# Payer rate benchmarking for providers > Compare your negotiated rates with competitors' for the same codes and payers, find underpaid services and prepare for negotiations. Coming soon. For hospitals, health systems & physician groups. HTML version: https://ushealth.io/for/providers Payers have always known what they pay every provider in your market. Now you can too. US Health.io compares your contracted rates with your peers' for the same codes and payers, so you can find underpaid services and go into negotiations with evidence. ## Where your rates sit in the market Illustrative example: one provider's negotiated rate with one payer for six common services, against the range that payer pays other providers in the market (10th to 90th percentile, as a percentage of the market median). The provider is paid 61% of the median for a brain MRI and 70% for an echocardiogram, below the market's middle range, and 138% for knee arthroscopy. (Illustrative example, not real prices.) ## In a negotiation, the payer sees everything Across the table, a payer knows its rates with every provider in your market. Until recently you knew only your own contracts. The rates insurers now publish change that, but only if they can be compared like for like: the same code, the same place of service, the same kind of provider. That's hard with raw files that run to hundreds of gigabytes and contain placeholder rates for services a provider would never perform. We clean and match them, so the comparison you bring to the table holds up. ## 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 price data does for your contracts - **Benchmark every contract**: Your rates against the market's percentiles, by payer, code and place of service. - **Find underpaid services**: Rank the services where you're paid below peers, so you know which to renegotiate first. - **Model a new contract**: Estimate what a proposed rate change would be worth using comparable rates from the market. - **Spot market opportunities**: See the service lines and regions where payers pay more, to inform growth and network decisions. ## Questions you'll be able to answer - Where are we paid below the market median, payer by payer? - How do our rates compare with the health system across town for the same codes? - Which payer pays the most for our highest-volume services? - What would moving our lowest rates to the market median be worth? ## What's coming - **Web portal** (For employers, brokers and providers, coming soon): Compare negotiated rates by procedure, provider, insurer and market, and export what you find. - **Reports** (Benchmarks and custom analysis, coming soon): Ready-made benchmark reports for your market and plans, or an analysis built around your question. ## How it will work 1. **Find your organisation**: Search by name, NPI or TIN, and pick the payers you contract with. 2. **See where you stand**: Your rates beside your peers' for the same codes, payers and places of service. 3. **Prepare the negotiation**: Explore in the portal or get a benchmark report for your contracting team. ## Questions ### Do you need our contracts or claims? No. Your negotiated rates are already in the files insurers publish, alongside your competitors'. We find them and compare them. ### Can you compare like for like? That's the point. Comparisons are made by billing code, place of service and whether the rate is for the facility or the professional, because mixing those makes benchmarks misleading. ### Is it only for hospitals? No. Physician groups, ambulatory surgery centers, imaging centers and labs all appear in insurers' files and can be benchmarked the same way. ### When can we use it? The portal and reports are coming soon. Join the early-access list and we'll be in touch. ## Request early access for your organisation Tell us your organisation and markets, and we'll reach out when benchmarks are ready. [Request early access](mailto:hello@ushealth.io?subject=Early%20access%3A%20provider%20rate%20benchmarks) (email to hello@ushealth.io; no pricing yet). ## Related - [Price transparency data for employers](https://ushealth.io/for/employers.md) - [Compare carrier networks on negotiated rates](https://ushealth.io/for/brokers.md) - [What machine-readable files are](https://ushealth.io/what-are-mrf-files) - Glossary: [Billing code](https://ushealth.io/glossary/billing-code) - Glossary: [Place of service](https://ushealth.io/glossary/place-of-service) - Glossary: [Provider group](https://ushealth.io/glossary/provider-group) - Glossary: [TIN](https://ushealth.io/glossary/tin) - Glossary: [MS-DRG](https://ushealth.io/glossary/ms-drg)