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Base URL

API Gateway: https://care-navigation-gateway-ccg16t89.wl.gateway.dev

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Authentication

All API requests require authentication using a query parameter: 
https://care-navigation-gateway-ccg16t89.wl.gateway.dev/pricing/in-network?key=your-api-key-here
Keep your API key secure and never expose it in client-side code.

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Getting Your API Key

Contact our support team at [email protected] to request API access and receive your API key.

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Quick Test

Try this example with real provider NPIs: 
curl -X POST "https://care-navigation-gateway-ccg16t89.wl.gateway.dev/pricing/in-network?key=your-api-key-here" \
  -H "Content-Type: application/json" \
  -d '{
    "npis": ["1043566623", "1972767655"],
    "planId": "942404110",
    "conditionCode": "99214",
    "codeType": "CPT"
  }'

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API Endpoints

The API provides two main categories of endpoints:

In-Network Pricing

Get contracted rates for healthcare providers with detailed negotiated prices, expiration dates, and summary statistics. Supports up to 50 NPIs per request.

Procedure Likelihood

Assess provider capability for specific medical procedures with confidence scores

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Response Format

All successful responses include:
  • data: Results organized by NPI
  • meta: Request metadata including payer, processing time, and record counts
Example pricing response structure: 
{
  "data": {
    "1043566623": [
      {
        "code": "99214",
        "codeType": "CPT",
        "negotiatedPrices": [
          {
            "negotiatedRate": 65.87,
            "expirationDate": "2024-12-31",
            "serviceCodes": ["11"],
            "billingClass": "professional",
            "negotiatedType": "negotiated",
            "tinType": "EIN",
            "tinValue": "123456789"
          },
          {
            "negotiatedRate": 128.45,
            "expirationDate": "2024-12-31",
            "serviceCodes": ["11"],
            "billingClass": "professional",
            "negotiatedType": "negotiated",
            "tinType": "EIN",
            "tinValue": "123456789"
          },
          {
            "negotiatedRate": 142.10,
            "expirationDate": null,
            "serviceCodes": [],
            "billingClass": null,
            "negotiatedType": "negotiated",
            "tinType": null,
            "tinValue": null
          },
          {
            "negotiatedRate": 189.50,
            "expirationDate": "2024-12-31",
            "serviceCodes": ["22"],
            "billingClass": "professional",
            "negotiatedType": "negotiated",
            "tinType": "EIN",
            "tinValue": "987654321"
          },
          {
            "negotiatedRate": 213.75,
            "expirationDate": null,
            "serviceCodes": [],
            "billingClass": null,
            "negotiatedType": "negotiated",
            "tinType": null,
            "tinValue": null
          },
          {
            "negotiatedRate": 266.88,
            "expirationDate": "2024-12-31",
            "serviceCodes": ["11"],
            "billingClass": "professional",
            "negotiatedType": "negotiated",
            "tinType": "EIN",
            "tinValue": "123456789"
          }
        ],
        "summary": {
          "minRate": 65.87,
          "maxRate": 266.88,
          "avgRate": 147.03,
          "instances": 6
        }
      }
    ],
    "1972767655": [
      {
        "code": "99214",
        "codeType": "CPT",
        "negotiatedPrices": [
          {
            "negotiatedRate": 104.46,
            "expirationDate": "2024-12-31",
            "serviceCodes": ["11"],
            "billingClass": "professional",
            "negotiatedType": "negotiated",
            "tinType": "EIN",
            "tinValue": "555666777"
          },
          {
            "negotiatedRate": 108.22,
            "expirationDate": null,
            "serviceCodes": [],
            "billingClass": null,
            "negotiatedType": "negotiated",
            "tinType": null,
            "tinValue": null
          },
          {
            "negotiatedRate": 112.88,
            "expirationDate": "2024-12-31",
            "serviceCodes": ["22"],
            "billingClass": "professional",
            "negotiatedType": "negotiated",
            "tinType": "EIN",
            "tinValue": "555666777"
          },
          {
            "negotiatedRate": 115.90,
            "expirationDate": null,
            "serviceCodes": [],
            "billingClass": null,
            "negotiatedType": "negotiated",
            "tinType": null,
            "tinValue": null
          },
          {
            "negotiatedRate": 119.33,
            "expirationDate": "2024-12-31",
            "serviceCodes": ["11"],
            "billingClass": "professional",
            "negotiatedType": "negotiated",
            "tinType": "EIN",
            "tinValue": "555666777"
          },
          {
            "negotiatedRate": 123.45,
            "expirationDate": null,
            "serviceCodes": [],
            "billingClass": null,
            "negotiatedType": "negotiated",
            "tinType": null,
            "tinValue": null
          },
          {
            "negotiatedRate": 135.67,
            "expirationDate": "2024-12-31",
            "serviceCodes": ["11"],
            "billingClass": "professional",
            "negotiatedType": "negotiated",
            "tinType": "EIN",
            "tinValue": "555666777"
          },
          {
            "negotiatedRate": 169.37,
            "expirationDate": null,
            "serviceCodes": [],
            "billingClass": null,
            "negotiatedType": "negotiated",
            "tinType": null,
            "tinValue": null
          }
        ],
        "summary": {
          "minRate": 104.46,
          "maxRate": 169.37,
          "avgRate": 117.78,
          "instances": 8
        }
      }
    ]
  },
  "meta": {
    "planId": "942404110",
    "planName": "UHC Choice Plus POS",
    "payer": "UNH",
    "requestId": "req_cf7f67790f92",
    "timestamp": "2025-06-15T23:15:48.734729Z",
    "processingTimeMs": 912,
    "inNetworkRecordsCount": 14
  }
}
Explore the interactive documentation below to test each endpoint.