Consumer app
Your coverage workspace
Healthcare transparency
Full cost-share, Rx tiers, prior auth, mental health, maternity, rehab, DME, and telehealth — modeled for low, medium, and high utilizers. Facility charges use explicit filed vs modeled labels (curated CMS shoppable-style samples — not a live crawl). Not live quotes; not insurance advice.
Machine-readable transparency (MRF)
Educational framing — how price transparency files relate to what we show
Federal rules require many hospitals and health plans to publish machine-readable files (MRFs) with negotiated rates and out-of-network allowed amounts. Those files are raw, huge, and not consumer-ready — but they are the compliance backbone behind “know before you go” pricing.
How we show price in this demo: we do not ingest live MRFs at runtime. Use the search box below for drugs & procedures by name or code; the facility panel shows curated shoppable-service charges with explicit filed vs modeled badges (sample file / not live crawl). Plan cards still combine cost-share with utilizer scenarios — educational models, not EOBs, guarantees, or insurance advice. See Trust & compliance and deductible vs OOP.
Transparency dataset by metro
Switch across the seven curated ZIP scopes (Dallas, Maine, NYC, Chicago, LA, Atlanta, Denver). Active: Dallas, TX · 75201. Drives the facility panel below.
Transparency metro
Dallas, TX · 75201
Switch curated hospital shoppable-service samples by metro. Educational data — not live MRF crawls or quotes; not insurance advice.
Search drugs & procedures
Find shoppable services by name or code in Dallas, TX · 75201. Facility charges labeled Filed; plan member share labeled Modeled when a plan is selected. Curated sample — not a live crawl. Not live quotes; not insurance advice.
No plan selected — showing filed facility prices only. Pick a plan to see modeled member share.
Try a CPT/HCPCS code (e.g. 70553, J1100) or a name like MRI, colonoscopy, chest X-ray, metabolic, or dexamethasone.
Filed = illustrative CMS shoppable / transparency-style facility charges (curated sample, not a live hospital crawl). Modeled = educational plan member-share estimate when a plan is selected (deductible + coinsurance or ER copay). Not live quotes. Not an EOB. Not insurance or medical advice.
Facility price transparency
Shoppable-service style facility charges by metro — every row labeled filed or modeled. Not live quotes; not insurance advice.
Transparency metro
Dallas, TX · 75201
Switch curated hospital shoppable-service samples by metro. Educational data — not live MRF crawls or quotes; not insurance advice.
Showing Dallas, TX (Dallas–Fort Worth (demo)). Demo Dallas household is fictional sample data — not a real member record.
| Facility | Charge | Provenance |
|---|---|---|
Parkland Memorial Hospital Chest X-ray, 2 views · 71046 | $265 | Filed |
Methodist Dallas Medical Center Chest X-ray, 2 views · 71046 | $390 | Modeled |
Baylor University Medical Center Chest X-ray, 2 views · 71046 | $420 | Filed |
Methodology & honesty labels
Parity facility price transparency (increments 2–6) WHERE NUMBERS COME FROM • CMS Hospital Price Transparency rules require hospitals to publish machine-readable files (MRFs) and a consumer shoppable-services list (typically ≥300 services) with gross charges, discounted cash prices, and payer-specific negotiated rates where applicable. Our "filed" samples are curated illustrative rows in that conceptual shape (CPT-ish shoppable services: MRI, ED visit, colonoscopy, childbirth, PT, chest X-ray, CT head, CMP lab, plus facility-administered Rx HCPCS e.g. J1100), not a live ingest of any hospital's MRF at runtime. • ZIP scopes in this demo: Dallas 75201 (primary), Maine 03904 (example), plus NYC 10001, Chicago 60611, Los Angeles 90012, Atlanta 30303, and Denver 80202. The Dallas household in demo-data is fictional — not any real user's PHI. • Bundled CMS MRF sample loader (cmsMrfSampleLoader): read-only ingest of a small in-repo JSON/CSV fixture shaped like simplified shoppable rows. Explicitly labeled "sample file / not live crawl" — never a live hospital crawl or live quote. WHAT IS MODELED • "modeled" rows are educational estimates (metro medians / relative adjustments) used when we lack a filed-style sample for that facility×service. They are labeled modeled in every API and UI surface. • Plan cost-share estimates elsewhere in Parity (deductible / coinsurance / OOP) remain separate modeled member-cost scenarios — not facility list prices. PLAN DETAIL (increment 3) • On /app/health/[planId], filed facility shoppable charges for the selected metro ZIP are shown side-by-side with modeled plan member cost-share (deductible + coinsurance or ER copay). See healthFiledVsModeled.ts. Badges remain Filed vs Modeled. DRUG / PROCEDURE SEARCH (increment 4) • Search box on /app/health (and transparency panel) matches