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Hospital & insurance transparencySource-backed product with Vlada enrichment

Commercial Negotiated Rates (Transparency in Coverage)

The actual prices health insurers have negotiated with providers, pulled from the price files every payer is now required to publish. It answers what a specific insurer really pays a specific provider for a specific procedure, comparable across payers, states, and codes.

What Vlada adds: Integrates and normalizes multiple public inputs into a queryable Vlada data product with source-traced lineage.

rows
11.68B
rows
datasets
5
datasets
cadence
Multiple publisher cadences
cadence
coverage
current
coverage

Publishers: U.S. health insurers and plan administrators

What's inside

Commercial Negotiated Rates — Transparency in Coverage (TiC)
Every commercial-insurer negotiated rate published under the federal Transparency-in-Coverage rule, parsed from raw machine-readable files into structured rate rows.
grain: One row per (payer, plan, NPI, code, modifier, billing_class, POS, negotiated_type) at a snapshot.
8.96B rows
Commercial Rate → Provider Links
The link between each negotiated rate and the providers it applies to — rate ID to NPI, payer, code, and state.
grain: One row per (rate_id, NPI) — links a negotiated rate to a provider.
2.43B rows
Commercial Rate Market View — by Code
Cross-payer market view of negotiated rates — what a given code costs across payers within a state.
grain: One row per fact_rate row (payer, state, rate_id), projected and partition-pruned by (payer_id, state, code_prefix).
140.4M rows
Commercial Rate Market View — by Provider Entity
Negotiated rates rolled up by the negotiating provider entity — a provider's rate profile across payers and codes.
grain: One row per (payer, entity, code) — entity-keyed negotiated rate.
140.4M rows
Commercial Negotiated Rates (legacy build)
Earlier build of the commercial negotiated-rate table; superseded by the current TiC rate build.
4.2M rows