Price Transparency Data
Price Transparency Data includes datasets for provider-payer contracted rates both at the individual and aggregate level for use in contracts negotiation and benchmarking, plan comparison, provider recruitment, and consumer care navigation. To be included in this category, vendors must provide detailed datasets that cover a wide range of services and procedures. Vendors must ensure that the data is up-to-date and compliant with relevant healthcare regulations and standards. Optional features may include advanced analytics and reporting tools to further enhance the usability and insights derived from the data.
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Serif Health
Claimed
Serif Health
Company Info
Founded: 2020
Headcount: 1-10
Customers
Verified Customers: 7
Customers Served: Digital Health Provider, Ambulatory Practice, Hospital / Health System, Health Plan, Employers, Life Sciences
Product Overview
2 ReviewsSerif Health provides healthcare pricing intelligence through APIs and self-serve analytics tools. Their platform processes machine-readable pricing data from health plans to deliver clean, actionable insights. These tools help provider organizations benchmark reimbursements, optimize pricing strategies, and improve contract negotiations. Health plans use Serif Health for network management and cost-effective care guidance, while employers and innovators utilize their data for plan audits, direct contracting, and integrating cost data into new healthcare products.
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Denniston Data
Claimed
Denniston Data Healthcare Pricing Guide
Company Info
Founded: 2020
Headcount: 11-50
Customers
Customers Served: Digital Health Provider, Ambulatory Practice, Hospital / Health System, Health Plan, Employers
Product Overview
The Denniston Data Healthcare Pricing Guide (HPG) provides a comprehensive tool for accessing U.S. medical benchmark prices using data from Transparency in Coverage and Medicare. It allows users to view negotiated prices from various healthcare payers for all services and providers. The guide includes reimbursement codes, quality control-checked prices, and compliance features for regulations like the Consolidated Appropriations Act and the No Surprises Act. It aims to help self-insured employers manage healthcare costs effectively.
SumHealth
Claimed
SumHealth
Company Info
Founded: 2024
Headcount: 1-10
Customers
Customers Served: Digital Health Provider, Ambulatory Practice, Hospital / Health System, Health Plan, Employers, Life Sciences
Product Overview
SumHealth enables provider search and price transparency, with tools to help users locate healthcare providers and access their pricing information. For providers, the product enables them to stay compliant with CMS price transparency requirements, and helps patients and other providers more easily find them.
Tribunus Health
Claimed
Tribunus Health Price Transparency
Company Info
Founded: 2019
Headcount: 11-50
Customers
Customers Served: Digital Health Provider, Ambulatory Practice, Hospital / Health System
Product Overview
Tribunus Health is a managed care contracting firm that also offers a Healthcare Price Transparency Tool, powered by PayerPrice, which provides detailed, actionable data on negotiated reimbursement rates from commercial payers across the U.S. This tool allows healthcare providers to compare their rates with others in their specialty and geography, helping them negotiate better contracts and understand their competitive positioning. It features comprehensive datasets, specialty-specific insights, and visualizations to aid in strategic decision-making.
FAIR Health
FAIR Health
Company Info
Founded: 2009
Headcount: 51-200
Customers
Customers Served: Digital Health Provider, Ambulatory Practice, Hospital / Health System, Health Plan, Employers
Product Overview
1 ReviewsSecurity and Compliance Certifications: HITRUST CSF, HIPAA
FAIR Health is a non-profit that offers a collection of private healthcare claims data for transparency on medical and dental costs. It manages an extensive database to help consumers, providers, and payers to understand healthcare costs and insurance allowables.
Clarify Health
Clarify Atlas
Company Info
Founded: 2015
Headcount: 201-500
Customers
Verified Customers: 3
Customers Served: Digital Health Provider, Ambulatory Practice, Hospital / Health System, Health Plan, Life Sciences
Product Overview
Clarify Health's Atlas platform is an enterprise analytics solution with over 15 billion claims in its dataset that can be used for price transparency in contract negotiations, building higher quality networks, reducing spend, and optimizing referrals. The platform aids in optimizing provider performance, reducing medical costs, and improving patient outcomes by integrating social determinants of health and detailed patient data.
