EARLY ACCESS · ONBOARDING DESIGN PARTNERS
Know what payers actually pay for continence supplies.
Commercial negotiated rates for nine HCPCS codes, pulled from payer transparency files every month and benchmarked against the Medicare DMEPOS allowable.
- covered lives
- 155.4 M
- payers
- 6
- rate refresh
- monthly
- HCPCS codes
- 9
Sum of each payer’s own publicly reported membership figure, on the basis that payer states, as of 2025-12-31, which is the oldest of those dates. Per-payer figures, bases and citations are on the payer pages.
Data from
- Aetna
- Anthem
- Centene
- Cigna
- Health Care Service Corporation
- Kaiser Permanente
Logos are the trademarks of their respective owners. Their display does not imply endorsement or affiliation.
Benchmark rates
See what each payer negotiated for a code, by geography, against the Medicare allowable.
Stay current
Code splits, LCD revisions, and fee-schedule updates for the codes you bill.
Research your way
Bring your own bulletins and documents, and query them alongside the rate data.
Nine codes, not five million
Horizontal platforms index the whole market. We know A4297 and A4353 share one 200-unit ceiling.
What you can ask
EARLY ACCESS- Which payers in Texas pay above the Medicare allowable for A4353?
- Has any payer priced A4479 yet?
- Show me every rate change for the hydrophilic codes since January.
- What documentation does this MAC require for a coudé tip?
How we compare
| PayorTransparency | Turquoise Health | DeductibleData | |
|---|---|---|---|
| Continence-specific code logic | Nine codes, with shared quantity ceilings modelled | Market-wide platform for prices, contracts, and transactionsverified 2026-08-06 | General-purpose negotiated-rate dataset extractionverified 2026-08-06 |
| Coverage rules alongside rates | Coverage criteria and documentation rules on the same page as the rate | Payer policies integrated to contractsverified 2026-08-06 | not published |
| Medicare benchmark built in | Medicare DMEPOS allowable, benchmarked on every code | Medicare fee schedules included in Clear Ratesverified 2026-08-06 | Commercial TiC rates only, directing Medicare and Medicaid pricing to CMS channelsverified 2026-08-06 |
| Published pricing | Structure published, figures on a call | not publishedverified 2026-08-06 | $164/moverified 2026-08-06 |
| Code-set depth vs market breadth | Nine codes in one category, not five million across the market | Built-in crosswalks across DRG, APC, HCPCS and custom codesverified 2026-08-06 | 16 billing code types, including CPT, HCPCS, MS-DRG and NDCverified 2026-08-06 |
Where a cell reads not published, that is a statement about the public record rather than about the company. It means we went looking on their own pages and did not find them saying it.
See the full comparisonTHE WORKFLOW THIS REPLACES
Four sites. Three formats. No single answer.
To settle one question about A4297, whether a hydrophilic kit can still go out under the old code and how many units you can ship this month, you read the LCD on CMS’s coverage database, cross-check PDAC’s classification guidance, find the DME MAC documentation article, and pull the quarterly DMEPOS fee schedule.
The coverage database blocks automated tools. One MAC publishes its guidance as a PDF that will not parse. None of them agree on where the answer lives.
Read the A4297 page- 01
Pick your codes
Tell us which of the nine you bill. That is the whole setup.
- 02
See the landscape
LIVESix payers, every geography they file, benchmarked against the Medicare allowable.
- 03
Stay ahead
EARLY ACCESSCode splits, policy revisions and fee-schedule updates as they land.
We are onboarding design partners now.
If you bill these codes, we want to build against your questions.
Book a call