# Hospital Negotiated Payer Prices by Billing Code

> 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

## Facts

- Endpoint: GET https://data.spencermcw.com/v1/hospital/payers?utm_source=zero.xyz
- Price: $0.02/call
- Payment: x402
- Status: unknown
- Last checked: 2026-10-22
- Activations on Zero: 0
- Tags: x402
- Canonical page: https://www.zero.xyz/c/hospital-negotiated-payer-prices-by-billing-code-1536c2d6
- Structured record (JSON): https://api.zero.xyz/v1/capabilities/cap_wTY2n41z106HMzihEtPgE

Status and success rate cover calls made through Zero and Zero's own probes. Third-party monitors may report differently.

## How to call it through Zero

Zero handles the 402 payment challenge and records the run. With the Zero CLI installed (`npm i -g @zeroxyz/cli`):

```sh
zero fetch --capability hospital-negotiated-payer-prices-by-billing-code-1536c2d6
```

Example prompt: What do different insurance plan types negotiate for CPT code 99213 within 25 miles of ZIP 90210? Show me commercial, Medicare Advantage, and Medicaid rates.

## When to prefer this

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.

## Known failure modes

- 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

## 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.

## Request schema (JSON Schema)

```json
{
 "type": "object",
 "$schema": "https://json-schema.org/draft/2020-12/schema",
 "required": [
  "input"
 ],
 "properties": {
  "input": {
   "type": "object",
   "required": [
    "type",
    "method"
   ],
   "properties": {
    "type": {
     "type": "string",
     "const": "http"
    },
    "method": {
     "enum": [
      "GET"
     ],
     "type": "string"
    },
    "queryParams": {
     "type": "object",
     "required": [
      "code"
     ],
     "properties": {
      "lat": {
       "type": "number",
       "maximum": 90,
       "minimum": -90
      },
      "lon": {
       "type": "number",
       "maximum": 180,
       "minimum": -180
      },
      "zip": {
       "type": "string",
       "pattern": "^\\d{5}$"
      },
      "code": {
       "type": "string",
       "pattern": "^[0-9A-Za-z]{3,5}$"
      },
      "setting": {
       "enum": [
        "inpatient",
        "outpatient"
       ],
       "type": "string"
      },
      "code_type": {
       "enum": [
        "CPT",
        "HCPCS",
        "MS-DRG"
       ],
       "type": "string"
      },
      "plan_type": {
       "enum": [
        "commercial",
        "medicare_advantage",
        "medicaid",
        "medicare",
        "exchange",
        "tricare",
        "va",
        "workers_comp",
        "auto",
        "supplemental",
        "other",
        "unspecified"
       ],
       "type": "string"
      },
      "radius_miles": {
       "type": "number",
       "maximum": 100,
       "exclusiveMinimum": 0
      }
     }
    }
   },
   "additionalProperties": false
  },
  "output": {
   "type": "object",
   "required": [
    "type"
   ],
   "properties": {
    "type": {
     "type": "string"
    },
    "example": {
     "type": "object",
     "properties": {
      "data": {
       "type": "object",
       "required": [
        "code",
        "location",
        "filters",
        "hospitals_with_prices",
        "payers_total",
        "payers"
       ],
       "properties": {
        "code": {
         "type": "object",
         "required": [
          "type",
          "code",
          "description",
          "description_source",
          "drg",
          "mrfs_statewide"
         ],
         "properties": {
          "drg": {
           "anyOf": [
            {
             "type": "object",
             "required": [
              "mdc",
              "kind",
              "weight",
              "gmlos",
              "amlos"
             ],
             "properti
… (truncated)
```

## More

- Live health (JSON, refreshed every minute): https://www.zero.xyz/c/hospital-negotiated-payer-prices-by-billing-code-1536c2d6/health.json
- [Zero catalog index](https://www.zero.xyz/llms.txt)
- [Other services from data.spencermcw.com](https://www.zero.xyz/host/data.spencermcw.com/llms.txt)