Loa Healthcare Pricing

Pricing Estimate

get_pricing_estimate

Read-onlyIdempotent

U.S. care only, for users anywhere. For non-U.S. care, explain coverage without calling this tool or substituting U.S. prices. Estimate median cash prices and typical ranges (25th–75th percentile) for CPT codes, statewide by ZIP or nationally. Report missingCodes and insufficient_data without inventing prices; totals require data for every code. Use get_market_pricing for insurer benchmarks or get_hospital_pricing for named hospitals.

Input Schema

Name	Required	Description	Default
`zip_code`	No	U.S. ZIP code used to pick the state (omit only for U.S. national figures)
`procedure_codes`	Yes	CPT procedure codes to price (e.g. ["99213", "85025"])

Output Schema

Name	Required	Description	Default
`state`	Yes
`zipCode`	Yes
`disclaimer`	Yes
`procedures`	Yes
`provenance`	Yes
`limitations`	Yes
`missingCodes`	Yes
`estimatedCost`	Yes

Schema Changelog

Changes observed during successful MCP inspections.

Changed2 schema fields changedOct 29, 2026

changedInput schema / properties / zip_code / description

Previous value: -"ZIP code used to pick the state (omit for national figures)"New value: +"U.S. ZIP code used to pick the state (omit only for U.S. national figures)"

addedOutput schema / properties / provenance / properties / source_url / description

Added value: +"Supporting source link. A CMS Hospital Price Transparency policy page is not the hospital source file; do not attribute hospital-published prices to CMS."

Changed21 schema fields changedSep 28, 2026

changedInput schema / properties / zip_code / description

Previous value: -"ZIP code for regional pricing (defaults to national average)"New value: +"ZIP code used to pick the state (omit for national figures)"

removedOutput schema / properties / containsHeuristicEstimates
```
Removed value: -{
-  "type": "boolean"
-}
```

addedOutput schema / properties / estimatedCost / anyOf

Added value: +[
+  {
+    "type": "number"
+  },
+  {
+    "type": "null"
+  }
+]

removedOutput schema / properties / estimatedCost / type
```
Removed value: -"number"
```

addedOutput schema / properties / limitations

Added value: +{
+  "items": {
+    "type": "string"
+  },
+  "type": "array"
+}

addedOutput schema / properties / missingCodes

Added value: +{
+  "items": {
+    "type": "string"
+  },
+  "type": "array"
+}

addedOutput schema / properties / procedures / items / properties / estimatedCost / anyOf
```
Added value: +[
+  {
+    "type": "number"
+  },
+  {
+    "type": "null"
+  }
+]
```
removedOutput schema / properties / procedures / items / properties / estimatedCost / type
```
Removed value: -"number"
```

addedOutput schema / properties / procedures / items / properties / hospital_count

Added value: +{
+  "anyOf": [
+    {
+      "type": "number"
+    },
+    {
+      "type": "null"
+    }
+  ]
+}

removedOutput schema / properties / procedures / items / properties / priceRange / additionalProperties
```
Removed value: -false
```

addedOutput schema / properties / procedures / items / properties / priceRange / anyOf

Added value: +[
+  {
+    "additionalProperties": false,
+    "properties": {
+      "max": {
+        "type": "number"
+      },
+      "min": {
+        "type": "number"
+      }
+    },
+    "required": [
+      "min",
+      "max"
+    ],
+    "type": "object"
+  },
+  {
+    "type": "null"
+  }
+]

removedOutput schema / properties / procedures / items / properties / priceRange / properties

Removed value: -{
-  "max": {
-    "type": "number"
-  },
-  "min": {
-    "type": "number"
-  }
-}

removedOutput schema / properties / procedures / items / properties / priceRange / required
```
Removed value: -[
-  "min",
-  "max"
-]
```
removedOutput schema / properties / procedures / items / properties / priceRange / type
```
Removed value: -"object"
```

changedOutput schema / properties / procedures / items / properties / pricingMethod / enum

Previous value: -[
-  "observed_market_median",
-  "heuristic_cpt_range"
-]New value: +[
+  "observed_market_median",
+  "insufficient_data"
+]

addedOutput schema / properties / procedures / items / properties / scope

Added value: +{
+  "anyOf": [
+    {
+      "enum": [
+        "state",
+        "national"
+      ],
+      "type": "string"
+    },
+    {
+      "type": "null"
+    }
+  ]
+}

changedOutput schema / properties / procedures / items / required

Previous value: -[
-  "code",
-  "description",
-  "estimatedCost",
-  "priceRange",
-  "pricingMethod",
-  "data_points"
-]New value: +[
+  "code",
+  "description",
+  "estimatedCost",
+  "priceRange",
+  "pricingMethod",
+  "scope",
+  "data_points",
+  "hospital_count"
+]

addedOutput schema / properties / state

Added value: +{
+  "anyOf": [
+    {
+      "type": "string"
+    },
+    {
+      "type": "null"
+    }
+  ]
+}

addedOutput schema / properties / zipCode / anyOf

Added value: +[
+  {
+    "type": "string"
+  },
+  {
+    "type": "null"
+  }
+]

removedOutput schema / properties / zipCode / type
```
Removed value: -"string"
```

changedOutput schema / required

Previous value: -[
-  "estimatedCost",
-  "procedures",
-  "zipCode",
-  "containsHeuristicEstimates",
-  "provenance",
-  "disclaimer"
-]New value: +[
+  "estimatedCost",
+  "procedures",
+  "zipCode",
+  "state",
+  "missingCodes",
+  "limitations",
+  "provenance",
+  "disclaimer"
+]

First observedJul 27, 2026

TDQS

A4.6/5.0

Behavior5/5

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

Annotations already cover the safety profile (readOnly, idempotent, non-destructive), yet the description adds real behavioral context: surface missingCodes and insufficient_data rather than inventing prices, and totals require data for every code. That is failure-mode guidance an agent cannot get from the structured fields.

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?

Dense and front-loaded: the geographic restriction leads, then capability, then integrity rules, then alternatives. Slightly packed with four distinct concerns in five sentences, but every sentence carries operational weight.

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

Completeness5/5

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

An output schema exists, so return values need no explanation. Given that, the description covers scope limits, fallback behavior for unsupported regions, data-integrity handling, and sibling routing — everything needed to call it correctly.

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

Parameters3/5

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

Schema coverage is 100%, so both parameters are already documented, including that ZIP selects the state and that codes are CPT with a 10-item cap. The description's "statewide by ZIP or nationally" largely restates the schema rather than adding format or edge-case detail, so baseline 3 applies.

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

Purpose5/5

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

States a specific verb and resource: "Estimate median cash prices and typical ranges (25th–75th percentile) for CPT codes, statewide by ZIP or nationally." It also names the exact siblings it is not (get_market_pricing, get_hospital_pricing), so an agent can route without opening any schema.

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

Usage Guidelines5/5

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

Gives explicit when-to-use and when-not-to-use rules: U.S. care only, and for non-U.S. care the agent should explain coverage without calling the tool or substituting U.S. prices. It also names two concrete alternatives with the condition that selects each.

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 tools Inspect

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