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Loa Healthcare Pricing

by io.github.aanari
OverviewDiscussionsAdmin

Market Pricing

get_market_pricing
Read-onlyIdempotent

Preferred benchmark pricing tool. Returns hospital-level market statistics for CPT codes from Loa's published hospital price-transparency data: cash/self-pay prices, list prices (gross charges before discounts), overall insurer-negotiated rates, and rates for the most common insurers. Each hospital counts once. Lead with the median and the p25-p75 range rather than min or max. Figures are statewide or national, never local to a ZIP code. When status is insufficient_data, say Loa doesn't have enough data instead of estimating, and always relay the limitations. Negotiated rates are not out-of-pocket costs.

Input Schema

TableJSON Schema
NameRequiredDescriptionDefault
stateNoState for regional pricing (e.g. "CA", "New York"). Unknown states return McpToolInvalidInput. When fewer than 5 hospitals in the state published a price, national figures are returned with a limitation.
zip_codeNoZIP code, used only to pick the state when state is omitted
cpt_codesYesCPT codes to look up (e.g. ["99213", "93000"])

Output Schema

TableJSON Schema
NameRequiredDescriptionDefault
stateYes
pricingYes
provenanceYes

Schema Changelog

Changes observed during successful MCP inspections.

  1. Changed12 schema fields changed
    • changedInput schema / properties / state / description
      Previous value: -"State for regional pricing (e.g. \"CA\", \"New York\"). Unknown states return McpToolInvalidInput. Valid states with no regional data fall back to national averages."New value: +"State for regional pricing (e.g. \"CA\", \"New York\"). Unknown states return McpToolInvalidInput. When fewer than 5 hospitals in the state published a price, national figures are returned with a limitation."
    • changedInput schema / properties / zip_code / description
      Previous value: -"ZIP code (used with state for location context)"New value: +"ZIP code, used only to pick the state when state is omitted"
    • changedOutput schema / properties / pricing / items / properties / cash_price / anyOf
      Previous value: -[
-  {
-    "additionalProperties": false,
-    "properties": {
-      "average": {
-        "type": "number"
-      },
-      "data_points": {
-        "type": "number"
-      },
-      "max": {
-        "type": "number"
-      },
-      "median": {
-        "type": "number"
-      },
-      "min": {
-        "type": "number"
-      },
-      "source": {
-        "type": "string"
-      }
-    },
-    "required": [
-      "median",
-      "average",
-      "min",
-      "max",
-      "data_points",
-      "source"
-    ],
-    "type": "object"
-  },
-  {
-    "type": "null"
-  }
-]New value: +[
+  {
+    "additionalProperties": false,
+    "properties": {
+      "average": {
+        "type": "number"
+      },
+      "data_points": {
+        "description": "Price records behind this figure",
+        "type": "number"
+      },
+      "hospital_count": {
+        "description": "Hospitals behind this figure; each counts once",
+        "type": "number"
+      },
+      "max": {
+        "type": "number"
+      },
+      "median": {
+        "type": "number"
+      },
+      "min": {
+        "type": "number"
+      },
+      "p25": {
+        "type": "number"
+      },
+      "p75": {
+        "type": "number"
+      },
+      "source": {
+        "enum": [
+          "state",
+          "national"
+        ],
+        "type": "string"
+      }
+    },
+    "required": [
+      "median",
+      "average",
+      "min",
+      "max",
+      "p25",
+      "p75",
+      "data_points",
+      "hospital_count",
+      "source"
+    ],
+    "type": "object"
+  },
+  {
+    "type": "null"
+  }
+]
    • addedOutput schema / properties / pricing / items / properties / insurance_by_payer
      Added value: +{
+  "items": {
+    "additionalProperties": false,
+    "properties": {
+      "data_points": {
+        "type": "number"
+      },
+      "hospital_count": {
+        "type": "number"
+      },
+      "median": {
+        "type": "number"
+      },
+      "p25": {
+        "type": "number"
+      },
+      "p75": {
+        "type": "number"
+      },
+      "payer": {
+        "type": "string"
+      }
+    },
+    "required": [
+      "payer",
+      "median",
+      "p25",
+      "p75",
+      "data_points",
+      "hospital_count"
+    ],
+    "type": "object"
+  },
+  "type": "array"
+}
    • changedOutput schema / properties / pricing / items / properties / insurance_price / anyOf
      Previous value: -[
-  {
-    "additionalProperties": false,