shoppable services by name or code against the curated transparency dataset for the selected metro ZIP (parity_health_zip). Results list filed facility prices with Filed/Modeled badges; when a plan context is selected, a modeled member-share estimate is shown — otherwise a clear "no plan selected" note. See healthTransparencySearch.ts. • Dataset remains curated/illustrative — not fake live feeds. FAVORITES / ANNUAL CARE (increments 5–6) • Users can favorite procedures/drugs from search or the facility panel; favorites persist on the household via AppState → localStorage (parity_app_v1). The health hub favorites list re-runs filed prices for the selected metro ZIP. • Annual care scenario bundles primary care / PT / imaging / lab / Rx admin (plus optional favorites) into plan × estimated yearly member cost using filed facility prices + modeled cost-share. Increment 6 adds pediatric and pregnancy presets and clipboard/printable export of plan × estimated yearly member cost. See healthFavorites.ts and healthAnnualScenario.ts. HONESTY • Never treat these as live quotes, guarantees, or insurance advice. • Always surface provenance badges: filed vs modeled. • Sample MRF path uses parseCmsLikeJson / parseCmsLikeCsv → normalizeCmsLikeRow; source badge must read sample file / not live crawl. • Metro ZIP picker (7 scopes) is first-class on /app/health; optional localStorage key parity_health_zip persists the selection.
Sample file / not live crawl — bundled fixture shaped like simplified CMS hospital price transparency shoppable rows. Parser demo only; not a live hospital MRF fetch, not live quotes, and not insurance advice.
See also Trust & compliance.
Annual care scenario
Sample yearly bundle for Dallas, TX · 75201 — filed facility prices where available + modeled plan cost-share. Not insurance advice; not live quotes (sample dataset, not a live crawl).
Adult (default) bundle
Primary care, PT, MRI, lab, and facility-admin Rx for a typical adult year.
- Primary care office visits ×2 (plan copay · Modeled)
- Physical therapy evaluation, low complexity
- MRI brain without & with contrast
- Comprehensive metabolic panel
- Injection, dexamethasone sodium phosphate, 1 mg
Export plan × estimated yearly member cost (clipboard / print)
Loading plan estimates…
Printable export — Adult (default)
Dallas, TX · 75201 · plan × estimated yearly member cost · Filed / Modeled honesty
Parity — Annual care scenario Metro / ZIP: Dallas, TX · 75201 Scenario: Adult (default) [adult] Bundle: Primary care office visits ×2; Physical therapy evaluation, low complexity; MRI brain without & with contrast; Comprehensive metabolic panel; Injection, dexamethasone sodium phosphate, 1 mg Plan × estimated yearly member cost (sorted low → high): 1. Anthem Catastrophic Shield (Anthem · catastrophic) Premium: $3,120 Est. care share: $2,232 Est. annual member: $5,352 Labels: Filed ×4 · Modeled ×5 2. Oscar Bronze Simple (Oscar · bronze) Premium: $4,680 Est. care share: $2,312 Est. annual member: $6,992 Labels: Filed ×4 · Modeled ×5 3. Aetna Bronze Essential (Aetna · bronze) Premium: $4,920 Est. care share: $2,332 Est. annual member: $7,252 Labels: Filed ×4 · Modeled ×5 4. Ambetter Silver Secure (Ambetter · silver) Premium: $6,600 Est. care share: $2,292 Est. annual member: $8,892 Labels: Filed ×4 · Modeled ×5 5. Cigna Connect Silver (Cigna · silver) Premium: $6,960 Est. care share: $2,312 Est. annual member: $9,272 Labels: Filed ×4 · Modeled ×5 6. BCBSTX Silver Choice (Blue Cross Blue Shield of Texas · silver) Premium: $7,440 Est. care share: $2,302 Est. annual member: $9,742 Labels: Filed ×4 · Modeled ×5 7. Molina Gold Care (Molina · gold) Premium: $8,880 Est. care share: $2,282 Est. annual member: $11,162 Labels: Filed ×4 · Modeled ×5 8. Humana Gold Plus (Humana · gold) Premium: $9,240 Est. care share: $2,272 Est. annual member: $11,512 Labels: Filed ×4 · Modeled ×5 9. UHC Gold Advantage (UnitedHealthcare · gold) Premium: $9,720 Est. care share: $2,085 Est. annual member: $11,805 Labels: Filed ×4 · Modeled ×5 10. Kaiser Permanente Platinum (Kaiser Permanente · platinum) Premium: $11,880 Est. care share: $253 Est. annual member: $12,133 Labels: Filed ×4 · Modeled ×5 Filed / Modeled: Estimated annual member cost = plan premium + educational care cost-share for this sample bundle. Filed = curated CMS shoppable-style facility charges for the selected metro ZIP (sample, not a live crawl). Modeled = plan deductible/coinsurance/copay applied to those charges (or PCP copay when no facility row). Not live quotes. Not an EOB. Not insurance or medical advice. Methodology: curated CMS shoppable-style filed facility charges (sample, not a live crawl) + modeled plan deductible/coinsurance/copay for a shared plan year — educational estimate only; not advice. Not insurance or medical advice. Sample dataset — not a live hospital crawl. Not a quote or EOB.
