README.md

metadata

pretty_name: RateCommons Cigna in-network rates
license: other
tags:
  - healthcare
  - price-transparency
  - transparency-in-coverage
  - insurance
  - parquet
configs:
  - config_name: rate_fact
    data_files:
      - split: release_2026_10
        path: release=2026-10/rate_fact/*.parquet
  - config_name: network_set
    data_files:
      - split: release_2026_10
        path: release=2026-10/network_set/*.parquet
  - config_name: block
    data_files:
      - split: release_2026_10
        path: release=2026-10/block/*.parquet
  - config_name: network
    data_files:
      - split: release_2026_10
        path: release=2026-10/network.parquet
  - config_name: source_file
    data_files:
      - split: release_2026_10
        path: release=2026-10/source_file.parquet
  - config_name: code
    data_files:
      - split: release_2026_10
        path: release=2026-10/code.parquet
  - config_name: provider_set
    data_files:
      - split: release_2026_10
        path: release=2026-10/provider_set/*.parquet
  - config_name: provider_list
    data_files:
      - split: release_2026_10
        path: release=2026-10/provider_list/*.parquet
  - config_name: provider_group
    data_files:
      - split: release_2026_10
        path: release=2026-10/provider_group.parquet
  - config_name: price_list
    data_files:
      - split: release_2026_10
        path: release=2026-10/price_list/*.parquet
  - config_name: price_term
    data_files:
      - split: release_2026_10
        path: release=2026-10/price_term/*.parquet

RateCommons: Cigna in-network rates

Every in-network rate Cigna published under the Transparency in Coverage rule, parsed, deduplicated across files and stored as Parquet. Part of RateCommons, a free public dataset of negotiated health care prices. Code: https://github.com/Harshu-Pande/ratecommons

Release 2026-10: 124 source files, 304,777,863 distinct rate facts from 1,928,514,784 published rate rows, 9.6 GB.

Tables

Table	Rows	What it holds
rate_fact	304,777,863	One row per distinct rate fact: a billing code, a provider set and a price list, with the set of networks it appears in (ns_id). Sorted by code. 16 parts by billing code.
network_set	13,826	ns_id -> the sorted list of network_ids sharing those facts. One file per rate_fact part, so a set can repeat across files.
block	9,204,687	One row per billing-code record (code plus its sorted provider-set/price-list pairs): rate count, how many files carry it, and its network set (ns_id).
network	124	One row per derived network: distinct file content (size and gzip trailer).
source_file	124	One row per source file: name, URL, size, gzip fingerprint, header, counts, parser flags, and its network_id.
code	116,566	Billing codes as published (type, version, code, arrangement), keyed by code_id. Descriptor text is withheld where it is licensed (see below).
provider_set	1,659,804	ps_id -> the provider lists (pli_ids) a rate applies to. Its ID is the hash of its sorted provider lists.
provider_list	130,324	pli_id -> the provider groups (pg_ids) of one provider reference as published.
provider_group	664,715	pg_id -> TIN (type, normalized value, raw values) and sorted NPI list; tin_wide when the file lists NPI 0 (the whole TIN). Business names are hints only.
price_list	28,290,701	pl_id -> the price terms (pt_ids) of one negotiated_prices list.
price_term	9,390,706	pt_id -> one negotiated price: type, amount (rate_e4 = dollars x 10,000, plus rate_raw exactly as published), billing class, setting, service codes, modifiers, expiration date, additional information, parsed revenue-code ranges and flags.

How the pieces fit

IDs are content hashes (xxh3-128 over a canonical encoding of the values), so the same provider group, provider set, price term or price list gets the same ID in every file, release and payer. code_id also covers the payer's own wording (name, description, arrangement), so join codes across payers on billing_code_type and billing_code. A rate is the join

rate_fact -> code (code_id)
          -> provider_set (ps_id) -> provider_list (pli_ids) -> provider_group (pg_ids)
          -> price_list (pl_id)   -> price_term (pt_ids)
          -> network_set (ns_id)  -> network / source_file (network_ids)

Example with DuckDB (reads only what the query needs):

INSTALL httpfs; LOAD httpfs;
CREATE VIEW fact AS SELECT * FROM 'hf://datasets/ratecommons/cigna/release=2026-10/rate_fact/*.parquet';
CREATE VIEW ps AS SELECT DISTINCT s.ps_id, unnest(l.pg_ids) AS pg_id
  FROM (SELECT ps_id, unnest(pli_ids) AS pli_id FROM 'hf://datasets/ratecommons/cigna/release=2026-10/provider_set/*.parquet') s
  JOIN 'hf://datasets/ratecommons/cigna/release=2026-10/provider_list/*.parquet' l USING (pli_id);
CREATE VIEW pg AS SELECT * FROM 'hf://datasets/ratecommons/cigna/release=2026-10/provider_group.parquet';
CREATE VIEW pl AS SELECT pl_id, unnest(pt_ids) AS pt_id FROM 'hf://datasets/ratecommons/cigna/release=2026-10/price_list/*.parquet';
CREATE VIEW pt AS SELECT * FROM 'hf://datasets/ratecommons/cigna/release=2026-10/price_term/*.parquet';

SELECT pg.tin_value, pg.npis, pt.negotiated_type, pt.rate_e4 / 1e4 AS rate, pt.rate_raw,
       pt.billing_class, pt.setting, pt.service_code, fact.ns_id
FROM fact JOIN ps USING (ps_id) JOIN pg USING (pg_id) JOIN pl USING (pl_id) JOIN pt USING (pt_id)
WHERE fact.billing_code_type = 'CPT' AND fact.billing_code = '99213'
  AND pg.tin_value = '123456789';  -- a 9-digit EIN

rate_fact is split into 16 parts by xxh3_64(billing_code_type + '\x1f' + billing_code) % 16, so a lookup by code can read one part. Files are ZSTD Parquet sorted by code, then provider set.

Reading it correctly

• A missing rate means "no published rate", never "out of network".
• A network here is a derived one: one distinct source file. network_set says which files carry a fact; source_file.name names the file (its product or region). Plan-to-file mappings are in the payer's table of contents, archived daily in ratecommons/raw-manifests.
• Rates keep the published string (rate_raw) next to the integer amount (rate_e4, ten-thousandths of a dollar). percentage rates are percents, not dollars. Read negotiated_type, billing_class and setting before comparing amounts.
• Provider identity is TIN plus NPI list. Names in payer files (business_names, network names) are not identities.
• Nothing is dropped for being odd: deviations from the schema are kept and counted as flags (price_term.flags, source_file.flags), for example placeholder amounts of $0.01 or several amounts under identical terms.

Code descriptions

Code numbers are published; descriptor text is not always ours to republish. Text is withheld (code.text_withheld = true, name and description empty) for CPT (AMA), CDT (ADA), revenue codes and proprietary DRG groupers, including descriptions inside bundle. HCPCS Level II, MS-DRG, ICD, APC, HIPPS, NDC and payer-defined codes keep their published text.

Provenance and license

Source: Cigna's machine-readable files published under 45 CFR 147.212 (Transparency in Coverage). source_file lists every file with its URL and fingerprint. RateCommons makes no claim to the underlying rates. This is not medical, legal or financial advice; a published rate is not a quote of what a patient will pay.