For self-funded employers
PriceIntel uses local market prices and service-specific quality evidence—with your plan’s claims, when shared—to show where your plan may be paying more than the local market, what value to protect, and where direct contracting, carve-outs, or preferred networks could improve cost and care.
Initial assessment: no fee. No obligation to continue.
Independent by design. No compensation from carriers, TPAs, PBMs, or providers.
How we workFrom information to understanding
Claims, prices, and quality tell different parts of the story. Put them in context, and the questions become clearer.
01 Gather the pieces
02 Make a fair comparison
Review before recommending.
03 Choose the next conversation
A connected picture supports a decision. It does not make the decision for you.
01 / Start with the evidence
A price difference gives you a question worth asking. The next step is to understand what it means for your plan.
Hospital-posted Blue Cross PPO-family rates
Outpatient facility price · CPT 70553
Multiples of the $356.43 national Medicare reference, before hospital-specific adjustments. A reference point, not a target price.
Three selected hospitals, not a market average. Hospital files dated April–September 2026; Medicare reference from July 2026. Published prices are not actual plan payments or patient quotes.
Hospital-posted negotiated dollar amounts for outpatient facility billing, CPT 70553, with no modifier. The selected records each contain one fee-schedule amount. Physician fees and other separately billed services are not included.
These are historical public-file snapshots, extracted October 6–7, 2026. The plan labels and publication dates differ; we have not established that the same terms are available to a particular employer. The selection does not represent the full Dallas market. Medicare is a reference point, not a commercial price target. No quality conclusion or hospital recommendation follows from this chart.
Price is one part of value
For a joint replacement, for example, the relevant questions concern complications and recovery—not just a hospital’s overall rating. Hospital and surgeon evidence stay separate.
Where relevant evidence is missing, the answer is “not yet known.” Missing evidence is not poor quality.
02 / Turn evidence into decisions
Start with a focused question. Make the next step clear, including the people and evidence it depends on.
Compare prices for the services your members use. Then check quality, access, and whether a provider will agree to different terms.
Compare the full episode with your standard network: procedure, follow-up care, program fees, travel, and relevant outcomes.
A favorable price with appropriate quality and access is worth preserving. Make that value visible before renegotiating or moving care.
Example decisions. The priorities and work required depend on your plan’s evidence.
03 / Work through it together
We give benefits teams clear, defensible answers about where to focus, supported by transparent evidence and an honest account of what remains unknown.
Choose the decisions, markets, and services that matter. Agree on the inputs and schedule.
Identify the claims extract and supporting information needed. Set up data handling with your team before transfer.
Work through priorities, favorable arrangements, and open questions. Decide which conversation to have next.
The initial assessment has no fee and no obligation to continue. Any further work is separately scoped at a flat fee. We receive no compensation from carriers, TPAs, PBMs, or providers.
This website does not accept claims uploads. Use the contact link to discuss your question; do not attach claims or member information. Data requirements, handling arrangements, and transfer method are agreed separately before data is shared.
Your next conversation
No fee for the initial assessment.