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
Payer coverage includes Aetna, UnitedHealthcare, Cigna, BCBS plans (commercial lines), Sentara Health Plans, and others.
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
- Cigna + behavioral health codes 90791,90832,90834,90837: /custom-data-pull?payers=cigna&codes=90791,90832,90834,90837&mode=bulk
- Florida Blue + E&M codes 99213,99214: /custom-data-pull?payers=florida_blue&codes=99213,99214&mode=bulk&states=FL
URL parameters:
payers— payer internal name (e.g.sentara_health_plan,cigna,florida_blue)codes— 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. Narrow selections (single payer, single code, single state) are typically under $100. Broad multi-payer, multi-code extractions scale accordingly.
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 20 commercial payers. For questions about a specific payer or code set, contact us.