Report-Builder: Peer Benchmarks

New report alert! In addition to our market benchmarks report, we are excited to announce we're adding a new report to Signal: peer benchmarks.

The purpose behind peer benchmarks is for our users to be able to track a set of providers' contracted rates everywhere they appear in-network.

The report enables quick side-by-side comparison of contracted rates amongst peers and automatic updating month-over-month to see how providers' contracts evolve (e.g., new networks they appear in, rate adjustments on existing contracts, etc.).

Entering peer benchmarks

When you enter Signal, you will see 3 modes for exploring price transparency data:

As shown above — just like searches, you can save, share, and restore reports using the same feature set as described here: https://secure.helpscout.net/docs/65ce65ffb668985dce304214/article/65fda4042c14892b973b0cc4/

Let's click on 'Peer Benchmarks' to get started — alternatively, you can also expand the left hand tool-bar and navigate to 'Peer Benchmarks' here as well:

Building, exporting, and exploring peer benchmark reports

Once you enter the peer benchmarks report mode, you will see the same set of panels you are familiar with for search mode — but with the following key differences:

  • Compared to search mode where you have to specify a payer, all you need to generate a peer benchmarks report is to select at least 1 EIN / provider group and a code — we will then query all the networks in our library to surface all the in-network contracted rates that appear in the provider's fee schedule disclosed by each payer
  • Before using this report, we first recommend reading our provider search guide to understand concepts like a provider's EIN, Type-2 NPI and our provider groups article to make full use of peer benchmarks' functionality

Once you have access to the right EINs, NPIs, you can generate a report simply by selecting which EINs / providers or groups you would like to see rates for and then clicking "Generate Report":


Then, for your given set of selected EINs and codes, peer benchmarks will automatically load in all the rates Serif Health has access to across our entire payer price transparency library:


  • As shown above, for each combination of code and EIN / group , peer benchmarks shows how many payers we saw rates for to direct you to the highest populated results
  • Additionally, for each code and EIN / group, you must select one of the following options to aggregate the data by:

    • Most NPIs: Recommended by default; grabs the rate associated with the largest npi-list. See 'why' this is our recommended methodology by reviewing https://help.serifhealth.com/article/24-how-should-i-pick-between-multiple-rates
    • Min: Useful if interested in the floor allowed-amount across all billing scenarios. For example, 'telehealth' / 'facility' place of service for a nurse assistant / other Masters level professional.
    • Max: Useful if interested in the highest allowed-amount across all billing scenarios. For example, 'office' place of service for a specialized physician.

  • If any data point piques your interest, you can always dive deeper into any given cell and see the full raw data the payer disclosed. For example, curious what the other 12 results were for this cell? Just click into the ‘$153’ and see in normal Signal format:


  • Lastly, if you would like to view all the information generated from the report, feel free to export the data to .csv.

If you need to edit or further narrow down the results, the following filters you are familiar with in search mode are available for use:

  • Payers: you can always select down the health plans you want to analyze (e.g., to just United, Cigna, Aetna) for example
  • Modifiers: by default, we exclude these to ensure apples-to-apples comparison against global rates in listed distributions but if you would like to look at specific modifiers (e.g., 'TC' for the technical component of radiology procedures) you can
  • Other filters:
    • Arrangement: Defaulted to fee-for-service to again ensure valid, like-for-like comparison across distributions
    • Negotiation Type: Percentage of billed charges arrangements excluded to ensure all rates loaded into benchmarks are comparable dollar amounts
    • Billing Class: Both professional and institutional provided by default; further filtering suggested to avoid mixing pro and facility fees
    • Is Billable: Balanced selected by default — more detail here: https://help.serifhealth.com/article/6-how-does-the-price-transparency-data-differ-from-claims-data
    • Hide Outliers: On by default to filter out 'noise' from placeholder rates (e.g., $99,999.99 for a 30 minute office visit)

Regions and Taxonomies filters are unavailable in Peer Benchmarks given the report already selects down to specific providers.


Other important notes:

  • Peer Benchmarks only performs searches on entries in the 'EIN' field. This means we do not search Type-1 NPIs (e.g., individual professionals) in provider groups.
  • For each payer and code, Peer Benchmarks will aggregate across all the relevant 'EIN' entries in the provider group. For example, let's say your provider group has 2 EINs: '871927518', '841856765' and you search 90837 in Cigna:
    • The raw data has 3 entries: 1 for EIN 871927518 (top row) and 2 for EIN 841856765 (bottom two rows).


    • In Peer Benchmarks, you will see the following result depending on which aggregation method you choose:
      • Most NPIs: This will grab the last row with 6745 npi's and return the rate as $109
      • Min: This will grab the second row with 1 npi in Colorado and return the rate as $74
      • Max: This will grab the first row with 1419 npis and return the rate as $109

We hope this report is useful and would love to hear feedback on any enhancements or suggestions to further improve the platform. If you have any questions or ideas, feel free to reach out to support@serifhealth.com

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