Our data & methodology.
Real negotiated rates and legally mandated files, not crowdsourced guesses. Where the numbers come from, and what they are not.
Figures below as of July 2026
32M+
Total price points
11
Data sources
9.03M
Providers indexed
9
Price fallback tiers
Our Data Sources
Every price on FairVisitHealth is backed by one or more of these official data sources. No guesswork, no user-submitted estimates.
Payer Negotiated Rates (Transparency in Coverage)
Individual negotiated rates from 10+ national payers, including major commercial insurers. Includes billing code, provider identifier, and the actual negotiated rate for each combination.
Source: Insurer Transparency in Coverage Files
Hospital Price-Transparency Files
Gross charges, discounted cash prices, and payer-specific negotiated rates published by hospitals as required by federal law. Matched at the ZIP3 level for geographic accuracy.
Source: 45 CFR 180.50
NPI Provider Directory
Every provider record is geocoded to its practice location, which is what lets us match you to nearby prices instead of just a state-level average.
Source: NPPES (National Plan and Provider Enumeration System)
Medicare Physician Fee Schedule (MPFS)
National rates for physician services, adjusted for your area using CMS geographic practice cost indices.
Source: CMS.gov
Medicaid Provider Rates
State-specific Medicaid reimbursement rates. Used as a benchmark for a fair market self-pay estimate where no payer or hospital rate is available.
Source: State Medicaid Programs
CMS Lab Fee Schedule (CLFS)
National and carrier-specific rates for clinical laboratory tests. Covers common blood panels, urinalysis, pathology, and specialized diagnostics.
Source: CMS.gov
ASC Payment Rates
Ambulatory surgery center payment rates, generally lower than the same procedure billed at a hospital outpatient department under CMS payment classifications.
Source: CMS.gov
DMEPOS Fee Schedule
Durable medical equipment, prosthetics, orthotics, and supplies. Covers wheelchairs, CPAP machines, prosthetic limbs, braces, and other medical devices.
Source: CMS.gov
Part B Drug Average Sales Price (ASP)
Average sales prices for provider-administered injectable and infused drugs. Covers J-codes and Q-codes for chemotherapy, biologics, and other specialty drugs.
Source: CMS.gov
NADAC Drug Prices
National Average Drug Acquisition Cost, representing what pharmacies actually pay for medications. The most current benchmark for retail drug pricing, refreshed weekly.
Source: CMS NADAC Survey
Dental Provider Prices
Cash prices dental providers publicly advertise on their own websites and listings. Covers cleanings, fillings, crowns, root canals, extractions, and other dental services. Most dental care sits outside the federal transparency rules, so this is the disclosed exception to our government-file sourcing.
Source: Publicly Advertised Provider Prices
How estimates are computed
When you search for a price, we check each source below in order, starting with the rate that's most specific to your insurance plan and your location. The first source with available data sets your price. If nothing specific to you is available, we widen the search to a regional summary, then a hospital cash price, then a national estimate.
Your Payer's Rate At This Provider
VerifiedYour insurer's actual negotiated rate for this specific provider and procedure. The most accurate price available.
Data source: Insurer Transparency in Coverage files
Your Payer's Rate Nearby
VerifiedYour insurer's negotiated rate with other providers in your 3-digit ZIP code area, used when no rate exists for that exact provider.
Data source: Insurer Transparency in Coverage files
This Hospital's Local Cash Price
VerifiedThe hospital's own posted price for your 3-digit ZIP code area, including discounted cash price and payer-specific rates.
Data source: Hospital price-transparency files
This Hospital's Statewide Price
HighStatewide average of that hospital's prices for this procedure. Used when no ZIP3-specific data is available.
Data source: Hospital price-transparency files (aggregated)
Nationwide Hospital Price Average
HighNational average from hospital price-transparency filings. Provides a broad benchmark when regional data is limited.
Data source: Hospital price-transparency files (nationwide)
National Procedure Estimate
HighA Medicare-based benchmark rate adjusted for your geographic area. A reliable reference since most providers accept rates in this range.
Data source: Medicare fee schedule, geographically adjusted
Medicaid-Based Estimate
MediumState Medicaid reimbursement rate, adjusted upward to approximate a fair self-pay estimate. Medicaid rates are typically the lowest reimbursed, so the adjustment corrects for that.
Data source: State Medicaid fee schedule
Dental-Specific Estimate
MediumFor dental procedures, this tier uses dental-specific pricing data drawn from multiple dental data sources.
Data source: Dental provider pricing data
Category-Level Estimate
EstimatedWhen no procedure-specific data exists, we use average pricing for the broader procedure category. Always labeled as an estimate, not a quote.
Data source: Category-level aggregated pricing
How We Calculate Each Price
1. Geographic Matching
We use your ZIP code to find the closest providers and prices. Our progressive bounding box algorithm starts with a 2-mile radius for dense metro areas, expands to 10 miles for suburban areas, and extends to the full search radius for rural locations. This ensures you see relevant nearby options first without missing providers in less-dense areas.
Hospital MRF prices are matched at the ZIP3 level (first 3 digits of your ZIP code), which corresponds to a regional mail distribution area. This provides geographic specificity beyond state-level averages while having enough data density for reliable pricing.
