What is PayerPrice?
PayerPrice is a specialized AI tool designed for healthcare contracting and revenue cycle management. It transforms trillions of messy, publicly available negotiated rates from commercial insurers into clean, usable data. The platform provides nationwide coverage with rates from over 10,000 health plans and 5.5 million providers across all 50 states, covering CPT, HCPCS, MS-DRG, and other billing codes.
The tool offers drag-and-drop analytics that visualize rates in dot plots, maps, and pivots without requiring SQL coding. Users can search by payer, provider, or code using NPI, Tax ID, or region parameters. Every rate is fully parsed, up-to-date, and never interpolated, providing defensible, audit-ready reimbursement data that helps identify market outliers and reimbursement gaps quickly.
Features
- Nationwide Coverage: Access rates from over 10,000 health plans and 5.5M+ providers across all 50 states for any billing code or service
- Drag-and-drop Analytics: Visualize rates in dot plots, maps, pivots, and more without SQL coding requirements
- Comprehensive Search: Look up any CPT, HCPCS, Revenue Code, or MS-DRG rate by NPI, Tax ID, or region
- Defensible Data: Every rate is fully parsed, up to date, and never interpolated for audit-ready reimbursement information
- Export Capabilities: Download full fee schedules in seconds and export to Excel for further analysis
Use Cases
- Contract benchmarking to compare rates across specialists and identify unfavorable fee schedules
- Market expansion analysis to identify contracting opportunities across specialties, plans, and markets
- Payment integrity verification to ensure fair market reimbursement rates
- Hospital price transparency compliance and analysis
- Revenue cycle management optimization through market rate comparison
FAQs
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What types of health plans are included in PayerPrice's data?
PayerPrice includes data from commercial health plans required to publish negotiated rates under the Transparency in Coverage rule, covering over 170 million lives with 95% commercial coverage nationwide. -
How current is the data in PayerPrice?
The data comes directly from insurers' own published files and is kept up to date, with every rate fully parsed and never interpolated for accuracy. -
Can users export data from PayerPrice for external analysis?
Yes, users can export full fee schedules in seconds and download data to Excel for further analysis and reporting. -
What geographic coverage does PayerPrice provide?
PayerPrice provides nationwide coverage across all 50 states with rates from over 10,000 health plans and 5.5 million providers.
