Market Benchmarks Methodology

Our market benchmarks report calculates distributions directly over price transparency data rows.

The methodology default is to only compare PPO plans, ignore modifiers and non-dollar, non-ffs rows, drop any record with an unbillable code / taxonomy pair, trim records with outliers .5 <= rate <= 20x CMS baseline, and treat the remaining data rows as observations in the distribution.

All data rows containing plans and payors in the same state region get rolled up together to calculate the state-level benchmark values. Search filters (provider taxonomy, billing metadata, etc) and the candidate payer list can be further customized to narrow the distribution analysis using the toolbar at the bottom.