Provider Price Search

Overview

Description: Search for providers that perform a given procedure and find the lowest insurance-specific price for a procedure in your area.

Endpoint: /v1/pricing/providers

Status: Live

Methods: GET

Example use-case: Search for all applicable provider negotiated rates, given a specific insurance and procedure (and optionally, a specific location/address and distance). For example, search for all providers near me who perform Leg MRIs and who take a given insurance, sorted by lowest price.

Search parameters

ParameterTypeDescriptionExample
plan_idplan_idExact insurance plan ID for negotiated rate with provider.
(can be retrieved from insurances endpoint)
a5a0c8ff-c62b-4a9e-af86-55e52bd7dc55
procedure_iduuidExact ID for the procedure the provider performs.61288975-67ad-4b1f-97d6-e1a6bc00afd3
procedurestringFuzzy search based on a string input.

Filter to only providers who perform and have rates for the given procedure.
Biopsy of ovary
specialty_idsList<uuid>A list of comma separated uuids to filter providers based on specialty
i.e. uuid1,uuid2,uuid3
fcc9a22c-7a0f-4405-b0c9-c5f8ad83b93e,8b5d3998-d7e2-4b9e-91d1-17c19cd089f5,44b0284c-f360-4312-a17d-d601651cb0ea
cpt_codestringCPT code that filters for providers who perform given code.58900
locationlat/longLatitude/longitude pair of coordinates in lieu of a string address (i.e. location=37.7489816,-122.4802092).37.7489816,-122.4802092
addressstringString input of an address that will be interpreted and geocoded in real time.2074 23rd Ave, San Francisco, CA 94116
distanceintegerDistance in miles from lat/long or address (i.e. 5 miles)10
page_sizeintegerNumber of providers to return per page25
pageintegerPage number to return1

Procedure Reference Endpoint

Leverage the /v1/procedures endpoint (more here) to search for and see all relevant CPT codes for a procedure or bundle.

Example Request

curl -X GET \
  'https://api.ribbonhealth.com/v1/pricing/providers?address=33 Irving Pl, NYC&insurance_id=2d5231c0-2d29-4026-9138-5dcbd0591404&procedure=Leg MRIz' \
  -H 'authorization: Token <your_token>'

Results

{
  "parameters": {
    "address": "33 Irving Pl, New York, NY 10003, USA",
    "procedure": "0f349633-c8bf-4f87-a003-8eb86c117cf5",
    "insurance_id": "2d5231c0-2d29-4026-9138-5dcbd0591404",
    "location_selection": "cost.min",
    "page": 1,
    "page_size": 25,
    "sort_by": "cost.min"
  },
  "data": [
    {
      "npi": "1992964035",
      "first_name": "Alexander",
      "middle_name": "J",
      "last_name": "Greenstein",
      "age": 42,
      "gender": "m",
      "insurance": { 
         "uuid": "081de5c4-8c6f-4d7d-905f-6beb8c3623e7",
         "carrier_name": "Aetna",
         "plan_name": "Aetna Whole Health - Metro NY"
      },
      "procedure": { 
         "uuid": "081de5c4-8c6f-4d7d-905f-6beb8c3623e7",
         "name": "Leg MRI"
      },
      "matched_location": {
        "uuid": "474144b5-e212-4cb1-abf5-c82c45063f53",
        "name": "General Hospital",
        "latitude": 48.3723,
        "longitude": -71.3484,
        "address": "575 N River St, New York, NY 10003, US",
        "confidence": 4,
        "phone_number": [
          { "phone": "2124567883", "detail": "primary" },
          { "phone": "2129563481", "detail": "secondary" },
          { "phone": "2124281109", "detail": "secondary" }
        ],
        "cost": {
          "median": 50,
          "max": 100,
          "min": 20
        }
      },
      "total_matched_locations": 3
    },
    ...24 more providers...
  ]
}