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PricePlain Hospital Price Lookup
x402
PricePlain Hospital Price Lookup is a paid API for AI agents from priceplain.onrender.com, paid per call via x402, $0.02/call, status unknown (last checked 2026-10-29).
Returns cleaned, CMS-compliant US hospital price data (cash, gross, and payer-negotiated rates) for a given CPT/DRG code and hospital, with provenance and data-quality flags
Price / call$0.02
Success—
StatusUnknown
How this service works
Three x402-paid data APIs on one host. PricePlain: Posted US hospital prices (CMS price-transparency files), cleaned: Twin Cities, MN first. Cash and payer-negotiated rates per CPT/DRG code with canonical insurer names, provenance (source file URL + date) and data-quality flags. Posted prices, not quotes. TableGrab: public URL or file -> typed JSON tables / Markdown. City Table Clean: Socrata/CKAN city CSV cleaner with a per-change log.
Output
A JSON object containing the procedure label, a summary row with gross charge, cash price, and min/median/max negotiated rates, detailed per-payer rate rows (negotiated dollar, plan type, algorithm, methodology, and deidentified stats), payer canonical name, data-quality flags, and full source provenance (MRF URL, last_updated_on, CMS HPT file URL).
Example use cases
Comparing insurer rates for outpatient imaging
“What is the negotiated rate that HealthPartners pays for an MRI brain (CPT 70553) at Regions Hospital in the Twin Cities — and what's the cash price if I pay out of pocket?”
Shopping for cheapest knee replacement DRG
“I need to know the cash price and payer-negotiated rates for MS-DRG 470 (knee replacement) at Abbott Northwestern Hospital in Minnesota — pull it from the CMS price transparency data.”
Checking UHC negotiated rate for a colonoscopy
“What does UnitedHealthcare negotiate for CPT 45378 (colonoscopy) at UMMC in the Twin Cities — show me the negotiated dollar amount, plan type, and where the data comes from.”
Technical details
Endpoint
GEThttps://priceplain.onrender.com/v1/price?utm_source=zero.xyzWhen to prefer
Use this endpoint when you need structured, cleaned, canonical hospital price data for a specific CPT or DRG code at a named Twin Cities hospital, especially when you need payer-specific negotiated rates with provenance. Prefer this over raw CMS MRF downloads when you want pre-cleaned, canonicalized insurer names, data-quality flags, and JSON-ready output without parsing multi-gigabyte CSV files yourself.
Side effects
- Hospital ID or CPT/DRG code not yet indexed — returns empty rows or 404
- Payer filter matches no rows for the requested hospital/code combination
- Code format incorrect (e.g. DRG not prefixed with 'DRG') — returns no results
- Hospital is outside currently indexed region (only Twin Cities/MN at launch)
- x402 payment failure — call blocked if USDC payment not sent
- Rate data truncated if hospital MRF has excessive plan rows (rates_truncated: true)
Input
Schema · Request body
| Field | Type | Description |
|---|---|---|
| inputrequired | object | |
| output | object |
Output
Schema · Response
{
"type": "json",
"example": {
"code": {
"code": "70553",
"label": "MRI brain without and with contrast",
"code_type": "CPT"
},
"rows": [
{
"cash": 912,
"flags": [],
"gross": 1900,
"rates": [
{
"count": "0",
"flags": [],
"p10_paid": null,
"p90_paid": null,
"payer_id": "bcbs-mn",
"algorithm": "Procedure Lookup: Procedure Code Tables: [[BC Commodities Fee Schedule]] 43.76% of Table Per Unit Multipliers: 100.00% Sort By: Allowed Amount Conditions: Process Daily: N Do not limit reimbursement When duplicate code found in Procedure Co",
"plan_type": "medicaid_managed_care",
"median_paid": null,
"methodology": "other",
"plan_name_raw": "BC PMAP (AMU)",
"payer_name_raw": "Blue Cross Blue Shield of Minnesota",
"negotiated_dollar": 370.38,
"negotiated_percent_of_charges": null
},
{
"count": "0",
"flags": [],
"p10_paid": null,
"p90_paid": null,
"payer_id": "bcbs-mn",
"algorithm": "Procedure Lookup: Procedure Code Tables: [[BC Commodities Fee Schedule]] 98.53% of Table Per Unit Multipliers: 100.00% Sort By: Allowed Amount Conditions: Process Daily: N Do not limit reimbursement When duplicate code found in Procedure Co",
"plan_type": "commercial",
"median_paid": null,
"methodology": "other",
"plan_name_raw": "BC State Health Plan (A)",
"payer_name_raw": "Blue Cross Blue Shield of Minnesota",
"negotiated_dollar": 833.94,
"negotiated_percent_of_charges": null
}
],
"setting": "outpatient",
"modifiers": null,
"description": "HCHG RAD MRI HEAD BRAIN WWO",
"other_codes": "CDM:116619;RC:610",
"billing_class": "facility",
"rates_truncated": false,
"deidentified_max": 1869,
"deidentified_min": 325.21
}
],
"payer": {
"name": "Blue Cross and Blue Shield of Minnesota (incl. Blue Plus)",
"payer_id": "bcbs-mn"
},
"source": {
"note": null,
"mrf_url": "https://www.allinahealth.org/-/media/allina-health/files/customer-service/billing-and-insurance/price-transparency/363261413_abbott-northwestern-hospital_standardcharges.csv",
"cms_hpt_txt": "https://www.allinahealth.org/cms-hpt.txt",
"hospital_id": "abbott",
"listed_mrf_url": null,
"last_updated_on": "2026-06-16",
"source_page_url": "https://www.allinahealth.org/customer-service/billing-and-insurance",
"template_version": "3.0.0",
"http_last_modified": "Wed, 24 Jun 2026 13:53:28 GMT"
},
"summary": {
"cash": 912,
"city": "Minneapolis",
"flags": [],
"gross": 1900,
"source": {
"note": null,
"mrf_url": "https://www.allinahealth.org/-/media/allina-health/files/customer-service/billing-and-insurance/price-transparency/363261413_abbott-northwestern-hospital_standardcharges.csv",
"cms_hpt_txt": "https://www.allinahealth.org/cms-hpt.txt",
"hospital_id": "abbott",
"listed_mrf_url": null,
"last_updated_on": "2026-06-16",
"source_page_url": "https://www.allinahealth.org/customer-service/billing-and-insurance",
"template_version": "3.0.0",
"http_last_modified": "Wed, 24 Jun 2026 13:53:28 GMT"
},
"hospital": "Abbott Northwestern Hospital",
"rows_used": 2,
"hospital_id": "abbott",
"row_selection": "facility, outpatient/both settings",
"negotiated_max": 1201.56,
"negotiated_min": 370.38,
"deidentified_max": 1869,
"deidentified_min": 325.21,
"rate_flag_counts": {},
"negotiated_median": 885.14,
"algorithm_only_rates": 0,
"cash_row_description": "HCHG RAD MRI HEAD BRAIN WWO",
"cash_values_all_rows": [
912
],
"negotiated_dollar_rates": 7,
"percent_of_charges_only_rates": 0
},
"disclaimer": "These are prices hospitals posted in their federally required machine-readable files (45 CFR 180), not quotes or estimates of what you will pay. Your cost depends on your plan, deductible, the services actually billed, and professional fees billed separately. Confirm with the hospital and your insurer."
}
}Tags
x402
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