Pricing
Transparent pricing, tied to the rates we win
Every engagement starts with an analysis of 4 commercial contracts. The analysis fee is credited toward the negotiation of your first contract. Performance fees are only owed once your rates actually move.
| Annual practice revenue | Analysis of 4 contracts | Each added contract | What's included |
|---|---|---|---|
| Under $1.2M | $5,000 | $2,500 | Fee credits toward negotiation of the first contract. |
| $1.2M – $3.5M | $10,000 | $2,500 | Same contingency structure and credit toward the first contract. |
| $3.5M – $7M | $15,000 | $2,500 | Same contingency structure and credit toward the first contract. |
| $7M – $25M | $20,000 | $2,500 | Same contingency structure and credit toward the first contract. |
| Over $25M | Custom quote | — | Custom quote from management — do not quote a fee on the call. |
Performance fee: $1,000 per percentage point of achieved rate lift, beginning at 5% and capped at 12%. Below 5% lift, nothing is owed.
The same numbers our analysts use
Pick your specialty to see the commercial carriers and benchmark allowed amounts we negotiate against — the identical reference data behind every NPAG rate model.
Top commercial carriers
- Blue Cross Blue Shield (local plans)~35.0% of commercial lives
Largest local book — evergreen contracts and silent renewals, often the hardest but highest-value lift.
- UnitedHealthcare~27.0% of commercial lives
National fee schedule with local flexibility; responds to benchmarked code-level data.
- Aetna~18.0% of commercial lives
Plan-level pricing and carve-outs can be renegotiated with strong utilization benchmarks.
- Cigna~12.0% of commercial lives
Quality and network-access levers often unlock better rates for independent practices.
- Humana~8.0% of commercial lives
Medicare Advantage-heavy mix; commercial rates move when anchored to competitive benchmarks.
Where the dollars sit
| CPT | Description | Annual units | Medicare allowed | Paid today (modeled) | Market ceiling | Annual opportunity |
|---|---|---|---|---|---|---|
| 99213 | Office visit, established patient, low complexity | 3,200 | $92.00 | $118.00 | $146.00 | $89,600 |
| 99214 | Office visit, established patient, moderate complexity | 2,600 | $130.00 | $168.00 | $208.00 | $104,000 |
| 99204 | Office visit, new patient, moderate complexity | 900 | $175.00 | $226.00 | $281.00 | $49,500 |
| 99215 | Office visit, established patient, high complexity | 540 | $184.00 | $238.00 | $296.00 | $31,320 |
| 99396 | Preventive visit, established, 40–64 yrs | 780 | $148.00 | $192.00 | $238.00 | $35,880 |
| 36415 | Routine venipuncture | 2,100 | $3.00 | $8.00 | $13.00 | $10,500 |
Model your engagement
- Modeled annual uplift
- $320,800
- Analysis & negotiation fees
- $17,500
- Performance fee at 12% lift
- $12,000
- Net kept by the practice
- $291,300
Illustrative only. Actual benchmarks depend on your executed contracts, geography and payer mix — which is exactly what the free quote below establishes.
Get a free quote
Send us your specialty and commercial volume. We'll come back with a fixed analysis fee and a first look at where your rates sit against the market — within one business day.