Reimbursement decisions are made every day on unverified assumptions.
Medlyze provides the rate of record: the latest commercial, Medicare and Medicaid rate for any code and provider, each with its source.
Send the codes, payers and states you care about. We return the latest rates on record, each with its source, within 24 hours.
Test an assumption first ↓What rate are you assuming? See who agrees.
Real New York commercial rates, each traced to its file. A small slice: three codes, one state. The record behind it covers 200+ payers and 5,600+ hospitals.
Dot = median · thin line = lowest to highest rate · shaded bar = middle half of a payer’s providers · amber band = your rate ±10%
Start from the decision in front of you.
Launching a product
Set launch price points and a payer plan. What commercial payers and hospitals have published for the codes your product bills under, by payer and state.
DRG 194, New York: 4 payers’ medians run $20,542 to $29,170.
Device manufacturers →Negotiating a contract
Walk into a renewal with the market in hand. Your contracted rates beside what other payers and hospitals have published, with renewal dates and notice deadlines.
Inside Cigna, one provider lists 4 rates for DRG 194, $21,332 to $33,226.
Providers →Evaluating an offer
Check a payer’s proposal. Each proposed rate is seen against the market, code by code.
Same code, same state: Emblem Health’s median is $29,170 and Aetna’s is $20,542.
Compare contracts →Planning expansion
Decide which payers and states to pursue. Commercial rates for your test codes, and the payers where your contracts leave the most uncovered.
8 New York hospitals publish DRG 194 commercial rates; medians run $6,554 to $35,188.
Diagnostics and labs →Other buyers: employers, brokers, legal, home health, revenue cycle, data partners.
| Code | Your contract | Payer median | Hospital median |
|---|---|---|---|
| DRG 194 | $21,500 | $24,254 | $13,757 |
| Your contract is | 11% below | 56% above |
Know where to focus negotiation effort before the conversation starts.
Securely load your payer contracts. We read the fee schedules, terms and renewal dates; you confirm each field. Then compare any two, and set them against the rates payers and hospitals have published.
“Before working with Medlyze, we were struggling through payer negotiations with no visibility in market rates and little leverage to improve our low reimbursement rates. Medlyze provided the exact support we needed by exposing competitor rates and delivering a clear contract negotiation strategy, finally giving us the data to align our approach. Now, we are positioned to increase our rates with our current payer and have a replicable strategy for future contracts with companies like Cigna.”
Where do the commercial and hospital rates come from?
From the files payers and hospitals are required to publish: 200+ payers’ negotiated-rate files and the price transparency files of 5,600+ hospitals. We collect, match and check them, then add Medicare and Medicaid for reference.
Is the demo real data?
Yes. The rates in the demo are real: New York payers’ August 2026 negotiated-rate files and New York hospitals’ price transparency files, for three inpatient codes. Your request covers the payers, hospitals and codes you name, with Medicare and Medicaid, each with its source.
We already have benchmarks.
A benchmark compares. The rate of record shows the rate and where it came from. Send three codes and the benchmark you use, and we reconcile them.
We already have consultants.
Bring them. They can work from the same record, so what they cite and what you cite match.
These files are public.
They are, and they are enormous and inconsistent. The work is collecting payer and hospital files, matching them to your codes and providers, and checking them, so you get an answer instead of a pile of files.
Is my data safe?
You send codes and payers to start. Contracts are loaded securely, with you.
Start with the decision in front of you.
Send the codes, payers and states involved. We return the latest rates on record, each with its source.