Pricing
Five datasets, and every common way to buy less than all of one. The rule behind the numbers is published too, so you can price a slice we have not listed without asking us first.
The five datasets
Full price is the whole grid — every code, every insurer, every state, refreshed quarterly. Everything below is a share of that.
| Specialty Drug Rates | Complete Rate File | Payer Coverage Requirements | Rates + Requirements | Contracted Rates by Provider | |
|---|---|---|---|---|---|
| Answers | What each insurer pays for every specialty and infusion drug, and for administering it. | The same rates across all 350,000+ billing codes, not just drugs. | Every hurdle an insurer puts between a prescription and a payment — prior authorization, step therapy, site limits, renewals. | Rates and coverage rules in the same row. No other published dataset has both. | What one named practice is contracted for, with which insurers, at what rates — down to the plan. |
| Price | $16,000 a year · slices from $6,000 | $60,000 a year for everything · slices from $8,000 | $150,000 a year for everything · slices from $6,000 | $210,000 a year for everything · slices from $20,000 | $80,000 a year for everything · slices from $10,000 |
| Status | Available now | Available now | Available now | In preview | In preview |
| Free sample | Yes | Yes | Yes | Not yet | Not yet |
| Table | rate_intel | rate_market | coverage_cell coverage_rule | rate_intel coverage_cell coverage_rule | rate_intel practice practice_member |
| Updated | Quarterly | Quarterly | Quarterly | Quarterly | Quarterly |
How a slice is priced
A slice that covers a share of the grid costs the square root of that share, times the full price.
Half the data is not half the work. Building, checking and delivering a narrow slice costs nearly what the whole thing costs, and a slice is worth more to the person who needs exactly it than its size suggests. A straight percentage would price small slices below what they cost us to ship and large slices above what they are worth to you.
Narrow the codes
One molecule, one drug family, one therapeutic area, or the specialty and infusion set instead of all 353,270 codes.
Narrow the market
One insurer, one state, or a defined region instead of 37 insurers across 50 states and DC.
Narrow both
Multiply the two shares together, then take the square root of the result.
One therapeutic area, in one region
- about 14% of the drug set
- about 20% of the market
- 14% × 20% = 2.8% of the grid. The square root of 2.8% is 17%.
17% of $75,000 is $12,600.
No slice prices below $6,000. Below that the delivery, the manifest and the support cost more than the licence, and we would rather say so than quietly ship you something worse.
Slices stack and never double-charge. If you buy one drug family and add a second later, you pay the difference between the two rungs, not the second rung again.
One thing the arithmetic does not capture: the specialty and infusion set is 5,550 codes out of 353,270 — 1.6% of the code universe and 6.8% of the rows — but it is priced at roughly a quarter of the full file. That is deliberate. Those codes carry the decisions that are worth money. We price a slice by how much of the question it answers, not by how many rows it has.
What the common slices cost
These are the asks that come up most. Anything here can be bought as listed, without a call.
By drug or procedure
You know the molecule or the code and you do not care about the rest of the book.
| Slice | Dataset | A year |
|---|---|---|
| One molecule, every insurer, every state | Rates | $6,000 |
| One molecule, every insurer | Coverage rules | $15,000 |
| One molecule, rates and rules joined | Both | $20,000 |
| One molecule at one insurer | Coverage rules | $6,000 |
| One procedure code, every insurer | Rates | $6,000 |
By cluster
A therapeutic area, a drug family, or a related set of procedures. The usual shape of a real project.
| Slice | Dataset | A year |
|---|---|---|
| One therapeutic area, every insurer | Rates | $6,000 |
| One therapeutic area, every insurer | Coverage rules | $55,000 |
| One therapeutic area, rates and rules joined | Both | $80,000 |
| All specialty and infusion drugs, every insurer | Rates | $16,000 |
By payer
One insurer you compete with, or the handful that matter in your market.
| Slice | Dataset | A year |
|---|---|---|
| One insurer, every code, national | Rates | $18,000 |
| Three insurers, every code, national | Rates | $32,000 |
| One insurer, every drug | Coverage rules | $25,000 |
| All 37 insurers, every code | Rates | $60,000 |
By geography
Rates vary by state, so most providers only need where they bill. Coverage rules are written nationally and do not slice this way.
| Slice | Dataset | A year |
|---|---|---|
| One state, every insurer, every code | Rates | $8,000 |
| One state, every insurer, specialty drugs only | Rates | $8,000 |
| One region, up to ten states, every insurer | Rates | $25,000 |
| One metro, provider level | Provider profiles | $10,000 |
By provider
What named practices are contracted for, rather than what a market pays on average. In preview.
| Slice | Dataset | A year |
|---|---|---|
| One metro | Provider profiles | $10,000 |
| One specialty, nationally | Provider profiles | $25,000 |
| Everything | Provider profiles | $80,000 |
If your slice is not on the card
Most of them are not, and that is fine. Combine any two narrowings and the rule prices it: multiply the two shares, take the square root, apply it to the full price. Oncology in Texas across two insurers is a normal ask, not a special one.
- A set of states that is not a region we list
- Priced on the state count.
- A code list you bring us
- Send the list. If we hold the codes, it prices off the share of rows they cover.
- One insurer’s rules for one therapeutic area
- Two narrowings on the coverage side, priced by the same rule.
- A vintage you do not subscribe to
- Single historical quarters are available where we still hold them.
- Something genuinely unusual
- We come back within one business day with a price and a start date, or we tell you we cannot do it.
Nothing prices below $6,000, and we will say so rather than quietly shipping you a thinner version of what you asked for.
Why the prices are what they are
Every number is anchored to something you can check — a competitor’s published list price or an awarded public contract.
Rates undercut the market on purpose
Other vendors sell negotiated rates built from the same public filings, so this half of the catalogue competes on price. The only published price in the category is a competitor listing one insurer’s rate file at $25,000 a year. The same thing here is $18,000. The full national file is $60,000, at the bottom of the $42,000 to $71,000 band that awarded federal contracts put comparable healthcare databases in.
Coverage Requirements is priced as the premium it is
No rate vendor sells this at all, and the vendors that do sell payer policy publish no prices and sell into enterprise pharma budgets. It is also by far the most expensive thing here to produce — every rule is read out of the insurer’s own document and quoted, never scraped or inferred. $150,000 for the full corpus, and it is the one dataset we do not discount to win a deal.
The join at $210,000
Large national claims databases run $190,000 to $233,000 a year on awarded federal contracts. Rates joined to the rules that gate them is the only dataset of its kind, and it is priced inside that band rather than above it.
Every slice is priced by a published rule
A slice covering a share of the grid costs the square root of that share, times the full price. That rule is written out with a worked example, so you can price your own subset before you contact us. Where the market says something different from the rule — the single-insurer rate file is the one real case — the market wins and we say so on the line.
Every slice is a real subset
A slice is the same columns, the same quality gates and the same quarterly refresh over less of the grid. Nothing is held back to make the full set look better, and slices stack — you are never asked to re-buy what you already hold.
Tell us which slice you need
Name the dataset and how much of it. We come back within one business day with a firm price and a start date.