-    "properties": {
-      "average": {
-        "type": "number"
-      },
-      "data_points": {
-        "type": "number"
-      },
-      "max": {
-        "type": "number"
-      },
-      "median": {
-        "type": "number"
-      },
-      "min": {
-        "type": "number"
-      },
-      "source": {
-        "type": "string"
-      }
-    },
-    "required": [
-      "median",
-      "average",
-      "min",
-      "max",
-      "data_points",
-      "source"
-    ],
-    "type": "object"
-  },
-  {
-    "type": "null"
-  }
-]New value: +[
+  {
+    "additionalProperties": false,
+    "properties": {
+      "average": {
+        "type": "number"
+      },
+      "data_points": {
+        "description": "Price records behind this figure",
+        "type": "number"
+      },
+      "hospital_count": {
+        "description": "Hospitals behind this figure; each counts once",
+        "type": "number"
+      },
+      "max": {
+        "type": "number"
+      },
+      "median": {
+        "type": "number"
+      },
+      "min": {
+        "type": "number"
+      },
+      "p25": {
+        "type": "number"
+      },
+      "p75": {
+        "type": "number"
+      },
+      "source": {
+        "enum": [
+          "state",
+          "national"
+        ],
+        "type": "string"
+      }
+    },
+    "required": [
+      "median",
+      "average",
+      "min",
+      "max",
+      "p25",
+      "p75",
+      "data_points",
+      "hospital_count",
+      "source"
+    ],
+    "type": "object"
+  },
+  {
+    "type": "null"
+  }
+]
    • addedOutput schema / properties / pricing / items / properties / limitations
      Added value: +{
+  "items": {
+    "type": "string"
+  },
+  "type": "array"
+}
    • addedOutput schema / properties / pricing / items / properties / list_price
      Added value: +{
+  "anyOf": [
+    {
+      "additionalProperties": false,
+      "properties": {
+        "average": {
+          "type": "number"
+        },
+        "data_points": {
+          "description": "Price records behind this figure",
+          "type": "number"
+        },
+        "hospital_count": {
+          "description": "Hospitals behind this figure; each counts once",
+          "type": "number"
+        },
+        "max": {
+          "type": "number"
+        },
+        "median": {
+          "type": "number"
+        },
+        "min": {
+          "type": "number"
+        },
+        "p25": {
+          "type": "number"
+        },
+        "p75": {
+          "type": "number"
+        },
+        "source": {
+          "enum": [
+            "state",
+            "national"
+          ],
+          "type": "string"
+        }
+      },
+      "required": [
+        "median",
+        "average",
+        "min",
+        "max",
+        "p25",
+        "p75",
+        "data_points",
+        "hospital_count",
+        "source"
+      ],
+      "type": "object"
+    },
+    {
+      "type": "null"
+    }
+  ]
+}
    • addedOutput schema / properties / pricing / items / properties / scope
      Added value: +{
+  "anyOf": [
+    {
+      "enum": [
+        "state",
+        "national"
+      ],
+      "type": "string"
+    },
+    {
+      "type": "null"
+    }
+  ]
+}
    • addedOutput schema / properties / pricing / items / properties / source_dates
      Added value: +{
+  "anyOf": [
+    {
+      "additionalProperties": false,
+      "properties": {
+        "earliest": {
+          "type": "string"
+        },
+        "latest": {
+          "type": "string"
+        }
+      },
+      "required": [
+        "earliest",
+        "latest"
+      ],
+      "type": "object"
+    },
+    {
+      "type": "null"
+    }
+  ],
+  "description": "Extraction dates of the underlying hospital files (YYYY-MM-DD)"
+}
    • addedOutput schema / properties / pricing / items / properties / states_covered
      Added value: +{
+  "anyOf": [
+    {
+      "type": "number"
+    },
+    {
+      "type": "null"
+    }
+  ]
+}
    • addedOutput schema / properties / pricing / items / properties / status
      Added value: +{
+  "enum": [
+    "ok",
+    "insufficient_data"
+  ],
+  "type": "string"
+}
    • changedOutput schema / properties / pricing / items / required
      Previous value: -[
-  "cpt_code",
-  "cash_price",
-  "insurance_price",
-  "confidence",
-  "cash_data_points",
-  "insurance_data_points"
-]New value: +[
+  "cpt_code",
+  "status",
+  "scope",
+  "cash_price",
+  "list_price",
+  "insurance_price",
+  "insurance_by_payer",
+  "confidence",
+  "cash_data_points",
+  "insurance_data_points",
+  "states_covered",
+  "source_dates",
+  "limitations"
+]
  2. First observed

