Compare one billing code's prices across hospitals
compare_code_pricesCompare negotiated rates for a medical billing code across hospitals. Returns min, quartiles, and max per payer plan with source file citations, and lists hospitals that don't publish the code.
Instructions
Negotiated-rate summary (min, quartiles, max over payer plans) for one billing code at each hospital in the release, for one rate basis, with the hospital's source file cited on every row. Hospitals that publish the code differently are listed in not_included with what they do publish.
Input Schema
| Name | Required | Description | Default |
|---|---|---|---|
| code | Yes | Billing code as published, e.g. CPT 99213, HCPCS J1885, MS-DRG 470. Use find_codes to get one. | |
| setting | No | Restrict to one care setting. Omit to get every setting, one row per hospital and setting. | |
| rate_basis | No | How the negotiated rate was published. 'dollar' = contracted dollar amount; 'dollar_from_percent' = a percentage of the hospital's own charge, converted to dollars; 'dollar_percent_unreconciled' = a dollar and a percentage that disagree (the dollar is used); 'algorithm_only', 'percent_only' and 'no_payer' carry no dollar rate. Compare hospitals on 'dollar' unless asked otherwise. | dollar |
| code_family | No | Only needed if the code string exists in more than one code family (the tool says so). |
Output Schema
| Name | Required | Description | Default |
|---|---|---|---|
| code | Yes | ||
| notes | Yes | ||
| prices | Yes | One row per hospital × setting. Never averaged or summed across rows. | |
| setting | Yes | The setting filter applied, or null for all settings | |
| rate_basis | Yes | ||
| code_family | Yes | ||
| release_tag | Yes | ||
| not_included | Yes | Hospitals with no row under this rate basis and setting, and what they publish instead |