Methodology: curated CMS shoppable-style filed facility charges (sample, not a live crawl) + modeled plan deductible/coinsurance/copay for a shared plan year — educational estimate only; not advice.
Bundle line items & honesty labels
Services in this run: Primary care office visits (×2) · Physical therapy evaluation, low complexity · MRI brain without & with contrast · Comprehensive metabolic panel · Injection, dexamethasone sodium phosphate, 1 mg
- Primary care office visitsModeled
Member ~$0 — Plan primary-care copay × visits — no facility filed row; educational only.
- Physical therapy evaluation, low complexityFiledModeled
Filed allowed ~$195 · Member ~$195 — Filed charge as allowed amount through shared-year deductible + coinsurance.
- MRI brain without & with contrastFiledModeled
Filed allowed ~$1,920 · Member ~$1,920 — Filed charge as allowed amount through shared-year deductible + coinsurance.
- Comprehensive metabolic panelFiledModeled
Filed allowed ~$95 · Member ~$95 — Filed charge as allowed amount through shared-year deductible + coinsurance.
- Injection, dexamethasone sodium phosphate, 1 mgFiledModeled
Filed allowed ~$22 · Member ~$22 — Facility-administered Rx charge through shared-year deductible + coinsurance — not retail pharmacy copay.
Estimated annual member cost = plan premium + educational care cost-share for this sample bundle. Filed = curated CMS shoppable-style facility charges for the selected metro ZIP (sample, not a live crawl). Modeled = plan deductible/coinsurance/copay applied to those charges (or PCP copay when no facility row). Not live quotes. Not an EOB. Not insurance or medical advice.
Aetna Bronze Essential
Aetna · bronze · HSA
Ind. deductible
$7,000
Ind. OOP max
$9,100
PCP / specialist
$50 / $90
Coinsurance
40%
ER copay
$500
Rx generic/brand
$20 / $60
Coverage matrix
Not covered / watch-outs
- ✕Cosmetic procedures
- ✕Adult dental/vision
- ✕Out-of-network except emergency
- ✕Experimental treatments
Network near 75201: 8 hospitals · 142 PCP · 380 specialists (Aetna Open Access)
Est. total · Medium utilizer · family 3
$8,470(premium $4,920 + care $3,550)
BCBSTX Silver Choice
Blue Cross Blue Shield of Texas · silver
Ind. deductible
$3,000
Ind. OOP max
$7,000
PCP / specialist
$35 / $65
Coinsurance
20%
ER copay
$350
Rx generic/brand
$15 / $45
Coverage matrix
Not covered / watch-outs
- ✕Cosmetic surgery
- ✕Non-formulary brand without exception
- ✕Acupuncture beyond 12 visits
Network near 75201: 14 hospitals · 210 PCP · 520 specialists (BCBSTX PPO)
Est. total · Medium utilizer · family 3
$10,775(premium $7,440 + care $3,335)
Cigna Connect Silver
Cigna · silver
Ind. deductible
$3,500
Ind. OOP max
$7,500
PCP / specialist
$40 / $70
Coinsurance
20%
ER copay
$400
Rx generic/brand
$10 / $50
Coverage matrix
Not covered / watch-outs
- ✕Out-of-network elective
- ✕Infertility beyond basic diagnostics
- ✕Weight-loss drugs without criteria
Network near 75201: 7 hospitals · 95 PCP · 260 specialists (Cigna Connect)
Est. total · Medium utilizer · family 3
$10,300(premium $6,960 + care $3,340)
