Free tool
Free toolPayer Fee Schedule Checker
Compare your contracted rates to Medicare benchmarks. This calculator is free, requires no signup, and runs entirely in your browser. Medonix never receives your inputs unless you opt in to receive a personalized report by email.
Result
Contracted vs Medicare
115%
How your rate compares to the Medicare baseline for the same code.
Contracted vs payer typical
97%
Typical BCBS (typical commercial) contracts pay ~118% of Medicare.
Expected rate
$111
Medicare × 1.18 multiplier for BCBS (typical commercial).
Annual gap @ volume
$-5.3k
Positive means above expected, negative means below.
Methodology
Payer multipliers: typical contracted rate as a percentage of Medicare for each payer, drawn from MGMA payer benchmark data supplemented by Medonix's founding client cohort. Actual rates vary by state, plan, and group size.
Note: this is a directional check, not a fee-schedule database. Negotiating leverage scales with volume; positive gaps below 5% are usually not worth re-opening.
Frequently asked
About the Payer Fee Schedule Checker.
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