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Pricing Service Rates

ColumnTypeDefinition
network_provider_sub_package_idbigintID representing distinct combination of Network Provider and Sub Package
network_provider_ssp_idbigintID representing distinct combination of Network Provider and SSP
idbigint
roidbigintRate Object ID to connect to Clear Rates
ssp_idvarchar
ssp_namevarchar
sub_package_idvarchar
payer_idvarchar
payer_namevarchar
network_idbigint
network_namevarchar
provider_idvarchar
provider_typevarchar
statevarchar
cbsavarchar
cbsa_namevarchar
fee_typevarcharprofessional or facility
is_package_base_codeinteger1 if this billing code is the base code for the sub-package, 0 otherwise
billing_codevarchar
billing_code_typevarchar
average_unitsdecimal(21,3)Average units for this billing code from SSP data
anesthesia_unit_conversiondecimal(21,3)Unit conversion factor for anesthesia codes (0.067 for anesthesia, 1 otherwise)
billing_code_descriptionvarchar
validated_ratebooleanRate has canonical_rate_score = 5
validated_prof_fee_rateboolean
claims_validated_rateboolean
commercial_validated_reimbursement_rateboolean
commercial_validated_cash_rateboolean
state_avg_negotiated_rate_usedbooleanGeographic backfill was used for negotiated rate
state_avg_discounted_cash_rate_usedbooleanGeographic backfill was used for cash rate
negotiated_ratedecimal(21,3)
discounted_cash_ratedecimal(21,3)
state_avg_medicare_ratedecimal(21,3)
lower_bounddecimal(21,3)Clear Rates outlier bound
upper_bounddecimal(21,3)Clear Rates outlier bound
contract_methodologyvarchar
gross_chargedecimal(21,3)
sourcevarcharhospital, payer, or imputation
hosp_payer_idintegerLegacy Hospital MRF payer ID
plan_aliasvarcharNetwork Name Representation on Consumer App
validated_subpackagebooleanSub-package has at least one validated base code
pricedecimal(21,3)Line-item price (negotiated_rate × average_units × anesthesia_unit_conversion)
allocationdecimal(21,3)Allocation factor for non-base facility codes (for cost share)
allocated_pricedecimal(21,3)Price after allocation factor applied