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Estimate Costs for a Procedure

Endpoint for estimating costs associated with a given procedure / procedure bundle

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Overview

Description: The procedure cost estimate endpoint calculates estimated costs for a given procedure based on a user's location.

Endpoint: /v1/procedure_cost_estimate

Status: Live

Methods: GET

Example use-case: Estimate the cost of a knee replacement surgery for a user in Boston so they can plan their personal finances accordingly.

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Power through the Procedures Reference Endpoint

Leverage the /v1/procedures endpoint to search for and see all relevant codes for a procedure or bundle.

Diving In

Use this endpoint to show users cost estimates across the most common "shoppable" procedures.

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Sources of Cost Estimate data

Estimates can either be insurance-specific, through Price Transparency data, or through aggregated claims.

Users will indicate which data source should be queried through the type parameter.

Request Parameters

procedure_ids
(required)		comma separated uuid listList of exact procedure uuids61288975-67ad-4b1f-97d6-e1a6bc00afd3,fbb223e6-9806-45b5-95b1-4d7a36cc9164
typeprice_transparency, claimsThe type of product to pull from, the claims-based product or the payer-filed-price transparency product.
(default: claims)		price_transparency
member_zip
(required)		stringZip code60606
plan_idstringExact insurance plan ID for negotiated rate with provider.
(can be retrieved from insurances endpoint). Necessary only if searching for 'price_transparency' powered estimates.		a5a0c8ff-c62b-4a9e-af86-55e52bd7dc55

Example Request

This endpoint will only use price transparency data if type=price_transparency parameter is set.

curl -X GET \
  'https://api.ribbonhealth.com/v1/procedure_cost_estimate?
  procedure_ids=00000000-0000-0000-0000-000000000000
      &member_zip=10011&type=price_transparency&plan_id=2d5231c0-2d29-4026-9138-5dcbd0591404' \
  -H 'authorization: Bearer your_token'

Example JSON Output

See below for an example JSON output for the call above. Median, minimum, and maximum values are displayed for the procedure's cost estimation.

{
    "parameters": {
        "procedures": [
            {
                "uuid": "00000000-0000-0000-0000-000000000000",
                "display": "MRI scan of lower spinal canal"
            }
        ],
        "member_zip": "60606",
        "type": "price_transparency",
        "insurance": "2d5231c0-2d29-4026-9138-5dcbd0591404"
    },
    "data": {
        "cost_estimates": {
            "minimum": 100.00,
            "median": 300.00,
            "maximum": 500.00
        }
    }
}

Updated 26 days ago