Estimate Costs for a Procedure
Endpoint for estimating costs associated with a given procedure / procedure bundle
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.
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.
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 list | List of exact procedure uuids | 61288975-67ad-4b1f-97d6-e1a6bc00afd3 ,fbb223e6-9806-45b5-95b1-4d7a36cc9164 |
type | price_transparency , claims | The type of product to pull from, the claims-based product or the payer-filed-price transparency product. (default: claims ) | price_transparency |
member_zip (required) | string | Zip code | 60606 |
plan_id | string | Exact 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