Hospital Transparency

Data dictionary for the Hospital Price Transparency data for medical and pharmaceutical services. Below are the fields available for Data Lake customers.

Additional metadata for the hospital address can be made available but is not part of our standard offering.

Field Name	Description / Sample Values	Original Source
ADDITIONAL_PAYER_NOTES	Free-text notes hospitals sometimes include for a payer or plan. e.g., “Only applicable to self-pay patients seen in ER,” “BCBS rates exclude lab fees”	HOSPITAL MRF
BILLING_CLASS	Claim classification. “Institutional”, “Professional”	HOSPITAL MRF
BILLING_CODE_CATEGORY	Broad clinical grouping of the billing code. “Imaging”, “Surgery–Outpatient”, “Lab & Pathology”	ADDED BY PAYERSET
CODE	Billing code exactly as published. “99213”, “0274”, “J9206”, “30145”	HOSPITAL MRF
CODE_TYPE	Coding system. “CPT”, “HCPCS”, “MS-DRG”, “APC”, “NDC”	HOSPITAL MRF
DESCRIPTION	Description from file (often truncated/abbreviated). “Office/outpatient visit est low-level”, “Knee arthroscopy w/ meniscus repair”	HOSPITAL MRF
DISCOUNTED_CASH	Hospital’s cash price offered to self-pay patients.	HOSPITAL MRF
DRUG_CATEGORY	Therapeutic class if row represents a drug. “Antineoplastic Agents”, “Analgesics”	HOSPITAL MRF
DRUG_TYPE	Brand / generic / biosimilar flag. “Brand”, “Generic”, “Biosimilar”	HOSPITAL MRF
DRUG_UNIT	Unit of measure for drug price. “mg”, “mL”, “tablet”	HOSPITAL MRF
GROSS	Hospital’s standard (chargemaster) price.	HOSPITAL MRF
HOSPITAL	Facility name from file header. “Mayo Clinic Hospital – Rochester”	HOSPITAL MRF
HOSPITAL_ID	Payerset stable hash / surrogate key for the facility.	ADDED BY PAYERSET
MAXIMUM	Highest negotiated rate among all payers/plans for this code.	HOSPITAL MRF
METHODOLOGY	Hospital’s narrative on how standard charges were derived. “Cost-to-charge ratio”, “Rate-setting committee approved”	HOSPITAL MRF
MINIMUM	Lowest negotiated rate among all payers/plans for this code.	HOSPITAL MRF
PAYER_NAME	Payer name as listed by hospital. “UnitedHealthcare”, “BCBS MN”, “Medicare FFS”	HOSPITAL MRF
PLAN_NAME	Plan or network label from hospital. “UMR PPO”, “Horizon Omnia Tier 1”	HOSPITAL MRF
PS_PAYER	Payerset-standardized payer name (mapped across hospitals).	ADDED BY PAYERSET
PS_PLAN	Payerset-standardized plan/network name.	ADDED BY PAYERSET
SETTING	Care setting or place of service (hospital-reported). “Inpatient”, “Outpatient”, “Emergency Dept”, “Ambulatory Surgery”	HOSPITAL MRF
STANDARD_CHARGE_ALGORITHM	Text describing how STANDARD_CHARGE_PERCENTAGE or STANDARD_CHARGE_DOLLAR was calculated. “Gross × 25%”, “Average of top 3 commercial contracts”	HOSPITAL MRF
STANDARD_CHARGE_DOLLAR	A flat-dollar “standard charge” (CMS-defined).	HOSPITAL MRF
STANDARD_CHARGE_PERCENTAGE	Percent-based standard charge, if reported. “150% of Medicare OPPS”	HOSPITAL MRF
SYSTEM	Parent health-system / IDN, if hospital provided or we inferred it. “HCA Healthcare”, “Sutter Health”	ADDED BY PAYERSET (fallback to MRF when present)