Negotiated Rates (Paid Trial)

Negotiated Rates — New York (Paid Trial)

The benchmark dataset: tens of millions of hospital-published negotiated dollar rates spanning 150+ New York hospitals across both rate surfaces, keyed to each hospital's CMS CCN, methodology- and setting-aware. For live counts, run COUNT(DISTINCT CMS_CCN) on the table itself; the Marketplace listing carries the precise, date-stamped figures for each release.

This dataset benchmarks payer-specific negotiated dollar rates; percent-of-charges contracts surface as a compliance disclosure signal, not a benchmarkable rate — negotiated dollar amounts are unaffected.

NEGOTIATED_RATES

Each row in MARKETPLACE.NEGOTIATED_RATES carries:

Column	Meaning
CMS_CCN, HOSPITAL_NAME	The hospital, CCN-keyed for joins.
CODE, CODE_TYPE, DESCRIPTION	The procedure code (CPT, HCPCS, MS-DRG, APR-DRG, APC, NDC, …) and its description.
SETTING	Care setting (inpatient / outpatient).
NEGOTIATED_RATE	The negotiated dollar amount, as published by the hospital.
NEGOTIATED_TYPE	Contract methodology as the hospital published it: case rate, per diem, fee schedule, … NULL means the source published no methodology cell.
RATE_TYPE	Rate basis — filter on 'negotiated_dollar' for dollar benchmarking.
PAYER_NAME, PLAN_NAME	The payer and plan exactly as the hospital reported them. Present on every row.
PAYER_CANONICAL, PAYER_LINE_OF_BUSINESS	Canonical parent payer and line-of-business tag (commercial / medicare_adv / medicaid / behavioral), where mapped.
AUDIT_FLAG	Additive data-quality annotation — see below.

Payer canonicalization

We ship a canonical payer key plus a line-of-business tag that collapses hospital-reported payer-name variants for New York's major payers into a single parent entity — so a commercial Aetna cross-hospital spread doesn't quietly absorb Aetna Medicaid or Medicare Advantage.

About two-thirds of negotiated-dollar rows are mapped to a canonical parent payer; the remainder retain their hospital-reported PAYER_NAME — present on every row — so the long tail of smaller and out-of-state payers is always matchable. Nothing is dropped: every row is either mapped to a parent or carries its source payer name. We extend the canonical map as we add hospitals.

AUDIT_FLAG

Every row carries an additive AUDIT_FLAG column: we never alter or remove a published value, but where a hospital's file shows a detectable constant-value pattern, we say so on the row. It has exactly two values — CONSTANT_VALUE_FILL (an evidence-backed verdict that the value is a source-side fill) and CONSTANT_RATE_PLATEAU (a neutral structural observation, consistent with real blanket, case-rate, or tiered-export arrangements) — or NULL, meaning no pattern was detected. You choose the filter; we don't choose for you.

The full definitions and both filter recipes are on the Data Quality Methodology page.

STANDARD_CHARGES

MARKETPLACE.STANDARD_CHARGES carries the four CMS-required standard charges per service item: gross, discounted cash, and the de-identified minimum and maximum. Joined to negotiated rates, it answers questions like "where does the negotiated rate sit relative to the cash price?"

COMPLIANCE_VIOLATIONS

MARKETPLACE.COMPLIANCE_VIOLATIONS carries row-level findings from our CMS-transparency checker where it has run: violation code, severity, the field path in the hospital's file, the CMS regulation section, and resolution status.

Read it carefully: an absent hospital means "not yet examined," never "clean." STANDARD_CHARGES.HAS_COMPLIANCE_CHECK = FALSE is the explicit "not yet examined" flag, and the absence of recorded violations is not a certification of compliance.

Worked examples

Eight hero queries — single-hospital lookup through market percentiles, cash spreads, compliance, and freshness — are on the Example Queries page, smoke-tested live on 2026-06-11.