not fit the existing schema format. |
| negotiation_arrangement | String | An indication as to whether a reimbursement arrangement other than a standard fee-for-service model applies. Allowed values: "ffs", "bundle", or "capitation" |
A list of in-network providers, including identifying information like NPI and TIN.
| Column | Data Type | Description |
|---|---|---|
| npi | Number | A National Provider Identifier (NPI). |
| npi_name | String | The name of the provider associated with the NPI from NPPES. |
| tin | String | The tax identification number of the provider. |
| tin_name | String | The name of the organization associated with the TIN (if available). |
General information about the health plan and reporting entity associated with the rate sheet.
| Column | Data Type | Description |
|---|---|---|
| plan_name | String | The plan name and name of plan sponsor and/or insurance company. |
| plan_id_type | String | Allowed values: "EIN" and "HIOS" |
| reporting_entity_name | String | The legal name of the entity publishing the machine-readable file. |
| reporting_entity_type | String | The type of entity that is publishing the machine-readable file (a group health plan, health insurance issuer, or a third party with which the plan or issuer has contracted to provide the required information, such as a third-party administrator, a health care claims clearinghouse, or a health insurance issuer that has contracted with a group health plan sponsor). |
Ready to unlock healthcare data?
Get started with PayerPrice on your preferred cloud platform and transform your data strategy today.