Access healthcare pricing intelligence via Vlada MCP.
US price data behind one MCP endpoint: what hospitals charge, what insurers actually pay, and the geographically localized Medicare benchmark and cost-to-charge that tell you whether a price is fair. Ask in plain language from Claude or any MCP client. Every answer comes back with its source file, vintage, and a replayable hash.
claude mcp add --transport http vlada https://mcp.vladahealth.com/mcpSame Streamable-HTTP URL for Claude Desktop and Cursor. Open while in preview. The authenticated, multi-tenant endpoint is mcp-secure.vladahealth.com (sign in on connect), request access.
Hospital pricing
CMS Hospital Price Transparency (machine-readable standard-charge files)Raw hospital files name payers inconsistently; we normalize them to 701 parent companies (85% of rates mapped).
- UnitedHealth Group286M rates / 4,154 hosp
- CVS Health (Aetna)284M rates / 4,005 hosp
- The Cigna Group200M rates / 3,479 hosp
- BCBS Michigan161M rates / 1,942 hosp
- Elevance Health (Anthem)134M rates / 2,366 hosp
- Centene131M rates / 3,192 hosp
- MultiPlan116M rates / 2,007 hosp
- Humana87.6M rates / 3,213 hosp
- Molina Healthcare51.4M rates / 1,746 hosp
- Medica46.8M rates / 697 hosp
Each rate is classified by line of business so commercial is never compared against government plans by accident.
- Commercial1.43B rates
- Medicaid312M rates
- Marketplace (ACA)108M rates
- Workers' comp84.2M rates
Insurance pricing
Transparency in Coverage (payer machine-readable in-network rate files)Each insurer's rate is keyed to a provider NPI and a state. Rates resolve through a 9.4M-NPI identity graph (Type 1 and Type 2).
- Blue Cross Blue Shield (national)3.00B rates / 55 st
- Highmark1.91B rates / 55 st
- CareFirst BlueCross BlueShield1.20B rates / 55 st
- Cigna730M rates / 53 st
- Priority Health (Cigna network)130M rates / 53 st
- Quartz101M rates / 21 st
- Kaiser Permanente64.1M rates / 44 st
- Geisinger Health Plan57.6M rates / 39 st
- Premera Blue Cross51.4M rates / 24 st
- Molina Healthcare37.2M rates / 43 st
- Priority Health33.3M rates / 20 st
- UPMC Health Plan33.1M rates / 17 st
Methodologies are not comparable, so the tools keep them separate (no blending a fee schedule with a percentage of charges).
- Negotiated dollar3.88B rates
- Fee schedule3.14B rates
- Percentage of charges286M rates
- Per diem68.3M rates
- Derived30.1M rates
Medicare benchmarks & cost
CMS fee schedules + HCRIS hospital cost reports (public)The public yardstick. Medicare publishes what it pays for every service, by setting, and hospitals file their actual cost. Together these turn any charge or rate into "X times Medicare" and into an estimated true cost.
Every Medicare benchmark resolves to where care is delivered. Professional fees adjust to each Medicare locality (GPCI); facility payments and cost are keyed to the hospital. So "X times Medicare" is computed for the actual place of service, not a flat US average.
What Medicare pays. Each service uses the right schedule; they are never mixed.
- Physician Fee Schedule (PFS)Office and professional services; the universal fair-price denominator92,128 rows
- Outpatient (OPPS)Hospital outpatient facility payments, by APC18,613 rows
- Ambulatory Surgery (ASC)Surgery-center procedures (separate system from OPPS)6,642 rows
- Clinical Lab (CLFS)Lab tests (use instead of PFS for lab HCPCS)1,971 rows
- Inpatient (IPPS / MS-DRG)Inpatient stays; DRG relative weights and length of stay1,528 rows
What care actually costs. The cost-to-charge ratio (CCR) turns a billed charge into an estimated real cost, whole-hospital or per service.
- Whole-hospital cost-to-chargeOverall CCR per hospital (total cost / total charge), turns a billed charge into estimated cost81,368 rows / 6,949 hosp / FY2011-2024
- Department cost-to-chargeService-specific CCR per Worksheet C cost center (CT, MRI, lab, OR ...)1.5M rows / 6,887 hosp
- Code to cost-center crosswalkMaps each billing code to the cost center where its cost accrues, so the CCR is accurate per service28,328 rows
- Outpatient volumeHospital outpatient service mix by Comprehensive APC892,793 rows
Coverage as of 2026-06-21. All three pillars share one provider, payer, and code spine, so a hospital's posted price, an insurer's negotiated rate, the Medicare benchmark, and the estimated cost line up on the same procedure.
You talk to the data in natural language; the agent picks the right tool and returns a typed, sourced answer. The common questions:
- What does an insurer pay a provider for a code?
- Give a payer, an NPI, a billing code, and a state and get the negotiated rate the way it actually resolves through the network, with the Medicare benchmark for context.get_negotiated_rate, compute_median_rate
- What does a hospital charge, and is it high?
- Pull a hospital's posted rate for a procedure, see the spread across hospitals, and compare it to Medicare and to the commercial rate for the same code.get_hospital_chargemaster, compare_hospital_rates, compare_hospital_to_commercial
- What's a fair, defensible price?
- Turn any procedure into a reference-based price anchored to Medicare, with the math and sources behind it, ready to put in front of an actuary.fair_rbp_price, fair_rbp_book
- Where is care cheapest in a market?
- Map the providers in a county, see who offers a procedure, and rank the options by price against the Medicare floor.county_intelligence, county_price_options
- Prove it.
- Every number carries a hash; turn any answer into an auditable, re-runnable receipt that points at the public source file it came from.prove_commercial_price, replay_*
- Run my own query.
- For power users: one read-only SQL SELECT over the tables your access allows, or the async lane for heavy pulls. Same provenance guarantees.query_substrate, submit_query / poll_query / fetch_query
Discovery is built in: ask "what data and tools do you have?" and the agent answers from the live catalog. Full machine-readable index at /api/catalog.