Benchmark Results Table
Results are displayed in a table with one row per billing code / payer combination. Each row shows:
| Column | Description |
|---|---|
| Billing Code | CPT/HCPCS code and description |
| Payer | Insurance company or plan |
| Your Rate | The average negotiated rate for the entered NPI(s) |
| Market Median | Median rate across all market providers for the same code and payer |
| 25th Percentile | Lower quartile of market rates |
| 75th Percentile | Upper quartile of market rates |
| Market Mean | Simple average of all market rates |
| Market Count | Number of rate records in the market comparison |
| Positioning | Whether the provider is Under Market, At Market, or Above Market |
| $ Difference | Dollar gap between the provider's rate and the market median |
| % Difference | Percentage gap relative to the market median |
Positioning Thresholds
A provider is classified as At Market if their rate is within ±5% of the market median. Rates more than 5% below the median are Under Market; rates more than 5% above are Above Market.
| Classification | Threshold |
|---|---|
| Under Market | Provider rate is more than 5% below market median |
| At Market | Provider rate is within ±5% of market median |
| Above Market | Provider rate is more than 5% above market median |
Summary Card and Opportunity Value
A summary card at the top of the results shows the total number of codes analyzed, the count in each positioning category, and the aggregate opportunity value — the total dollar gap across all above-market codes, representing the potential savings if rates were brought to market median.
Use case: The opportunity value is particularly useful when preparing for contract negotiations. It quantifies the aggregate dollar impact of above-market rates and can be exported as a CSV to share with your contracting team.
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