Release Summary
- 2.26 billion negotiated rates
- 407,975 provider records
- 6,533 unique hospital and health system EINs
- 60 payers and their widest networks
Covered Hospital and Health Systems
- Includes 6,533 unique hospital and health system EINs
- Covers 12,602 total hospital NPIs
- Represents acute care, psychiatric, rehabilitation, and military hospitals
- Includes both single-facility hospitals and multi-facility health systems
Covered Payors and Networks
- Includes 60 payors and their widest networks
| # | Payer Name | Network Name | Covered EINs | TIC v2 |
|---|---|---|---|---|
| 1 | Aetna | Aetna Exchange - Aetna PPO | 5,874 | ✓ |
| 2 | Anthem BC California | Blue Cross of California PAR providers | 552 | ✓ |
| 3 | Anthem BCBS Central States | Blue Traditional | 856 | ✓ |
| 4 | Anthem BCBS Colorado | BluePreferred PPO | 113 | ✓ |
| 5 | Anthem BCBS Connecticut | Century Preferred | 76 | ✓ |
| 6 | Anthem BCBS Georgia | BCBS Georgia PAR providers | 291 | ✓ |
| 7 | Anthem BCBS Kentucky | Anthem BCBS Blue High Performance | 142 | ✓ |
| 8 | Anthem BCBS Maine | Anthem Main Blue Choice | 71 | ✓ |
| 9 | Anthem BCBS Missouri | Blue Access Choice | 192 | ✓ |
| 10 | Anthem BCBS Nevada | Anthem Nevada BluePreferred | 66 | ✓ |
| 11 | Anthem BCBS New Hampshire | Anthem BCBS - Preferred Blue | 89 | ✓ |
| 12 | Anthem BCBS Ohio | Participating Providers | 140 | ✓ |
| 13 | Anthem BCBS Virginia | Anthem KeyCare PPO | 178 | ✓ |
| 14 | Anthem BCBS Wisconsin | Blue Preferred POS | 237 | ✓ |
| 15 | Arkansas BCBS | True Blue PPO | 125 | ✓ |
| 16 | BCBS of Mississippi | BCBS Mississippi - PAR Network | 128 | ✓ |
| 17 | BCBS of Rhode Island | Classic Blue | 32 | ✓ |
| 18 | BCBS Of Arizona | Blue Preferred | 114 | |
| 19 | BCBS of Massachusetts | BCBS Massachusetts Blue Care Elect | 568 | ✓ |
| 20 | BCBS of Michigan | TRUST | 452 | ✓ |
| 21 | BCBS of Nebraska | Network BLUE | 120 | |
| 22 | BCBS of North Dakota | Traditional | 70 | ✓ |
| 23 | BCBS of Wyoming | BCBS Wyoming - PAR Network | 57 | ✓ |
| 24 | BCBS of Alabama | BCBS Alabama - PAR Network | 138 | |
| 25 | BCBS of Hawaii | Preferred Provider Network | 62 | ✓ |
| 26 | BCBS of Illinois | BCBS Illinois - Participating Provider Option | 306 | ✓ |
| 27 | BCBS of Kansas | BCBS Kansas Blue Choice | 154 | ✓ |
| 28 | BCBS of Kansas City | Preferred Care PPO | 54 | ✓ |
| 29 | BCBS of Louisiana | BCBS Louisiana Blue High Performance | 198 | ✓ |
| 30 | BCBS of Minnesota | BCBS Minnesota Aware | 162 | |
| 31 | BCBS of Montana | BCBS Montana - PAR Network | 76 | ✓ |
| 32 | BCBS of New Mexico | New Mexico Par Network | 64 | ✓ |
| 33 | BCBS of North Carolina | Preferred Provider Network (PPN) | 1,328 | ✓ |
| 34 | BCBS of Oklahoma | Blue Traditional | 155 | ✓ |
| 35 | BCBS of Texas | PAR Network (Preview) | 528 | ✓ |
| 36 | BCBS of Vermont | BCBS Vermont - PAR providers | 32 | ✓ |
| 37 | BC of Idaho | BC Idaho - Preferred Blue | 86 | ✓ |
| 38 | BS of California | BS California - PPO Network | 304 | ✓ |
| 39 | BCBS of Puerto Rico | Triple S - PAR Network | 63 | ✓ |
| 40 | BCBS of South Carolina | PAR providers | 90 | ✓ |
| 41 | Capital BC | Capital Blue Cross Traditional | 687 | |
| 42 | CareFirst BCBS | CareFirst BCBS - PAR Network | 114 | ✓ |
| 43 | Cigna | Localplus | 5,475 | |
| 44 | Empire BCBS | Empire BCBS - PPO Network | 419 | ✓ |
| 45 | Excellus BCBS | BlueShield Par | 99 | |
| 46 | Florida Blue | BlueChoice | 243 | |
