The Provider Analysis dashboard allows you to benchmark your pricing against similar organizations in your region and specialty.Requirements for this dashboard include:
Access to Provider Profiles
If you do not have access to Provider Profiles, please contact your administrator to request access.
The filter bar at the top of the dashboard allows you to refine your analysis based on specific criteria. You can filter by provider, market, payer, network, billing class, and care setting. These filters apply across dashboard views in your session, allowing you to maintain a consistent analysis context as you navigate.Available Filters:
Provider: Select specific providers to analyze their pricing data.
Payer: Filter by specific insurance payers to see how your rates compare against them.
Network: Filter by network type (e.g., in-network vs. out-of-network) to understand how your rates perform in different contexts.
Billing Class: Filter by billing classification (e.g., professional vs. institutional) to analyze specific types of services.
Setting: Filter by care setting (e.g., inpatient (facility) vs. outpatient (non-facility)) to see how your rates compare in different healthcare environments.
To add or change a filter, click the filter dropdown and select the desired criteria. The dashboard automatically updates to reflect your selections, so you can see how your provider’s rates compare against peers under the specified conditions.
You can export data from any table in the dashboard by clicking the three-dot menu in the top-right corner of the table and selecting “Download.” This lets you download the data in CSV format for further analysis or reporting.You can then choose your download format (CSV or Excel) and click “Download” to save the file to your computer.Tip for exporting data:
Always select “Exclude hidden columns” if you have applied filters to ensure you only download the relevant data.
The Contract Percentiles table displays the percentile your provider rates fall into by billing code group for major payers:
BCBS (Blue Cross Blue Shield)
Cigna
Aetna
UHC (UnitedHealthcare)
Regional payers
Each row represents a specific billing code group (such as surgical procedures, imaging, or office visits), while columns show the contract percentile for each payer. The percentile indicates where your negotiated rate falls within the market distribution. For example, higher percentiles mean your rates are above most competitors in the market.Color-coded percentile values provide quick visual performance indicators: green highlights above-market rates (higher percentiles), while red indicates below-market rates (lower percentiles). This helps you quickly identify which payer contracts and billing code groups are performing well versus those that may need attention during future negotiations.
This table displays your provider’s current contracted rates for various payers. Each row represents a specific contract with detailed information including:
Payer Name: The insurance company name
Billing Code: The specific CPT or procedure code
Mod: Modifier codes that affect reimbursement
% of Current CMS: Your rate expressed as a percentage of Medicare rates
Display Rate: The actual dollar amount for the procedure
This table serves as a quick reference guide to your active contracts, making it easy to compare how different payers reimburse for the same procedure. You can see at a glance which payers offer rates closest to or furthest from Medicare benchmarks, helping you understand your overall payer mix performance.
A heat map visualization showing how different provider organizations compare to Medicare rates across the full distribution spectrum. The table displays percentiles ranging from the lower end of the market through the upper end, allowing you to see the complete picture of market pricing.Each row represents a different provider organization or claims group, with columns showing their reimbursement rates at different percentile levels expressed as percentages of Medicare rates. The heat map uses color gradients to quickly highlight performance patterns:
Red zones indicate rates below or near Medicare levels
Yellow/neutral zones show moderate rates above Medicare
Green zones highlight significantly higher reimbursement rates
This visualization helps you understand not just where your organization stands, but also how wide the market variation is for each provider type. You can identify which organizations consistently achieve higher reimbursement across all percentile levels and use this information to set realistic targets for your own negotiations.
