Transparency

Data Sources & Methodology

FairVisitHealth believes in radical transparency. Here's exactly where our pricing data comes from, how often it's refreshed, and our methodology for estimates.

Important: Price Verification Required

All prices shown are estimates based on publicly available data sources. Actual prices may vary based on your specific situation, insurance status, and provider policies. Always verify prices directly with healthcare providers before receiving services.

Data Sources

NADAC (Drug Wholesale Costs)

Primary

National Average Drug Acquisition Cost - what pharmacies actually pay for medications. Published weekly by CMS based on pharmacy surveys. Powers our drug markup exposure feature.

Refresh:Weekly (Wednesdays)
License:Public Domain (US Government)
Schema validated
Does not include dispensing fees. Represents average, not lowest available price.
View source

CMS Hospital Price Transparency

Primary

Machine-readable files (MRFs) containing hospital standard charges, cash prices, and negotiated rates as required by 45 CFR 180.50.

Refresh:Annually (hospitals) / Monthly (our parsing)
License:Public Domain (US Government)
Schema validated
Not all hospitals fully compliant. Formats vary between hospitals.
View source

NPPES NPI Registry

Primary

National Plan and Provider Enumeration System providing verified provider identities, specialties, and practice locations. 8.88M+ provider records.

Refresh:Weekly incremental updates
License:Public Domain (US Government)
Schema validated
Addresses may be outdated if providers move.
View source

Medicare Physician Fee Schedule

Benchmark

Medicare payment rates used as reference benchmarks for fair pricing comparisons. Used in our Fair Price calculation (Medicare × 1.2).

Refresh:Annually with quarterly updates
License:Public Domain (US Government)
Schema validated
Medicare rates typically lower than commercial. Geographic adjustments apply.
View source

Community-Reported Prices

Community

User-submitted pricing from actual bills, EOBs, and receipts. Verified through pattern matching and outlier detection.

Refresh:Real-time
License:User submissions (CC BY-NC)
Schema validated
Self-reported data may contain errors. Sample sizes vary by procedure.
View source

Google Places API

Enrichment

Provider location verification, hours of operation, ratings, and contact information.

Refresh:Real-time
License:Google Maps Platform Terms
Schema validated
Business hours may be outdated.
View source

Medical Code Sets

Medical procedure and diagnosis codes are subject to various licensing requirements. Here's how FairVisitHealth handles each code set:

CPT® Codes

American Medical Association

Code numbers only for identification purposes. Full CPT descriptors are proprietary to the AMA.

License: Numbers used under fair use; descriptions avoided or licensed

HCPCS Codes

CMS (Public Domain)

Healthcare Common Procedure Coding System codes used freely for pricing reference.

License: Public Domain

ICD-10 Codes

WHO / CMS adaptation

Diagnosis codes for categorization and pricing lookup.

License: Public Domain (US implementation)

Pricing Methodology

How We Calculate "Fair Price"Ranges

  1. Aggregate cash prices from CMS Hospital Price Transparency files for your region
  2. Cross-reference with Medicare fee schedule as a baseline benchmark
  3. Apply regional cost-of-living adjustments using CMS geographic indices
  4. Weight by data freshness (more recent = higher confidence)
  5. Display range showing 25th to 75th percentile of available prices

Confidence Scoring

Each price estimate includes a confidence score based on:

  • High (80-100%): Multiple verified sources agree within 15%
  • Medium (50-79%): Single verified source or moderate variance
  • Low (below 50%): Limited data, estimates only, or high variance

Savings Claim Methodology

When we state "save 40-80%", this compares typical insurance-billed rates (chargemaster prices) to negotiated cash-pay rates from CMS transparency data. Individual results vary significantly based on procedure, provider, location, and negotiation success. Past savings do not guarantee future results.

Data Collection Policy

FairVisitHealth does not scrape websites. All pricing data is obtained through:

  • Official government data sources (CMS, NIH, state health departments)
  • Licensed API integrations with data providers
  • Direct provider submissions through our partner network
  • User-submitted quotes (verified and anonymized)

We do not bypass paywalls, terms of service, or access controls. All data use complies with applicable terms of service and licensing agreements.