EarnestMD turns insurers’ own published rate data into a live rate workbench. Enter your practice and see exactly what comparable providers are paid by the same payers for the same procedures — ranked by the dollars you’re leaving on the table.
See your rate gap on one code — free, no credit card. See pricing.
Prefer it done for you? Founder-led Strategy takes the negotiation off your plate.
The problem
The insurer sits on the complete picture of what every provider in your market is paid. You see one contract: your own. That asymmetry is the whole game.
When the payer's offer lands, you have nothing to check it against. Without a market reference, "fair" is whatever they decide to call it.
Most contracts roll over untouched for years while the market moves. Without a benchmark, you can't tell whether you're at, above, or well below the going rate.
"We'd like a raise" loses. "Comparable groups in this market are paid 22% more by your plan for these exact codes" is a different conversation.
Who it’s for
Rate dynamics differ sharply by specialty — conversion factors, site of service, facility fees. Our models are built per specialty, not one-size-fits-all.
What we deliver
Three things in one workbench: the benchmark, the strategy, and the document you hand the payer.
Your contracted rates set against comparable providers — by payer, by CPT, by site of service. The exact gap, quantified.
A rate-gap and conversion-factor model showing precisely where you're underpaid and what closing the gap is worth in annual dollars.
A sanitized market-position document you can put directly in front of the insurer — your case, in their language, without exposing your strategy.
How it works
Enter your NPIs (or just your group name) and the payers and CPT codes that matter. No claims data, no contracts required.
We match your providers and comparable peers to the negotiated rates payers are federally required to publish — automatically.
Your rates land in a live workbench, benchmarked against your peer group by payer, code, and site of service — every gap quantified in dollars.
Rank every code by recoverable dollars, then print a board-ready report and a sanitized, payer-facing proposal — yourself, anytime.
The data
Since 2022, every commercial insurer has been federally required to publish its negotiated rates. That disclosure is public — but it lands as vast, fragmented machine-readable files no practice can use raw.
We’ve done the hard work of turning that disclosure into clean, comparable benchmarks — for your specialty, your codes, and your market — across the major commercial payers.
Why EarnestMD
Benchmarking today means stale surveys, expensive one-off decks, or raw files no one can parse. Here’s where we land instead.
Self-reported, blended national medians — often months stale and not tied to your actual payers or contracts.
EarnestMD: Your contracted rates vs. named-payer peers on the exact codes, drawn from the payers' own current filings.
$15–50K and weeks of back-and-forth for a one-time deck you can't refresh on your own.
EarnestMD: A live workbench you open yourself from $199/mo — refreshed monthly, re-run anytime. (Done-for-you is still there when you want it.)
Selected work
Client details are confidential, so the examples below are anonymized. The pattern is the same: find the gap, quantify it, arm the negotiation.
We benchmarked the group's ASA conversion factor against regional peers contracted with the same insurer, surfaced a material gap on the highest-volume codes, and produced both an internal strategy model and a sanitized proposal for the payer.
A site-of-service analysis quantified office vs. hospital-outpatient economics across professional and facility fees — showing the practice, the facility, and the combined health system what each procedure is actually worth in each setting.
We pulled negotiated rates for the group's highest-volume surgical CPT codes across every major commercial payer, exposing which contracts trailed the market and by how much.
Get in touch
Tell us a little about your practice. We’ll tell you whether there’s a payer gap worth chasing — before you commit to anything.
FAQ
From the negotiated-rate disclosures every commercial insurer has been required to publish under the federal Transparency in Coverage rule since July 2022. It is public data — the value is in turning it into clean, comparable, specialty-specific benchmarks.
The source data is public by federal mandate. Your own rates, volumes, and strategy stay confidential — that analysis lives only in the internal report. The document that goes to the payer is deliberately sanitized to make your market-position case without revealing your hand.
Just your provider NPIs (or your group name) and which payers you care about. We do not need your claims data or your existing contracts to produce a benchmark — the workbench resolves your providers and rates for you.
That's what the workbench is for: it hands you a defensible, sourced market-position case — your rates versus comparable providers on the exact codes, with the gap quantified in dollars. Our step-by-step guide covers when and how to formally request a renegotiation, the data to gather, a sample request letter, and the timing and legal guardrails.
Read the payer renegotiation guide →UnitedHealthcare, BlueCross BlueShield (state and national plans), Aetna, and Cigna. Humana exited the commercial market and no longer publishes commercial rates, so they are not available from any source.
Minutes. The workbench is self-serve — enter your practice, we resolve your providers and rates, and your benchmarks are live. There's no engagement to schedule. If you'd rather have it done for you, our founder-led Strategy option is there when you want it.
Open the workbench and see your payer gaps in minutes — or book a call and we’ll walk you through it. The live demo needs no account.