Healthcare pricing data — what commercial payers actually pay for specific procedures — has been publicly available since July 2022 under the Transparency in Coverage rule. The problem has never been access; it's been volume. A single payer publishes hundreds of gigabytes of machine-readable files. Finding the rate you need without extracting and parsing the full file set is not practical without the right tool.
DeductibleData solves this by pre-processing those files and letting you query negotiated rates by payer, CPT code, and provider in minutes.
What You Can Query
Every commercial payer covered by the Transparency in Coverage rule is fair game. That includes:
- Behavioral health codes: 90791 (psychiatric evaluation), 90832 / 90834 / 90837 (psychotherapy by session length), 90847 (family therapy), 99213 / 99214 (evaluation and management)
- Surgical codes: CPT ranges 10000–69999
- Radiology and lab: CPT ranges 70000–89999
- HCPCS Level II codes: DME, drugs, and other non-physician services
Coverage spans more than 30 commercial payers — the largest national carriers, regional plans, and BCBS plans (commercial lines). Every payer the quote tool lists as selectable is priced and sold self-serve. There is no footprint threshold and no "too large for the configurator" tier: the biggest payers in the book check out through the same page as the smallest. We do not publish a payer roster here, because which payers are selectable moves with the publishers rather than with us — the dropdown is the live list, and /api/lookup/payers returns the same thing to a machine.
How to Get a Rate Quote Instantly
Option 1: Use the quote tool directly
Go to deductibledata.com/custom-data-pull. Select a payer, add one or more CPT codes, choose a provider scope (bulk by state and specialty, or specific NPIs), and your price calculates in real time. No account required to see the price.
Option 2: Open a pre-configured quote URL
If you know the payer and codes you want, you can open a pre-built quote directly:
- Sentara Health Plans + CPT 90837: /custom-data-pull?payers=sentara_health_plan&codes=90837&mode=bulk
- Blue Cross Blue Shield of Illinois + behavioral health codes 90791,90832,90834,90837: /custom-data-pull?payers=bcbs_of_illinois&codes=90791,90832,90834,90837&mode=bulk
Availability moves with the publisher, not with us: a payer's files sit behind signed URLs that expire, and when a payer's access lapses we price the selection but will not sell it. The quote tool shows the current state for whatever you select, so treat the links above as a starting point rather than a standing promise.
URL parameters:
payers— payer internal name (e.g.sentara_health_plan,bcbs_of_illinois,bcbs_of_tennessee); the exact values come from/api/lookup/payerscodes— comma-separated CPT or HCPCS codesmode—bulk(all providers matching filters) orspecific(individual NPIs)states— comma-separated state abbreviations to narrow the provider pool
What a Quote Shows You
When you land on a configured quote page or save a quote, you see:
- Payer and plan files — how many in-network files are included and their total size
- Billing codes — the CPT/HCPCS codes included in the extraction
- Provider scope — how many providers are covered by the selection
- Price estimate — the cost to extract and deliver the data
The price reflects actual compute cost — processing time against the payer's file set for your specific code list and provider scope. What a pull costs depends mostly on how much file the payer publishes, not on how many codes you ask for. A small payer's full network can run under $100 for a single code; a large payer's can run into the thousands for the same code. Narrowing the provider scope is what moves the number most. The quote tool prices your exact selection before you buy.
Proceeding from Quote to Data Delivery
From any quote page, click Proceed to Checkout. If you're not signed in, you'll be prompted to create an account or sign in — this takes about 30 seconds. Checkout accepts credit card or ACH bank transfer.
Once payment confirms, an extraction job starts automatically. Most jobs complete within 2–4 hours. You receive an email with a secure download link when your file is ready.
What's Not Available
Medicare Advantage plans — Aetna Medicare, Humana Medicare, Anthem Medicare, and all other MA plans are exempt from the Transparency in Coverage rule. No machine-readable in-network rate files exist for Medicare Advantage networks. If you need Medicare reimbursement benchmarks, the CMS Medicare Physician Fee Schedule (MPFS), updated annually and available at cms.gov, is the correct source.
Magellan Health — Magellan operates as a behavioral health TPA and hosts TiC files on a per-client basis rather than publishing a national in-network file. The per-client files contain empty in-network arrays with no rate data. There is no usable Magellan national rate dataset.
Medicaid managed care — State-specific Medicaid managed care organizations are not covered by the TiC rule.
Sharing a Quote
After configuring your data pull, click Save Quote. This saves the full configuration — payer, codes, provider scope, and pricing — as a shareable link. Send it to a colleague, a client, or include it in an email. The recipient sees the same configuration and price without needing an account. Quote links are valid for 5 days.
DeductibleData processes TiC machine-readable files monthly across more than 30 commercial payers. For questions about a specific payer or code set, contact us.