TDQS

A4.2/5.0
Behavior5/5

Does the description disclose side effects, auth requirements, rate limits, or destructive behavior?

Annotations already cover the read-only/idempotent safety profile, yet the description adds substantial non-obvious behavior: each hospital counts once, figures are statewide/national and never local to a ZIP, the insufficient_data status handling, and the caveat that negotiated rates are not out-of-pocket costs. This is exactly the behavioral context annotations cannot carry.

Agents need to know what a tool does to the world before calling it. Descriptions should go beyond structured annotations to explain consequences.

Conciseness4/5

Is the description appropriately sized, front-loaded, and free of redundancy?

Front-loads what the tool returns before the presentation caveats, and every sentence carries a directive. It runs slightly long with several distinct guidance clauses, but none are wasted.

Shorter descriptions cost fewer tokens and are easier for agents to parse. Every sentence should earn its place.

Completeness4/5

Given the tool's complexity, does the description cover enough for an agent to succeed on first attempt?

With an output schema present, return values need no explanation, and the description adequately covers scope, the insufficient_data case, and interpretation pitfalls. The main remaining gap is that it never explicitly distinguishes itself from get_hospital_pricing/get_pricing_estimate for the agent.

Complex tools with many parameters or behaviors need more documentation. Simple tools need less. This dimension scales expectations accordingly.

Parameters4/5

Does the description clarify parameter syntax, constraints, interactions, or defaults beyond what the schema provides?

Schema coverage is 100%, so the baseline is 3, but the description adds scope semantics: results are statewide or national and never local to a ZIP, reinforcing the state vs. zip_code relationship. It doesn't expand on cpt_codes beyond the schema's example.

Input schemas describe structure but not intent. Descriptions should explain non-obvious parameter relationships and valid value ranges.

Purpose4/5

Does the description clearly state what the tool does and how it differs from similar tools?

States a specific verb and resource: it returns hospital-level market statistics (cash, list, and insurer-negotiated rates) for CPT codes, and calls itself the 'preferred benchmark pricing tool.' This differentiates it conceptually from siblings like get_hospital_pricing, though it never names an alternative explicitly.

Agents choose between tools based on descriptions. A clear purpose with a specific verb and resource helps agents select the right tool.

Usage Guidelines4/5

Does the description explain when to use this tool, when not to, or what alternatives exist?

Gives clear context for use ('preferred benchmark pricing tool') and operational directives: lead with median and p25-p75 rather than min/max, and say data is insufficient rather than estimating. It does not, however, state when to prefer this over get_pricing_estimate or get_hospital_pricing, so tool-selection exclusion is left to inference.

Agents often have multiple tools that could apply. Explicit usage guidance like "use X instead of Y when Z" prevents misuse.

All Loa Healthcare Pricing toolsInspect
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