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PayerParity Claim Pricer

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Independent claim pricing workbench at cmswebpricer.com for health plans, TPAs, reference-based pricing vendors and payment integrity teams. Prices inpatient claims by MS-DRG at any US hospital, with Original Medicare and Medicare Advantage out-of-network payment side by side, plus SNF, outpatient and ASC, and professional claims. State Medicaid APR-DRG pricing covers New York, Texas, Colorado, Virginia and Washington, plus Maryland's rate-regulated system. Every price shows its full formula: weights, wage index, outliers, transfers and add-ons. Import 837I files, reprice claims in batch, model contracts as a percent of Medicare, and export repriced 837 and 835 files. In a 5,000-claim test, every claim matched CMS's own Web Pricer within $1. Independent tool, not affiliated with CMS.

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