Pricing

Get in-network contracted rates

Retrieve contracted rates for healthcare providers (NPIs) for specific billing codes and insurance plans.

This endpoint supports bulk lookups for up to 10 NPIs per request, enabling efficient pricing discovery across multiple providers simultaneously.

Supported Rate Types

Fee-for-Service (FFS) – Per-procedure contracted rates
Capitated – Monthly per-member rates (coming soon)
Bundled – Episode-based payment models (coming soon)

Use Cases

Care navigation and provider comparison
Patient cost estimation and transparency
Network adequacy analysis
Provider directory integration
Contracting and compliance analysis

POST

pricing

in-network

curl --request POST \
  --url https://care-navigation-gateway-ccg16t89.wl.gateway.dev/pricing/in-network \
  --header 'Content-Type: application/json' \
  --data '{
  "npis": [
    "1043566623",
    "1972767655"
  ],
  "planId": "942404110",
  "conditionCode": "99214",
  "codeType": "CPT"
}'

{
  "data": {
    "1043566623": [
      {
        "code": "99214",
        "codeType": "CPT",
        "negotiatedType": "negotiated",
        "minRate": 65.87,
        "maxRate": 266.88,
        "avgRate": 147.03,
        "instances": 6
      }
    ],
    "1972767655": [
      {
        "code": "99214",
        "codeType": "CPT",
        "negotiatedType": "negotiated",
        "minRate": 104.46,
        "maxRate": 169.37,
        "avgRate": 117.78,
        "instances": 8
      }
    ]
  },
  "meta": {
    "planId": "942404110",
    "payer": "UNH",
    "requestId": "req_cf7f67790f92",
    "timestamp": "2025-06-15T23:15:48.734729Z",
    "processingTimeMs": 912,
    "inNetworkRecordsCount": 14
  }
}

Authorizations

key

string

query

required

API key authentication via query parameter. Add as query parameter: ?key=YOUR_API_KEY

Get your API key by reaching out to support@docaroo.com.

Body

application/json

Response

200

application/json

Successful pricing lookup

The response is of type object.

API Reference Get procedure likelihood scores

curl --request POST \
  --url https://care-navigation-gateway-ccg16t89.wl.gateway.dev/pricing/in-network \
  --header 'Content-Type: application/json' \
  --data '{
  "npis": [
    "1043566623",
    "1972767655"
  ],
  "planId": "942404110",
  "conditionCode": "99214",
  "codeType": "CPT"
}'

{
  "data": {
    "1043566623": [
      {
        "code": "99214",
        "codeType": "CPT",
        "negotiatedType": "negotiated",
        "minRate": 65.87,
        "maxRate": 266.88,
        "avgRate": 147.03,
        "instances": 6
      }
    ],
    "1972767655": [
      {
        "code": "99214",
        "codeType": "CPT",
        "negotiatedType": "negotiated",
        "minRate": 104.46,
        "maxRate": 169.37,
        "avgRate": 117.78,
        "instances": 8
      }
    ]
  },
  "meta": {
    "planId": "942404110",
    "payer": "UNH",
    "requestId": "req_cf7f67790f92",
    "timestamp": "2025-06-15T23:15:48.734729Z",
    "processingTimeMs": 912,
    "inNetworkRecordsCount": 14
  }
}

Overview

API Documentation