Reimbursement rate benchmarking
Know where your rates stand before you renegotiate.
Compare your practice's published rates with similar providers to prepare your next rate request.
Payer-published in-network negotiated rates. Not claim payments.
Compare rates within your specialty and setting.
Rates vary by plan, network, and provider group. Who you compare changes where your practice stands.
Choose a published rate for your practice, then compare providers in the same specialty and setting.
HOW THE COMPARISON IS BUILT
Measure where your selected rate falls in the market.
Choose the published rate you want to compare.
Check the payer, service, and setting of your practice's published rates before choosing a comparison.
Select comparable providers by specialty, location, and setting.
Choose your specialty, geography, and provider types. Check the included services and settings.
See your selected rate's percentile and supporting rates.
See your rate's market position, the provider count, and the supporting rates.
PREPARE YOUR PAYER CONVERSATION
Draft a fee schedule renegotiation letter from your analysis.
Use Contract Modeling to draft a renegotiation letter from your payer and code comparisons.
Check proposed rates and contract details. Add your practice's value and relationship history before sending.
Schedule a benchmarking walkthroughInspect your benchmark's rates and providers.
Check the supporting rates and providers to confirm the comparison fits your payer conversation.
Read the benchmarking FAQs →Inspect provider, network, and rate-type details
Review the provider, network, service setting, and rate type in the supporting data before using a rate in your request.
Count the rates and providers behind the comparison
Use the rate, provider, and billing-entity counts in percentile analysis to judge the size of the comparison.
Check the data period
Check the report period and source dates before using published rates in your request.
Check rate definitions, provider coverage, and data freshness.
Understand how to choose a comparison and what to check against your own fee schedule.
Schedule a benchmarking walkthrough →Is this our contracted rate or what we were actually paid?
These are payer-published negotiated rates, which you should verify against your fee schedule.
They do not show what a payer paid on a particular claim.
Why are there several rates for the same code?
Rates vary by plan, network, provider group, setting, modifier, and rate type.
Check those details before choosing a comparison.
Can we filter hospitals out of the comparison?
Filter by provider type, specialty, geography, or named providers and groups.
Check the included providers and billing settings to confirm the comparison matches your intended practices.
How many providers are behind the number?
Percentile analysis counts rates, provider identifiers (NPIs), and billing-entity identifiers (TINs).
These differ: one provider can have several rates, and several providers can share a billing entity.
How old is the data?
The prior month's payer data is generally available in the first week of the following month.
Check the report period and source dates. Import dates can differ from payer update dates.
Can I see who is getting the higher rates?
Supported percentile results open underlying rate rows with associated providers and groups.
These show published rates, not evidence that a claim was paid at that amount.
Do you negotiate with the payer or provide the data?
PayerPrice provides comparisons, modeling tools, and draft materials.
Your team or contracting adviser chooses the request and handles the payer conversation.
Walk through a payer rate comparison with our team.
Bring one payer and your key codes. Explore published rates and comparable providers.