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Hospital Negotiated Payer Prices by Billing Code
x402
Hospital Negotiated Payer Prices by Billing Code is a paid API for AI agents from data.spencermcw.com, paid per call via x402, $0.02/call, status unknown (last checked 2026-10-22).
Returns negotiated prices for a single billing code across payers and plan types in a specified US location
Price / call$0.02
Success—
StatusUnknown
How this service works
Negotiated prices for one billing code in one area, per canonical payer and plan type
Output
Returns a structured object containing the billing code metadata (type, description, DRG info if applicable), location context, applied filters, total number of payers with prices, and a list of payers with their negotiated rates broken down by plan type. Includes aggregate stats like how many hospitals have prices and how many MRF files were scanned.
Example use cases
Patient cost research before procedure
“I'm having an outpatient knee arthroscopy soon — CPT code 29881. Can you look up what commercial insurance plans typically pay for that within 30 miles of ZIP 30301?”
Healthcare analyst payer rate comparison
“Pull the negotiated rates for MS-DRG 470 (major joint replacement) near lat 40.71, lon -74.01 across all plan types — I want to see how Medicare Advantage compares to commercial plans.”
Benefits consultant benchmarking tool
“What are the typical negotiated hospital prices for HCPCS code G0439 in the outpatient setting within 50 miles of ZIP 60601, broken down by payer?”
Technical details
Endpoint
GEThttps://data.spencermcw.com/v1/hospital/payers?utm_source=zero.xyzWhen to prefer
Use this endpoint when you need payer-level negotiated price breakdowns for a specific billing code in a geographic area — especially when comparing plan types (commercial, Medicare Advantage, Medicaid, etc.) across multiple hospitals. Prefer this over the raw hospital-price endpoint when your goal is payer and plan-type aggregation rather than per-hospital posted chargemaster prices. Ideal for benefits analysis, cost benchmarking, and insurance rate research workflows.
Side effects
- Missing required 'code' query parameter returns validation error
- Invalid code format (not 3-5 alphanumeric chars) rejected by schema
- No hospitals with price data found for the given area/radius returns empty payers list
- Overly small radius with sparse data may yield zero results
- Invalid ZIP code format (non-5-digit) rejected
- Lat/lon out of valid range rejected
- Payment not fulfilled triggers 402 response before data is returned
Input
Schema · Request body
| Field | Type | Description |
|---|---|---|
| inputrequired | object | |
| output | object |
Tags
x402
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