Personal Injury Defense Benchmarks

Challenge inflated medical bills with defensible market-based pricing benchmarks. Reduce claim costs by 30-50% and strengthen negotiation positions with CMS-validated pricing data.

Sample Medical Billing Reasonableness Report - CPT 73130 showing billed charge of $984.94 vs market 75th percentile of $40.50, demonstrating 96% reduction potential

Establish Reasonable Charges

Define defensible ranges for reasonable charges using negotiated rate data from CMS price transparency files

Challenge Inflated Bills

Expose disparities between billed charges and actual negotiated rates accepted by providers

Support Expert Testimony

Provide traceable, source-verified evidence that expert witnesses can reference in court

Why Choose Medlyze for PI Defense?

CMS-Validated Data

Access publicly verifiable rates from CMS price transparency files showing exactly what insurers agreed to pay for specific services

Defensible Methodology

Transparent, explainable methodology backed by independent economic analysis supporting negotiated rates as appropriate measure of value

Proven Cost Reduction

Typical bill reductions of 30-50% by challenging inflated charges with market-based benchmarks

How Price Transparency Data Strengthens PI Defense

Establish Reasonable and Customary Charges

Negotiated rate data helps define a defensible range for reasonable charges in damages calculations. Show the spectrum of rates that providers have accepted from various payers for identical services, backed by verifiable data rather than a single expert's opinion.

Challenge Inflated Provider Bills

Transparency data exposes disparities between billed charges and actual negotiated rates. When a provider bills $50,000 for a procedure but routinely accepts $8,000 from commercial insurers, that gap becomes powerful evidence against inflated medical specials.

Support Settlement Negotiations

Objective pricing benchmarks strengthen negotiation positions by anchoring discussions to verifiable market rates. When both sides reference the same publicly available data, conversations become more productive and often accelerate resolution.

Prepare Expert Witness Testimony

Price transparency data provides traceable, source-verified evidence that expert witnesses can reference when testifying about medical damages. The ability to trace every number back to its original source file adds credibility and makes cross-examination more difficult for opposing counsel.

Need More Detailed Insights? Call Us.

Get expanded data to inform game-changing insights

Access comprehensive rate databases with CMS-validated pricing data
Compare billed charges to market benchmarks and identify overcharges
Integrate pricing data into your systems using our APIs