| 47 | Highmark BCBS Delaware | BCBS Delaware Blue Choice | 27 | ✓ |
| 48 | Highmark BCBS West Virginia | Super Blue Plus | 64 | ✓ |
| 49 | Highmark BCBS of Western New York | HighMark BlueCross BlueShield of Western New York-PPO | 53 | ✓ |
| 50 | Highmark BS Pennsylvania | Highmark BS Network | 232 | ✓ |
| 51 | Highmark BS of Northeastern New York | PPO | 33 | ✓ |
| 52 | Horizon BCBS of New Jersey | Select Hospitals/PAR Physicians | 215 | ✓ |
| 53 | Independence BC | Independence BC - PAR Network | 181 | |
| 54 | Premera BC | Traditional | 182 | ✓ |
| 55 | Regence BCBS of Oregon | Regence BCBS Oregon - PAR Network | 94 | ✓ |
| 56 | Regence BCBS of Utah | ValueCare | 47 | ✓ |
| 57 | Regence BS of Idaho | Blue Shield Preferred Providers | 71 | ✓ |
| 58 | Regence BS of Washington | Regence BS BlueCard PPO | 88 | ✓ |
| 59 | UnitedHealthcare Insurance Company | Choice | 5,356 | ✓ |
| 60 | Wellmark BCBS of Iowa | Wellmark BCBS Iowa Alliance Select | 163 |
Included Tables and Views
Tables
providers
Contains provider-level information from transparency in coverage files, including:
- NPI and TIN identifiers
- Business and provider names
- Imputed EIN attribution for hospital and health system grouping
- Network and payer associations
- Provider taxonomy and location data
rates
Contains negotiated rate information for billing codes:
- Billing codes (CPT, HCPCS, DRG, etc.) with modifiers
- Negotiated rates and arrangement types
- Service settings and classifications
- Bundled code relationships
- Rate descriptions and metadata
payer_network_manifest
Metadata table containing:
- Payer and network names and identifiers
- Count of covered EINs per payer-network combination
- TIC v2 format indicator
Views
V_PROVIDER_RATES
A denormalized view that joins the providers and rates tables to provide complete provider and rate context in a single query. This view includes all provider attributes alongside their associated negotiated rates, enabling efficient analysis of provider-specific pricing without needing to manually join the tables.
Join Keys:
schedule_idpayer_slugnetwork_slugdate_key
Payer Network Manifest
Thepayer_network_manifest table contains metadata about each payer-network combination in this release.
Table Columns
| # | Column Name | Type | Description |
|---|---|---|---|
| 1 | payer_slug | string | Standardized payer identifier |
| 2 | payer_name | string | Full payer name |
| 3 | network_slug | string | Standardized network identifier |
| 4 | network_name | string | Full network name |
| 5 | num_covered_eins | number | Count of covered hospital/health system EINs |
| 6 | is_tic_v2 | boolean | Indicates TIC v2 format compliance |
Column Descriptions
payer_slug
Type: string Standardized payer identifier used for consistent referencing and filtering. Example Values:payer_name
Type: string Full legal or business name of the insurance payer organization. Example Values:network_slug
Type: string Standardized network identifier, typically includes payer identifier and network name components. Example Values:network_name
Type: string Full name of the insurance network or plan. Example Values:num_covered_eins
Type: number Count of unique hospital and health system EINs with negotiated rates in this payer-network combination. Example Values:is_tic_v2
Type: boolean Indicates TIC v2 (Transparency in Coverage version 2) format compliance. Possible Values:true- Complies with TIC v2 formatfalse- Uses earlier TIC format version