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Insights and updates on healthcare data, pricing transparency, and industry trends.
155 measured extraction runs across 39 payers: one insurer's files need nearly an hour of machine time per gigabyte, another's largest files run 18 hours each, and the biggest delivery we ever shipped — 32 terabytes — took 40.9 hours end to end. The physics of price transparency data, from real machine logs.
We ranked one insurer's providers separately on a scan, an office visit, a physical-therapy session, a joint injection, and a blood test — then asked whether a practice that's expensive on one is expensive on the others. The physician-delivered services move together: rank a provider on its head CT and you've largely ranked it on its office visits, PT, and injections. Labs don't move with any of them. A provider isn't one price position with this payer. It's two.
In one insurer's published imaging rates for a single state, a provider's price position barely moves from code to code. Rank a provider on a head CT and you have essentially ranked them on their brain MRI, their lumbar X-ray, and seven other scans — the correlation runs 0.96 even among the two-thirds of providers who don't sit on a standard fee schedule. A provider's imaging rate isn't ten numbers. It's one position wearing ten price tags. Which is good news and a trap at the same time.
In a single insurer's published rate file for one metro, a common blood test carries 64 distinct in-network prices and nearly half of all providers sit on the same one. A routine office visit in the same file carries about 1,500 distinct prices, and the most common covers barely one provider in ten. The gap tells you something a benchmark can't: which of your rates were negotiated and which were assigned — and it reveals a trap, because the services with the biggest markup are the ones you can't negotiate at all.
In one insurer's Nashville-area imaging file, the standard rate for a head CT is either $82 or $346 — and each price is shared, to the cent, by thousands of providers. Four of the five most common imaging schedules sit at or below Medicare; the fifth pays about three times Medicare. The top schedule is exactly 4.23 times the bottom on nine of ten codes. The number on your contract isn't a negotiated rate. It's a schedule assignment.
A payer's price file lists imaging providers as if each one negotiated their own rate. In one metro, 228 of them — radiologists, a cardiologist, a dermatologist, speech-language pathologists, even students — carry byte-identical rates across all ten imaging codes. Unrelated specialties don't co-negotiate an MRI contract. That is not 228 negotiations. It is one schedule the payer wrote.
We published a piece arguing that payer price files don't label whether a number is the professional, technical, or global rate. An outside review of our work found we were wrong: the file labels every one of them. The reason we couldn't see it is the more useful story — and it implicates our own pipeline.
We analyzed 45,678 negotiated imaging rates from one Blues plan in one metro market. The gap between the lowest- and highest-paid providers for the same scan is at least 6x — and measured like-for-like in the raw file, wider still.
You can now query negotiated rates for any commercial payer and CPT code combination instantly — no sales call required. Here's exactly how it works.
Healthcare price transparency regulations are evolving in 2026 with schema 2.0, actual price requirements, and expanded data sources. Learn how these changes impact analysts and consultants working with machine readable files.
The Transparency in Coverage Rule fundamentally changed access to healthcare pricing data. Learn what the TiC Rule requires, why it matters, and how to effectively use machine readable files for analysis.