DataRise™ Commercial Reimbursement Data is available for custom orders.
Subscribers now have unprecedented access to virtually all commercial contract reimbursement rates by health plan, provider, and service. Available commercial reimbursement rates include hard-to-find services, such as:
- Ambulatory surgery center (ASC) reimbursement (click here to see more)
- Air ambulance reimbursement
- Fertility benefit reimbursement (click here to see more)
- Hospital-based physician reimbursement
- Hospital inpatient & outpatient reimbursement (click here to see more)
- Lab service reimbursement
- Out-of-network reimbursement
- PCP & specialist reimbursement
- Telemedicine reimbursement (new codes in 2025)
- Urgent care reimbursement
- AND MUCH MUCH MORE!
New York HFMA Demo 10/16/25
North Carolina HFMA Demo 2/6/26
Washington-Alaska HFMA Demo 4/19/26
Georgia HFMA Presentation (6/19/25) w/40 Data Examples
#1 Intro & Agenda02:26
#2 What is the Transparency in Coverage Rule?02:54
#3 GA Commercial Reimbursement: Physician Services16:18
#4 GA Commercial Reimbursement: Surgery Centers03:01
#5 National ASC Chains Dominate Reimbursement05:21
#6 GA Commercial Reimbursement: Inpatient Hospital02:00
#7: Observations in Other States10:39
#8: Use Applications02:15
#9 New Treatment Pricing03:10
#10 Fertility Treatment Pricing01:57
#11 Specialty Pharmacy Drug Trends02:24
#12 Closing00:48
Queries are custom searches performed by an Acuvance professional upon request. Turnaround times will be quoted at order, but expect turnaround times of 24 to 72 hours for raw data for most query searches. Analysis is a separate service that can be provided by Coker’s consultants.
If there are more than 1 million results, your data will be accessible via a private online portal. The Unlimited Query Plan is subject to limitations on processing time (24 to 72 hours per health plan ordered).
Commercial Reimbursement Examples
- Crush Readmissions & Make Money with Cardiac Rehab
- Retinopathy of Prematurity: FMV of Pediatric Ophthalmology Services
- Alaska: The Outlier State for Physician Services
- Fair Market Value for Interpretation of Molecular Diagnostic & Genomic Tests
- $17 Billion in Doctor Deals Done By Drug Distributors
- Telemedicine Commercial Reimbursement Trends
- Out-of-Network Reimbursement: 3 Things to Know
- 2024 Fertility Benefits Commercial Reimbursement
- Commercial Reimbursement for ASCs & Endoscopy Dominated by Chain Operators
- Highest 2024 Hospital Fees Signal New Trend
Where does this data come from?
UnitedHealthcare, Cigna, Aetna, Elevance, and other commercial carriers released hundreds of thousands of massive data files (>100 GB per file) under the Transparency in Coverage rules. Unfortunately, these carriers released health plan data files in an obscure data format (json) that is difficult to parse. Most of these massive multi-gigabyte files cannot be opened in Microsoft Excel.
We do the hard programming work, so you don’t have to.
Do NOT pay more to FAIR Health or Optum for blinded data for one procedure code in one ZIP code.
Purchase prepaid Health Plan Query Credits.
Use these credits whenever you need them. These query credits never expire.
What is a Per Health Plan Query Credit? What does it get me?
Pricing is based on the number of unique health plans searched, not the number of service codes searched. If you request searches on three (3) health plans, pricing does not change whether you request searches for one (1) service code or 100 service codes on those three health plans. Searching three health plans costs three credits.
Each one of the four examples above is an example of one query on one health plan (UHC Choice Plus in Colorado).
Queries are custom searches performed by an Acuvance professional upon request. Turnaround times will be quoted at order, but expect turnaround times of 24 to 72 hours for most query searches.
If there are more than 1 million results, your data will be accessible via a private online portal. The Unlimited Query Plan is subject to limitations on processing time (24 to 72 hours per health plan ordered).