Keywell.ai
Keywell.ai PriceLink
Company Info
Founded: 2018
Headcount: 1-10
Customers
Verified Customers: 4
Customers Served: Digital Health Provider, Ambulatory Practice, Hospital / Health System, Health Plan
Product Overview
Keywell.ai offers PriceLink, which provides detailed insights into negotiated rates across providers and payers using price transparency data. It helps generate customizable market reports and provider comparisons, helping organizations like payers, providers, and accountable care organizations make informed decisions about pricing, cost reductions, and network management.
Mathematica
Mathematica Price Transparency
Company Info
Founded: 1968
Headcount: 1001-5000
Customers
Verified Customers: 1
Customers Served: Digital Health Provider, Ambulatory Practice, Hospital / Health System, Health Plan, Employers
Product Overview
Mathematica Price Transparency aggregates and analyzes pricing data from national and regional health plans to provides insights into reimbursement rates, Medicare comparisons, provider performance, and service utilization. The platform enables healthcare providers, payers, and purchasers to make data-driven decisions for rate negotiations, service line growth, and value-based care. It includes a customizable dashboard for real-time data visualization and detailed reports.
Payerset
Payerset
Company Info
Founded: 2022
Headcount: 1-10
Customers
Verified Customers: 5
Customers Served: Digital Health Provider, Ambulatory Practice, Hospital / Health System, Health Plan, Employers
Product Overview
PayerSet offers price transparency data solutions sourced from payer MRF files. The platform includes tools like Rate Explorer for self-service exploration of these rates, and Data Lake for integrating this data into existing systems. PayerSet's datasets help organizations with cost management, competitive pricing, and strategic planning by providing granular details on rates, billing codes, and provider plans, all refreshed quarterly for accuracy.
TALON
TALON
Company Info
Founded: 2014
Headcount: 11-50
Customers
Verified Customers: 1
Customers Served: Employers, Health Plan
Product Overview
Security and Compliance Certifications: SOC 2 Type 2, HIPAA
TALON's healthcare price transparency platform offers a suite of tools for viewing price transparency data, including consumer price shopping tools and features for claims analysis, healthcare pricing data, and financial modeling.
Trek Health
Trek Health Payer Transparency
Company Info
Founded: 2022
Headcount: 11-50
Customers
Verified Customers: 15
Customers Served: Digital Health Provider, Ambulatory Practice, Hospital / Health System, Health Plan, Employers
Product Overview
Trek Health's Payer Transparency platform provides real-time analytics to enhance payer negotiations and financial strategy. Key capabilities include accessing real-time payer fee schedules, assessing payer mix, and maximizing claims reimbursement through actionable data. The platform also supports market expansion by offering insights into competitor landscapes and optimizing negotiation terms with robust payer rate comparisons.
Turquoise Health
Turquoise Health
Company Info
Founded: 2020
Headcount: 51-200
Customers
Verified Customers: 4
Customers Served: Digital Health Provider, Ambulatory Practice, Hospital / Health System, Health Plan, Employers
Product Overview
Security and Compliance Certifications: SOC 2 Type 2
Turquoise Health is a data platform that provides price transparency data and payer-provider contracting solutions. Their price transparency data platform enables pricing through competitive benchmarking and customized rate setting, particularly for value-based reimbursement structures such as bundled rates. Their managed care contracting software enables more efficient rate negotiations.
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Visible Charges
Visible Charges
Company Info
Founded: 2021
Headcount: 1-10
Customers
Verified Customers: 1
Customers Served: Digital Health Provider, Ambulatory Practice, Hospital / Health System, Health Plan, Employers
Product Overview
Visible Charges provides a price transparency dataset of healthcare charges using MRF data that is updated on a monthly basis. This data includes detailed information on negotiated rates by payer and plan for various procedures, supplies, and drugs across different types of healthcare providers. The platform helps analyze and compare prices, supporting transparency and better decision-making in healthcare costs.