First, we parse every single file (TPAs, employer plans, etc.). Since real rates are scattered across all of the files, we parse every file to ensure our customers receive the correct rates. Then, we enrich the data with real-world all-payer claims to remove noise (ghost rates, unlikely rates) and connect what is in the contract (price transparency data) to what was paid (claims remits).
Finally, we work with our customers across the country, who validate the data with contracts in hand. From all of them, we have heard: “This matches our contract rates to the penny.”
Access and Understand Price Transparency Data with Self-Service Exploration
Move beyond guesswork and understand every negotiated rate detail to empower your pricing strategy
Request a Free DEMOFeatures
Explore Every Rate Detail
Choose any combination of payers, providers, and services to analyze every negotiated rate in a interface designed for everyone.
Features
Complete the picture with Claims and Remits
Unlock deeper insights by layering in all-payer claims highlighting volumes, claim and paid amounts all in a single location
Features
Move from Analysis to Action
Leverage out-of-the-box advanced analytics and automated insights to empower everyone with expert analysis
Built Differently
A platform approach to trusted healthcare pricing
In our mission to democratize healthcare pricing and make price transparency useful, our holistic approach ensures your team can instantly access and make sense of payer-provider reimbursement rates.
Feature
Comprehensive Data
Access Historical Rates
Open Claims
Paid Claims (Remits)
Healthcare Affiliations
Description
Every machine readable file posted, then cleaned and associated with health plan names and plan types VS Only select MRF files based on specific health plans
Self-service access to full set of price transparency historical data with quarterly snapshots for easy comparisons
Integration with one of the largest all-payer claims data sources in the market (Commercial, MA, Medicare)
Ability to not only see open claims but complete the picture with actual claims remits after adjudication for a complete 360 degree view
Healthcare Organization affiliations data enriched by actual claims data instead of only NPPES enrichment of price transparency NPIs
Impact
Ensures accurate comparisons, supports reliable analysis, and prevents gaps that can lead to misleading conclusions or missed opportunities in pricing strategy
Understand how rates evolve over time for any combination of payer and provider as well as analyze how coverage changes over time
Compare negotiated rates against actual payments (claims remits), spot pricing outliers, and validate trends with real-world utilization
Seeing both submitted and actual payments enables more accurate benchmarking, revenue forecasting, underpayments analysis, contract evaluations, and much more
Allows easy bucketing and slicing of Organizational parent names, specialties, and taxonomies for targeted comparisons and analysis
Blogs
Explore our Stories and Insights
National Healthcare Price Transparency Conference Recap
The Positive Future of Price Transparency in the U.S. in 2025
The Positive Future of Price Transparency in the U.S. in 2025
Making Sense of Hospital Price Transparency Data
Making Sense of Hospital Price Transparency Data
Frequently asked questions
Everything you need to know about the product and billing.
How do you ensure the negotiated rates are accurate?
How do you clean and prepare the price transparency data?
We perform significant de-duplication, cleansing, and enrichment to ensure our data is comprehensive, easy to explore, and accurate. This includes enrichment through our billing code categorization, health plan categorization, healthcare organization affiliations, and all-payer claims enrichment.
How often is Rate Explorer data refreshed?
Our data is fully refreshed quarterly. The historical quarters are always available for you via our self-service solution.
Can my organization test the rates for accuracy?
Yes. For qualified organizations, we will provide 1 CBSA (core-based statistical area) with up to 50 healthcare organization NPIs, up to 10 billing codes, and up to 2 insurance carriers (payers) so that you can validate and move forward with confidence.
What’s the difference between hospital and payer price transparency?
While there are efforts to homogenize these disparate sources over time, they are very different. The rules, data schema, and enforcement for price transparency from health insurance companies (health plan price transparency) and hospitals (hospital price transparency) differ in many ways, but they contain data that can complement one another. For this reason, we include both hospital and payer-sourced price transparency data within our pricing intelligence platform.
Request a Demo of Payerset Price Intelligence
Let’s talk about how price transparency data can empower your organization.
