# Healthcare price transparency API and data

> Clean, normalised negotiated rates from US health insurers' price files, by API or bulk extract, for products and research. Coming soon.

For developers & researchers. HTML version: https://ushealth.io/for/developers

Ask for a procedure and a place, and get back what every insurer pays every provider nearby, in one API or SDK call. The 300 GB files, the duplicates and the placeholder rates are dealt with before your request arrives.

## One call, every price

Illustrative example: one SDK call, ushealth.rates.search with the billing code 70553 (MRI of the brain) and the ZIP code 80202 (Denver), returns JSON listing each nearby provider's negotiated rate on the chosen plan, sorted by price: $412, $538, $1,290 and $2,140, each with the provider's NPI, distance, place of service and publication date. The same search is one HTTPS GET request. (Illustrative example, not real prices.)

## The data is public. Using it isn't easy.

Every US health insurer publishes its negotiated rates, but a single file can be nearly 300 GB of JSON, layouts vary from insurer to insurer, and the same rate can appear thousands of times. Many files also list placeholder rates for services a provider is unlikely ever to perform.

Building on that means a download, parsing and storage pipeline before you write a line of your own product. We've built that pipeline, so you can start from clean, comparable rates.

## Why comparing prices matters

- **Up to 40×**: difference in price for the same service within a single metro area ([Health Care Cost Institute, Past the Healthy Marketplace Index](https://healthcostinstitute.org/hcci-research/past-the-healthy-marketplace-index-exploring-actual-prices-paid-for-specific-services-by-metro-area))
- **$562 – $9,691**: negotiated rate for an outpatient colonoscopy in the Chicago area, depending on where it was done ([Trilliant Health, 2025 price transparency report](https://www.trillianthealth.com/market-research/reports/2025-price-transparency))
- **67.5% lower**: median colonoscopy price at an ambulatory surgery center than at a hospital outpatient department ([Trilliant Health, 2025 price transparency report](https://www.trillianthealth.com/market-research/reports/2025-price-transparency))
- **Since July 2022**: health insurers and plans have had to publish the rates they negotiate with providers ([CMS, Transparency in Coverage final rule fact sheet](https://www.cms.gov/newsroom/fact-sheets/transparency-coverage-final-rule-fact-sheet-cms-9915-f))

## What you get

- **One schema for every insurer**: Billing code, rate, rate type, place of service, billing class and provider, in the same shape whichever insurer published it.
- **Linked to real providers**: Rates tied to NPIs and TINs, with provider names, specialties and locations from the national provider registry.
- **Cleaned for analysis**: Duplicate rates removed, and placeholder rates for services a provider is unlikely to perform flagged, so averages and comparisons mean something.
- **History you can track**: Each publication we process is kept, so you can see how a rate changed from one file to the next.

## What you'll be able to ask

- What does each insurer pay for CPT 70553 (MRI of the brain) at every provider in a metro area?
- Which in-network providers near a ZIP code have the lowest price for a procedure?
- How did the negotiated rate for a service change between two publications?
- How widely do prices for the same service vary within a market?

## What's coming

- **API & bulk data** (For developers and researchers, coming soon): Clean, normalised negotiated rates by API or as bulk extracts, linked to providers.

## For researchers and journalists

Published negotiated rates are the most detailed public record of what US healthcare costs. Clean extracts make it practical to study price dispersion within and across markets, the effect of consolidation on prices, or how rates change over time, and to report on local healthcare costs from primary-source data.

If you're working on a study or a story, tell us about it when you join the early-access list.

## How it will work

1. **Get a key**: Join early access and we'll send an API key as your markets come online.
2. **Make one call**: Search rates by billing code, location, insurer or provider, from the SDK or a plain HTTPS request.
3. **Build on the answer**: Show prices in your product, or pull bulk extracts into your analysis.

## Questions

### Where does the data come from?

From the machine-readable files that US health insurers and group health plans must publish under the federal Transparency in Coverage rules. Read more in our guide to MRF files.

### How current is it?

We process files as insurers publish them and keep each publication, so you can see both the latest rate and what changed.

### How will access work?

Through an API for lookups and integrations, and bulk extracts for analysis. Tell us which you need when you join early access.

### When can I start?

The API and bulk data are coming soon. Join the early-access list and we'll be in touch.

## Join the API early-access list

Tell us what you're building or studying, and we'll reach out as access opens. [Request API access](mailto:hello@ushealth.io?subject=Early%20access%3A%20API%20%26%20bulk%20data) (email to hello@ushealth.io; no pricing yet).

## Related

- [Payer rate benchmarking for providers](https://ushealth.io/for/providers.md)
- [Price transparency data for employers](https://ushealth.io/for/employers.md)
- [What machine-readable files are](https://ushealth.io/what-are-mrf-files)
- Glossary: [Machine-readable file](https://ushealth.io/glossary/machine-readable-file)
- Glossary: [In-network rate file](https://ushealth.io/glossary/in-network-rate-file)
- Glossary: [Table of contents file](https://ushealth.io/glossary/table-of-contents-file)
- Glossary: [NPI](https://ushealth.io/glossary/npi)
- Glossary: [TIN](https://ushealth.io/glossary/tin)
