Requires all hospitals to publicly disclose negotiated rates, cash pay prices, and standard charges for all items & services.
Requires insurers and health plans to publish in-network negotiated rates, out-of-network allowed amounts, and drug pricing data.
The result? For the first time ever, pricing power shifted—giving providers, analysts, and health systems access to the same contract data payers once kept safely behind closed doors.
THE DATASET
What's being published today?
Today, payers publish machine-readable files (MRFs) with negotiated rates by CPT code and provider, while hospitals publish charge masters and shoppable services in CSV or JSON formats.
This data contains trillions of rates. We download every file every month. That's more data than Wikipedia, LibGen, and Netflix combined.
95%
Commercial coverage
covering over 170M lives
10,000+
Reported insurance plans
across all 50 states
3.5M+
Healthcare providers
and organizations included
All codes
CPT, HCPCS, MS-DRG
and more…
Great, so can I go search any provider's rate in the MRFs?
Unfortunately, it's not that simple. The raw files are huge—often incomplete, poorly structured, or inconsistent. PayerPrice ingests every payer and hospital file monthly, parsing trillions of rows into clean, structured, queryable data.
We normalize rates, link them to providers by NPI or Tax ID, and layer in metadata like payer IDs and plan names — turning raw compliance dumps into usable pricing benchmarks for providers.
Speed up audits, automate your workflows, get paid accurately.
PayerPrice delivers up-to-date, contract-specific rate data in clean Excel exports or API. No guesswork. No payer delays. Just data you can use today to start recovering revenue.
Instant fee schedules
Get complete payer fee schedules in minutes. No payer portals required. Search by NPI, Tax ID, or specialty.
Keep allowables accurate
We download every rate, every month. Ensure that your fee schedules are always current, never stale.
Benchmark rates by region
Break down reimbursement by code, geography, payer, and specialty to identify negotiation opportunities.
Connect via API
Automate data extraction and revenue integrity workflows with structured rate data delivered straight to your tools.
Automate OON re-pricing
Use real contracted rates to set the usual, customary, and reasonable charges for out-of-network repricing.
Automate QPA calculation
Benchmark out-of-network qualified payment amounts (QPAs) using clean, contract-specific market data.
Payer Contracting & Benchmarking
Compare reimbursement rates across payers, providers, and markets to negotiate stronger reimbursement, faster.
New Market Expansion & Business Development
Understand reimbursement before entering a new market. Use payer data to support expansion, de novo builds, and diligence.
RCM, Payment Integrity, & Contract Compliance
Pull up-to-date fee schedules in seconds. Automate payment integrity and contract management at scale.
Case Study
What top negotiators achieve with PayerPrice
Identified rates below market by specialty, plan, and region
Replaced manual benchmarking with sharable presentation-ready visuals
Helped teams defend double-digit increases in payer negotiations
"Our top-line rates increased 15%"
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