clear-pricer-mcp

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Negotiated rates for one code at one hospital, by payer and plan

get_payer_rates

Read-onlyIdempotent

Retrieve every published payer, plan, setting, and negotiated rate for a billing code at a selected hospital, plus gross and cash prices.

Instructions

Every published charge for one billing code at one hospital: payer, plan, setting, negotiated rate (or the percentage/algorithm when no dollar figure is published), gross and cash price, with the charge's position in the hospital's source file. The first call downloads the 117 MB charge table once.

Input Schema

TableJSON Schema

Name	Required	Description
`code`	Yes	Billing code as published, e.g. 99213. Use find_codes to get one.
`limit`	No
`payer`	No	Case-insensitive match on payer name, e.g. 'aetna', 'blue cross'
`setting`	No
`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. Omit for every basis (each row is labelled).
`hospital_id`	Yes	nm = Northwestern Memorial Hospital, rush = RUSH University Medical Center, uchicago = The University of Chicago Medical Center

Output Schema

TableJSON Schema

Name	Required	Description
`code`	Yes
`notes`	Yes
`rates`	Yes
`returned`	Yes
`truncated`	Yes
`code_family`	Yes
`hospital_id`	Yes
`release_tag`	Yes
`matched_charges`	Yes	Distinct charge rows matching every filter
`by_setting_and_basis`	Yes	Distinct charges per setting × rate basis before the payer filter and limit; equals compare_code_prices' charge_rows

Schema Changelog

Changes observed during successful MCP inspections.

First observedv0.1.0Oct 7, 2026

TDQS

A3.8/5.0

Behavior4/5

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

Annotations already establish read-only, idempotent, closed-world behavior. The description adds genuinely new operational context: the first call downloads a 117 MB charge table once, and rows without a published dollar figure fall back to percentage/algorithm values. That first-call cost disclosure is exactly the kind of trait annotations cannot convey.

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

Conciseness5/5

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

Two sentences, both earning their place: the first defines the payload and scope, the second front-loads the one-time download cost. No filler and no repetition of the title.

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, the description need not spell out return values, and it complements the annotations with the download-cost note. Minor gaps remain around pagination/default limit behavior, but nothing essential to correct invocation is missing.

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 67%, so the schema already documents code, payer, rate_basis and hospital_id well. The description reinforces the rate-basis concept and the payer/plan/setting fields but says nothing about limit or result ordering, leaving part of the parameter space undocumented.

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?

The description names a specific resource and scope: every published charge for one billing code at one hospital, enumerating the returned fields (payer, plan, setting, negotiated rate, gross/cash price). It clearly reads as a single-code lookup, though it never explicitly distinguishes itself from the sibling compare_code_prices.

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

Usage Guidelines3/5

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

Usage is implied by the scope statement (one code, one hospital), but there is no explicit when-to-use, when-not-to-use, or named alternative. The find_codes routing hint lives only in the schema for the code parameter, not in the description.

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

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