Nonprofit ยท FAIR Health
FAIR Health Consumer cost estimates
A nonprofit's tools for estimating what providers charge and what insurers pay in your area, plus insurance basics. Useful evidence in an out-of-network payment dispute. It does not file appeals or negotiate for you.
Know before you go
The estimates come from claims data: the page says the database holds tens of billions of private and Medicare claim records, and that the cost data on the site is updated twice a year. An estimate is not a quote, and it is not what your plan must pay or a provider must accept. The page says New York, Connecticut and other states use FAIR Health information in consumer-protection laws, so a benchmark may carry weight in some disputes. The site does not file appeals or negotiate bills for you.
- Cost
- Not stated on the page. Our research review found no charge and no advertising on the consumer site.
- Where
- Nationwide
- How to start
- Open the medical and hospital cost tool, enter the procedure and your area, and keep a copy of the result with your appeal or your bill dispute.
- Have ready
- The procedure or service name or billing code from your bill; Your ZIP code; Whether the provider was in or out of your plan's network
Where this comes from
- Provider
- FAIR Health
- Source we read
- https://www.fairhealthconsumer.org/
- Date we read it
- . This is not a fresh check.
- Date the provider printed
- Not displayed
- What we checked
- We read the provider's public page. We have not verified availability, eligibility or outcomes for any individual.
Other starting points
- Program or service
Legal Action Center free legal help in New York
Free legal help for New Yorkers with substance use disorders or mental health care needs, including insurance barriers to treatment. Nationwide help is limited to certain addiction-medication cases.
From Legal Action Center
- Program or service
National Alliance on Mental Illness guide to insurance denials
A plain explanation of why mental health care is denied, five signs of a possible parity violation, and a link to a longer appeals guide written with The Kennedy Forum. Information only.
From National Alliance on Mental Illness
- Program or service
No Surprises Help Desk: surprise bill questions and complaints
The federal help desk for questions or complaints that a plan, provider or facility broke the surprise billing rules. It reviews the complaint and may refer it to another federal or state enforcer.
From Centers for Medicare & Medicaid Services