UHC Gold Advantage
UnitedHealthcare · gold
Ind. deductible
$1,000
Ind. OOP max
$4,500
PCP / specialist
$25 / $50
Coinsurance
15%
ER copay
$250
Rx generic/brand
$10 / $35
Coverage matrix
Not covered / watch-outs
- ✕Cosmetic procedures
- ✕Private duty nursing
- ✕Non-medically necessary genetic tests
Network near 75201: 16 hospitals · 240 PCP · 610 specialists (UHC Choice Plus)
Est. total · Medium utilizer · family 3
$12,259(premium $9,720 + care $2,539)
Humana Gold Plus
Humana · gold
Ind. deductible
$1,200
Ind. OOP max
$5,000
PCP / specialist
$20 / $45
Coinsurance
20%
ER copay
$275
Rx generic/brand
$8 / $40
Coverage matrix
Not covered / watch-outs
- ✕Adult hearing aids
- ✕Cosmetic dental
Network near 75201: 10 hospitals · 170 PCP · 400 specialists (Humana PPO)
Est. total · Medium utilizer · family 3
$12,096(premium $9,240 + care $2,856)
Kaiser Permanente Platinum
Kaiser Permanente · platinum
Ind. deductible
$0
Ind. OOP max
$3,000
PCP / specialist
$15 / $30
Coinsurance
10%
ER copay
$150
Rx generic/brand
$5 / $25
Coverage matrix
Not covered / watch-outs
- ✕Care outside Kaiser except emergency
- ✕Non-formulary without exception
Network near 75201: 2 hospitals · 45 PCP · 120 specialists (Kaiser Integrated)
Est. total · Medium utilizer · family 3
$12,411(premium $11,880 + care $531)
Oscar Bronze Simple
Oscar · bronze · HSA
Ind. deductible
$6,500
Ind. OOP max
$9,100
PCP / specialist
$40 / $80
Coinsurance
50%
ER copay
$500
Rx generic/brand
$15 / $55
Coverage matrix
Not covered / watch-outs
- ✕Broad out-of-network
- ✕Many brand Rx without step therapy
Network near 75201: 5 hospitals · 70 PCP · 180 specialists (Oscar Circle)
Est. total · Medium utilizer · family 3
$8,110(premium $4,680 + care $3,430)
Ambetter Silver Secure
Ambetter · silver
Ind. deductible
$4,000
Ind. OOP max
$8,000
PCP / specialist
$30 / $60
Coinsurance
30%
ER copay
$375
Rx generic/brand
$12 / $45
Coverage matrix
Not covered / watch-outs
- ✕Narrow specialty panels in some ZIPs
- ✕Out-of-network elective
Network near 75201: 6 hospitals · 88 PCP · 210 specialists (Ambetter From Superior)
Est. total · Medium utilizer · family 3
$9,876(premium $6,600 + care $3,276)
Molina Gold Care
Molina · gold
Ind. deductible
$1,500
Ind. OOP max
$5,500
PCP / specialist
$25 / $55
Coinsurance
20%
ER copay
$300
Rx generic/brand
$10 / $40
Coverage matrix
Not covered / watch-outs
- ✕Limited tertiary hospitals
- ✕Some specialty centers
Network near 75201: 4 hospitals · 60 PCP · 150 specialists (Molina Marketplace)
Est. total · Medium utilizer · family 3
$12,095(premium $8,880 + care $3,215)
Anthem Catastrophic Shield
Anthem · catastrophic
Ind. deductible
$9,100
Ind. OOP max
$9,100
PCP / specialist
$0 / $0
Coinsurance
0%
ER copay
$0
Rx generic/brand
$0 / $0
Coverage matrix
Not covered / watch-outs
- ✕Most services until deductible met
- ✕Age/eligibility restrictions typical of catastrophic plans
Network near 75201: 12 hospitals · 180 PCP · 450 specialists (Anthem Blue Access)
Est. total · Medium utilizer · family 3
$5,880(premium $3,120 + care $2,760)