Documentation Index
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Overview
These examples demonstrate common analytical patterns using the February 2026 hospital release. All queries use the providers, rates, and V_PROVIDER_RATES view.
Setup
USE DATABASE PRICEMEDIC_CORE_HOSPITAL_HS;
USE SCHEMA SNAPSHOT_FEB_2026;
Example Queries
Identify the largest hospital systems by provider count and payer coverage.
SELECT
imputed_ein_name,
COUNT(DISTINCT npi_number) AS hospitals,
COUNT(DISTINCT payer_slug) AS payers,
COUNT(DISTINCT network_slug) AS networks,
COUNT(DISTINCT schedule_id) AS schedules
FROM providers
GROUP BY imputed_ein_name
ORDER BY hospitals DESC;
Sample Output:
| IMPUTED_EIN_NAME | HOSPITALS | PAYERS | NETWORKS | SCHEDULES |
|---|
| PRISMA HEALTH-UPSTATE | 74 | 4 | 4 | 38 |
| NEW YORK CITY HEALTH AND HOSPITALS CORPORATION | 69 | 4 | 4 | 82 |
| UNIVERSITY OF CALIFORNIA SAN FRANCISCO MEDICAL CENTER | 68 | 5 | 5 | 31 |
| CATHOLIC HEALTH INITIATIVES COLORADO | 42 | 5 | 5 | 39 |
Use Case: Market intelligence on which health systems have the widest footprint and payer relationships.
2. Payer Coverage Analysis
Analyze provider footprint by payer to understand market coverage.
SELECT
payer_slug,
COUNT(DISTINCT npi_number) AS npis,
COUNT(DISTINCT imputed_ein) AS hospital_systems,
COUNT(DISTINCT schedule_id) AS schedules
FROM providers
GROUP BY payer_slug
ORDER BY npis DESC;
Sample Output:
| PAYER_SLUG | NPIS | HOSPITAL_SYSTEMS | SCHEDULES |
|---|
| uhc | 10,033 | 4,902 | 6,956 |
| aetna | 8,142 | 5,300 | 9,070 |
| cigna | 6,263 | 4,266 | 3,610 |
| anthem_bcbs_in | 993 | 657 | 994 |
| bcbs_tx | 684 | 482 | 517 |
Use Case: Identify which payers have the broadest provider networks and most comprehensive transparency data.
3. Procedure Rate Benchmarking
Compare institutional rates for knee replacement (CPT 27447) across states.
SELECT
npi_state,
COUNT(DISTINCT imputed_ein) as n_eins,
COUNT(*) AS n_observations,
ROUND(APPROX_PERCENTILE(negotiated_rate, 0.25), 0) AS p25_rate,
ROUND(APPROX_PERCENTILE(negotiated_rate, 0.50), 0) AS median_rate,
ROUND(APPROX_PERCENTILE(negotiated_rate, 0.75), 0) AS p75_rate
FROM V_PROVIDER_RATES
WHERE billing_code = '27447'
AND billing_class = 'institutional'
AND negotiated_rate > 100
AND negotiated_type != 'percentage'
AND npi_taxonomy_code LIKE '282N%' -- General Acute Care Hospitals
GROUP BY npi_state
HAVING COUNT(*) >= 5
ORDER BY npi_state DESC;
Sample Output:
| NPI_STATE | N_EINS | N_OBSERVATIONS | P25_RATE | MEDIAN_RATE | P75_RATE |
|---|
| WY | 16 | 224 | 9,104 | 11,187 | 28,493 |
| WV | 41 | 1,724 | 10,005 | 20,326 | 27,729 |
| WI | 83 | 2,648 | 13,200 | 17,239 | 22,764 |
| WA | 55 | 1,818 | 8,618 | 21,959 | 52,252 |
| VT | 5 | 10 | 14,228 | 16,640 | 17,148 |
| VA | 62 | 3,230 | 8,420 | 17,009 | 26,911 |
| UT | 23 | 1,216 | 6,795 | 23,998 | 32,594 |
| TX | 331 | 11,624 | 4,480 | 8,674 | 14,522 |
| TN | 87 | 2,776 | 4,739 | 7,660 | 12,857 |
| SD | 20 | 676 | 10,020 | 13,194 | 18,147 |
| SC | 41 | 8,602 | 9,584 | 18,429 | 29,224 |
| RI | 10 | 186 | 4,505 | 6,768 | 15,150 |
Use Case: Rate benchmarking - understand regional pricing variations and market positioning.
Extract complete fee schedules for a specific provider-payer combination.
SELECT DISTINCT
payer_slug,
network_slug,
billing_code,
billing_code_modifier,
negotiated_rate,
negotiated_type
FROM V_PROVIDER_RATES
WHERE imputed_ein = '390813418' -- Mayo Clinic Arizona EIN
AND payer_slug = 'uhc'
ORDER BY billing_code
Sample Output:
| PAYER_SLUG | NETWORK_SLUG | NEGOTIATED_RATE | NEGOTIATED_TYPE | BILLING_CODE | BILLING_CODE_MODIFIER |
|---|
| aetna | aetna_exchange_aetna_ppo | 0 | fee schedule | 99202 | [“55”] |
| aetna | aetna_exchange_aetna_ppo | 56 | fee schedule | 99202 | null |
| aetna | aetna_exchange_aetna_ppo | 0 | fee schedule | 99202 | [“52”] |
| aetna | aetna_exchange_aetna_ppo | 0 | fee schedule | 99202 | [“56”] |
| aetna | aetna_exchange_aetna_ppo | 43 | fee schedule | 99202 | null |
| aetna | aetna_exchange_aetna_ppo | 32 | fee schedule | 99202 | null |
| aetna | aetna_exchange_aetna_ppo | 37 | fee schedule | 99202 | null |
| aetna | aetna_exchange_aetna_ppo | 66 | fee schedule | 99202 | null |
| aetna | aetna_exchange_aetna_ppo | 50 | fee schedule | 99202 | null |
| aetna | aetna_exchange_aetna_ppo | 88 | fee schedule | 99203 | null |
Use Case: Quickly pull complete fee schedules to verify negotiated rates.
Tips for Working with PriceMedic Core
- Filter by
negotiated_type: Exclude 'percentage' rates when calculating dollar amount statistics
- Use taxonomy codes: Filter to specific facility types using
npi_taxonomy_code (e.g., 282N% for hospitals)
- Leverage the view: Use
V_PROVIDER_RATES to avoid manual joins between providers and rates
- Watch for outliers: Apply reasonable min/max filters on
negotiated_rate to exclude data errors