Non-Commercial Line of Business Selected.
Medicare Advantage and Medicaid rates are often materially lower than
commercial rates and are not recommended as the basis for a
Reference-Based Pricing reimbursement cap. Use this data for context
only; set your RBP cap based on Commercial rates.
RBP Rate Calculator
1
Find Your Procedure
Code type
Search by code or description
Matching codes
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2
Set RBP Target
RBP Analysis
Medicare Reference Rate
Percentile Rank
Market Median
Rate Observations
Hospitals
Commercial Rate Distribution
P10 → P25
P25 → Median
Median → P75
P75 → P90
Your proposed rate
| Percentile | Rate | vs. Your Proposal |
|---|
Top Payers by Rate Volume
| Payer | Median Rate | Rates | vs. Proposal |
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Hospital Rate Comparison
| Hospital | State | Median Rate | Rates | Acceptance |
|---|