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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
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)
cbsa_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
validated_subpackagebooleanSub-package's base code (facility, or professional if an Imaging Center) has a plausible negotiated rate (> 1)
pricedecimal(21,3)Line-item price (negotiated_rate × average_units × anesthesia_unit_conversion); NULL for non-base-code facility lines
allocationdecimal(21,3)Share (0-1) of the case rate attributed to this facility line item, based on its relative cost vs. other billing codes in the sub-package; renormalized within each payer/network/provider/sub-package so allocations always sum to 1. Always 1 for professional rows.
allocated_pricedecimal(21,3)Case rate × allocation for facility line items, so SUM(allocated_price) across a sub-package's facility lines equals the case rate. NULL for professional rows — use price instead.