2. Provider-Level Variation
Be clear on what estimate-tier prices are: when a result comes from an estimate tier (the national procedure, Medicaid-based, dental-average, or category-level estimates), the per-provider dollar figure is modeled, not measured. It starts from a shared area-level benchmark, and we then apply a variation of up to plus or minus 15%, tied to each provider's NPI number, to approximate the realistic spread between providers in the same area. Those figures are NOT individually sourced prices for that specific provider. Verified-tier prices (payer-negotiated rates and hospital-published prices) ARE provider-specific.
The variation is deterministic, meaning the same provider always shows the same modeled figure on every visit. This keeps results stable between searches, and the confidence badge on each row tells you whether a price is measured or modeled.
3. Confidence Scoring
Every price displayed includes a confidence badge so you always know how the price was derived:
Verified
Direct payer-negotiated rate or hospital price for this specific provider and procedure.
High
Medicare rate with geographic adjustment, or multiple data sources agree on the price range.
Medium
Estimated from state or regional averages. Reliable as a negotiation benchmark.
Estimated
Category-level fallback with limited procedure-specific data.
4. Fair Price Range
Where sufficient payer data exists, we show the 25th percentile, median, and 75th percentile of negotiated rates. This gives you the full picture:
If a hospital or provider charges above the 75th percentile, that is a signal that the price may be inflated and worth negotiating. Our negotiation tools reference these percentiles directly in dispute and negotiation letters.
Data Quality & Freshness
Automated Pipelines
Our data pipelines run automatically: drug prices refresh weekly from CMS NADAC data, payer and hospital price files refresh monthly (matching how often payers and hospitals actually re-publish them), and the provider directory refreshes weekly. All imports are logged and validated.
Pre-computed Statistics
Price statistics for the most common procedure codes are pre-computed and refreshed weekly, so search results reflect the latest imports without recalculating from raw files on every query.
Quality Validation
An automated data validator runs daily to check data freshness, detect anomalies, and flag stale records. Price sanity caps prevent extreme outliers from skewing results.
Query Performance
Search queries have a 15-second statement timeout to ensure consistent performance. All queries are logged for performance monitoring. The search function uses optimized indexes and progressive bounding boxes for fast results.
What our prices are not
Not a binding quote
Every price on FairVisitHealth is an estimate built from historical data, not a quote from the provider. Your actual bill can differ based on your specific visit, any complications, and add-on services.
Focused on self-pay and cash pricing
Our data centers on self-pay and cash-pay pricing. If you have insurance, your plan's actual negotiated rate and your deductible status determine what you owe, not the price shown here.
Thinner in some rural areas
Data density varies by market. Large metro areas have deep payer and hospital coverage; some rural and deep-rural areas have thinner data, so the price shown may lean on a broader regional or national estimate instead of a local rate.
Always confirm with the provider
Call the provider's billing department and confirm the price before your visit, especially for anything scheduled or elective. Use our price as a reference point in that conversation, not a guarantee.
Why this data exists
Federal law already requires this data to be public. The Hospital Price Transparency Rule (45 CFR Part 180) requires hospitals to publish their standard charges. The Transparency in Coverage rule requires insurers to publish machine-readable files of the rates they've negotiated with providers. Both rules exist so patients can shop for care before they receive it.
In practice, these files are massive, inconsistently formatted flat files built for machines, not people. A single payer's file can run hundreds of gigabytes, with no search and no way to compare providers. We download, parse, clean, and match these files to real providers so pricing that is already legally public actually becomes usable.
What Makes Us Different
A side-by-side comparison of data depth and consumer tools.
| Feature | FairVisitHealth | GoodRx | Healthcare Bluebook | Turquoise Health |
|---|---|---|---|---|
| Total price points | 32M+ | Drug prices only | Limited procedures | Hospital + payer files |
| Real negotiated rates | 27.1M+ payer rates | No | Estimated | Yes |
| Provider-specific pricing | 9.03M providers | Pharmacy only | No | Hospitals + payer-file providers |
| Medicare benchmarks | 13.5K procedures | No | Yes | Yes |
| Consumer negotiation tools | 15+ consumer tools | Price comparison | Price comparison | B2B data platform |
| Update frequency | Weekly-Monthly | Real-time (drugs) | Periodic | Monthly |
| Dental pricing | 370K+ prices | No | No | No |
| Drug pricing (NADAC) | 1.6M+ records | Yes (primary focus) | No | No |
Comparison as of July 2026, based on publicly available product information.
Frequently asked questions
Sources
- CMS.gov - Medicare Physician Fee Schedule (MPFS), Conversion Factor, and GPCI Localities
- Centers for Medicare & Medicaid Services - Hospital Price Transparency Rule (45 CFR Part 180)
- Transparency in Coverage Final Rule - Insurer Machine-Readable File Requirements (85 FR 72158)
- CMS.gov - Clinical Laboratory Fee Schedule, ASC Payment System, DMEPOS Fee Schedule
- CMS.gov - Medicare Part B Drug Average Sales Price (ASP) Files
- Medicaid.gov - State Medicaid Fee-for-Service Fee Schedules
- CMS NADAC Survey - National Average Drug Acquisition Cost