{
  "dataset": "specialty-drug-rates",
  "kind": "SAMPLE",
  "vintage_quarter": "2026-Q2-06",
  "generated": "2026-08-21",
  "scope": {
    "states": [
      "CA",
      "TX",
      "FL"
    ],
    "insurers": [
      "aetna",
      "centene",
      "cigna",
      "uhc"
    ],
    "rows": 17817,
    "billing_codes": 987,
    "administration_codes": {
      "rows": 57,
      "codes": 19,
      "insurers": [
        "uhc"
      ],
      "note": "19 infusion administration codes (96360-96417), UnitedHealthcare only in this slice."
    }
  },
  "grain": "payer x state x billing_code x billing_class x negotiated_type",
  "columns": [
    "payer",
    "state",
    "billing_code",
    "billing_class",
    "negotiated_type",
    "n_tin",
    "n_distinct_rates",
    "p25",
    "p50",
    "p75",
    "min_rate",
    "max_rate",
    "asp_plus6",
    "medicare_bench",
    "pct_of_asp6",
    "ratio_vs_medicare"
  ],
  "reading_it": {
    "p50": "The middle negotiated rate. p25 and p75 bound the middle half.",
    "pct_of_asp6": "p50 as a percentage of ASP+6%, the federal drug benchmark. Under 100 means commercial pays less than Medicare would.",
    "n_tin": "How many tax IDs are behind the row. Judge depth by this, not by the rate.",
    "negotiated_type": "A code can appear more than once per insurer and state \u2014 a fee schedule rate, a negotiated rate and a derived rate are different things and are kept apart rather than averaged."
  },
  "things_that_will_look_odd": [
    "11,223 of 17,817 rows (63%) have p25 = p50 = p75. That is what a fee schedule looks like \u2014 every provider is paid the same number, so there is no spread to report.",
    "340 rows have a median of exactly $1.00. Those are floor or placeholder rates as the insurer filed them. We ship them rather than delete them so you can see what is in the source.",
    "Some rows have no asp_plus6, because the code is a procedure rather than a drug and has no average sales price."
  ],
  "not_in_this_sample": [
    "The other 33 insurers in the build.",
    "The other 48 states.",
    "Administration codes for the other three insurers. This slice carries them for UnitedHealthcare only.",
    "Tax-ID level detail \u2014 these are market distributions, not per-provider rates.",
    "Coverage rules, which are a separate dataset."
  ],
  "files": [
    {
      "path": "carecost_specialty_drug_rates_SAMPLE_2026Q2.csv",
      "bytes": 1825523,
      "sha256": "d2b89d192865a7da0c147ebfc244bdd6b898dc941ca2f136d8e8d6fd44f488d7"
    },
    {
      "path": "carecost_specialty_drug_rates_SAMPLE_2026Q2.parquet",
      "bytes": 478224,
      "sha256": "08e2e5ebbc53aa687dc992e82838c9ff7b3af455b84971492528d5cf2d036e5f"
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  ]
}