Current payerAnthem Blue Access PPO ยท #HFO-2291
WorksitesCincinnati, OH ยท Covington, KY
MarketsWithin 25 mi ยท OH, KY
ScopeImaging + surgical
Cohort~40 comparable plans (anonymized)
Plan year2026 ยท updated Jul 12
Measured overspend vs your cohort
$312K / year

โ‰ˆ$200K (about two-thirds of the $312K measured gap) realistically addressable, phased over the plan year โ€” directional. Year-one capture typically runs 10โ€“20% of the measured gap (โ‰ˆ$31โ€“62K), ramping toward the โ‰ˆ$200K net over time.

78th percentile of cost among similar plans โ€” anonymized cohort of ~40 comparable manufacturers.

Plan year 2026 12 monthly data versions Updated Jul 12
โ‡„

RFP comparison

Renewal-ready doc: your rates vs the peer-cohort target.

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iBased on public MRF data โ€” connect your claims feed in settings to weight this by your actual utilization.
1,240
Procedures analyzed
~40
Cohort size (anonymized)
64%
Procedures above cohort median
12
Months trended

Where you sit in the cohort

Distribution of total cost across ~40 similar plans โ€” anonymized, no named employers.

p25 median p75 You ยท 78th Lower cost Higher cost

Largest-variance procedures

Annualized. Cohort median + your excess.

Median Your excess
$0$25K$50K$75K$100K
MRI, lower spine
$88K
Knee arthroscopy
$71K
CT, abdomen
$54K
Colonoscopy
$41K

Common procedures

Your negotiated rate vs. cohort median.

You Median
MRI, lower spine CPT 72148
$3,480
$2,410
+44%
Knee arthroscopy CPT 29881
$6,120
$4,600
+33%
CT, abdomen w/ contrast CPT 74160
$1,890
$1,510
+25%
Colonoscopy, screening CPT 45378
$2,260
$1,970
+15%

Rate trend over time

12 monthly MRF versions โ€” the recurring intelligence a static report can't match.

Your rate Cohort median
$3.6K $3.2K $2.8K $3,480 $2,410 Aug '25 Nov '25 Feb '26 May '26 Jul '26

Local cost position

Your sites sit ~$840 per common procedure above the local median.

Directional โ€” a blended position across the facilities near your worksites, weighted by common CPTs. For the ranked facility map and exact per-procedure rates, use Compare.

Look up any procedure โ†’ Compare
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