For Healthcare Consultants

One rate dataset, every engagement

Stop rebuilding a rate pull for every new client. MedReveal gives consultants negotiated rates and Medicare benchmarks for any payer, code or specialty — sourced, current, and ready to drop into the deliverable you're already building.

What the output looks like

A sample benchmarking report

Five orthopaedic surgery codes on BCBS, professional rates, TX — client rate against the market distribution for each code.

BCBSOrthopaedic SurgeryTXProfessional rates
Market benchmarking report for BCBS: Orthopaedic Surgery professional rates in TX, five billing codes, against Medicare
CodeClient ratePercentileMinQ1MedianMeanQ3P95MedicareClient % of Medicare
27447Total knee arthroplasty$1,627.5252nd$918.63$1,401.10$1,610.36$1,860.27$2,030.65$3,312.69$1,212.23134%
27130Total hip arthroplasty$1,629.6153rd$919.80$1,410.92$1,610.41$1,868.76$2,075.93$3,540.45$1,215.27134%
29827Shoulder arthroscopy, rotator cuff repair$1,359.1959th$725.09$1,057.06$1,239.66$1,426.34$1,573.14$2,531.03$1,016.11134%
29881Knee arthroscopy, meniscectomy$696.5558th$365.95$549.75$641.92$749.53$824.51$1,444.17$533.44131%
20610Arthrocentesis, major joint$82.0573rd$30.97$52.94$64.58$75.51$83.73$142.05$70.37117%

Source: BCBS negotiated-rate files, professional billing class, filtered to Orthopaedic Surgery taxonomies, TX. Medicare reference: Medicare, Houston locality, non-facility, CMS Physician Fee Schedule 2025.

Payer-to-payer comparison, one code

The same query, one code at a time, across every payer in the market — CPT 27447, Total knee arthroplasty. Violet markers show where the client's contracted rate sits in each payer's distribution: 22nd on UHC and 18th on Cigna (the renewal priorities), 40th on Aetna, and 62nd on BCBS. Closing just the UHC gap to median is roughly $225.36 per case.

Medicare $1,21222ndUHC$1,61040thAetna$1,33318thCigna$1,55662ndBCBS$1,628$0$760$1,520$2,280$3,040$3,800
Q1–Q3MedianMeanMedicare $1,212Client22ndPercentile

Orthopaedic Surgery, professional rates, TX · whiskers are Tukey bounds (1.5×IQR) · full figures in the table below

Negotiated rate distribution for CPT 27447 by payer in TX, Orthopaedic Surgery providers, with the client's contracted rate marked on each payer against Medicare.
Full rate distribution by payer for CPT 27447, including the client's contracted rate and percentile
PayerClient ratePercentileMinQ1MedianMeanQ3P95Countvs Median
UHC$1,385.0022nd$918.63$1,401.10$1,610.36$1,860.27$2,030.65$3,312.69811$-225.36
Aetna$1,285.0040th$1,062.00$1,176.00$1,333.36$1,548.99$1,665.74$2,676.29640$-48.36
Cigna$1,295.0018th$350.00$1,442.37$1,555.60$1,926.94$2,229.78$3,372.43796$-260.60
BCBS$1,695.0062nd$1,056.37$1,256.21$1,627.52$1,661.21$1,740.23$2,280.00+$67.48
How it works

From engagement scope to finished deliverable

01

Scope the engagement

Pull the code list, payer set and geography for the client in front of you — a single facility, a health system, or a market-entry footprint.

02

Benchmark the rates

Get the full negotiated-rate distribution for each code and payer, alongside the current Medicare amount, so every number has a reference point.

03

Build the analysis

Layer in the client's own contracted rates or a target network to see exactly where they sit against the market, code by code.

04

Hand off the deliverable

Export the tables and figures into the report, deck or RFP response — sourced, dated, and ready for a client to act on.

What consultants build with it

Contract negotiation support

Give a provider or payer client the market distribution behind a renewal ask, instead of a percentage they can't defend in the room.

RFP and proposal responses

Back a network-adequacy or pricing claim in a proposal with sourced rate data instead of an assertion the buyer has to take on faith.

Market entry and due diligence

Size the reimbursement landscape in a new market or for an acquisition target before the client commits capital to it.

Network and payer mix strategy

Compare what every payer in a market pays for the same codes to find the network or contracting strategy with the best return.

Questions consultants ask

Can I run analyses for more than one client?
Yes. Each pull is scoped to the codes, payers and geography you set for that engagement, so you can work multiple client analyses side by side without them mixing.
Where does the underlying data come from?
Payer machine-readable files published under the CMS Transparency in Coverage rule, plus the CMS Medicare Physician Fee Schedule. It is disclosed data — we organize and index it, we do not survey or estimate it.
Can I export data into my own deliverables?
Yes — figures and tables are built to drop into a client report, deck or RFP response, with the source and date attached so a client can verify them independently.
Do you support both provider-side and payer-side engagements?
Yes. The same negotiated-rate data supports a provider contract-renewal analysis and a payer network-adequacy or competitiveness review.
How current is the data?
Negotiated-rate files are republished by payers on a monthly cadence and we index each new release. Medicare rates track the current CMS Physician Fee Schedule and its annual conversion factor.
Why consultants use MedReveal

Built for firms running multiple client engagements

One dataset, every client

Stop rebuilding a rate pull from scratch for each engagement. Query negotiated rates and Medicare benchmarks for any payer, code or specialty, then repeat it for the next client in minutes.

Deliverable-ready output

Percentiles, spreads and Medicare comparisons formatted for the tables and charts that go straight into a client deck — not a raw file you have to clean before anyone can read it.

Defensible sourcing

Every figure traces back to payer machine-readable files published under the CMS Transparency in Coverage rule and the CMS Physician Fee Schedule — sourcing a client can verify independently.

Built for multiple engagements at once

Work provider-side and payer-side analyses in parallel without one client's data view leaking into another's — each pull is scoped to the codes, payers and geography you specify.

Bring your next engagement's rate data in-house

Tell us the codes, payers and geography your client needs, and we'll show you what MedReveal returns for it.