ClearCost Health

What ClearCost Health does

ClearCost Health is a SaaS healthcare price transparency and provider search company founded in 2010 and headquartered in San Francisco. The company builds a configurable platform that combines Machine Readable File (MRF) pricing data with claims data and real-time accumulator data to deliver out-of-pocket cost estimates, provider search across 120+ specialties and 30+ facility types, quality ratings, and member-experience customization for healthcare payers and self-insured employers. Its product surface includes a core Provider Search & Price Transparency module, MRF Analytics for payer-side network and contracting analysis, a suite of embeddable APIs (MRF Pricing, Provider Directory, Fair Price, CMS Compliance, Accumulator, and Custom), plus add-on modules for Member Experience, Reporting, and a Client Portal for self-service configuration.

The company operates on a B2B SaaS subscription model, selling through enterprise field sales and a demo-driven conversion process. It targets two primary buyer segments — healthcare payers needing CMS-compliant price transparency tools and MRF analytics, and self-insured employers seeking member-facing cost-reduction tools — while serving end users (health plan members) indirectly through those enterprise contracts. The platform is HITRUST Certified, HIPAA-compliant, and was the first to implement CMS price transparency user-tool compliance requirements in 2023. ClearCost reports 3.5+ million users across 150+ client implementations over 10+ years of operation with an 11–50 employee headcount.

On July 22, 2025, ClearCost Health was acquired by MacroHealth, a healthcare technology company operating a data-driven marketplace for payers and health-market partners. Post-acquisition, ClearCost's solutions are distributed through MacroHealth's marketplace in addition to direct sales, and the ClearCost team continues to operate under the ClearCost Health brand. The acquisition combines ClearCost's provider search, price transparency, and MRF analytics capabilities with MacroHealth's ecosystem to expand network optimization, member experience, and regulatory compliance offerings for payer customers.

Name

ClearCost Health

Legal name

ClearCost Health

Website

https://clearcosthealth.com

Company type

Private

Founded year

2010

Operating status

Acquired

Headcount range

11–50 employees

Short description

ClearCost Health is a SaaS platform providing healthcare price transparency, provider search, and MRF analytics to healthcare payers and self-insured employers, delivered via configurable applications and embeddable APIs. Acquired by MacroHealth in July 2025.

Ownership category

akta.pro rank

Product category

Healthcare Price Transparency Software

NAICS

Financial Transactions Processing, Reserve, and Clearinghouse Activities (52232), Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292), Computing Infrastructure Providers, Data Processing, Web Hosting, and Related Services (518)

SIC

Services-Computer Programming, Data Processing, Etc. (7370), Hospital & Medical Service Plans (6324)

akta.pro primary industry

Price Transparency, Estimates & Patient Financial Clearance (HLACACAK)

akta.pro secondary industries

Healthcare Terminology, Ontology & Code Set Management (SNOMED/LOINC/ICD/RxNorm) (HLACAIAF), Data Access, Sharing & Marketplace Platforms (incl. TEFCA/QHIN enablement) (HLACAIAL)

Keywords

• Healthcare price transparency
• Provider search platform
• MRF analytics
• Healthcare API services
• Out-of-pocket cost estimation

Headquarters

HQ city

San Francisco

HQ country

United States

HQ region

North America

Markets served

GTM type

B2B

Offering type

Software

Cost components

Personnel, Technology or R&D, Operations, Marketing or Sales, Infrastructure

Revenue model

1. SaaS/Platform Subscription: ClearCost Health operates as a B2B SaaS platform providing provider search and price transparency solutions to healthcare payers and self-insured employers. Revenue is generated through platform/subscription fees for access to their provider search, price transparency, and MRF analytics tools, along with API service fees.

Go-to-market motion2 records

Distribution channels3 records

Marketing channels4 records

Core offering

ClearCost Health provides a B2B SaaS platform that combines provider search with healthcare price transparency. The platform analyzes Machine Readable Files (MRFs) and claims data to deliver real-time cost estimates and out-of-pocket spending calculations across 120+ specialties and 30+ facility types. It serves healthcare payers and self-insured employers through customizable member-facing experiences, reporting tools, and a suite of APIs for embedding transparency capabilities into client applications.

Product overview

ClearCost Health offers a unified healthcare price transparency and provider search platform. The core offering is the Provider Search & Price Transparency product, which combines advanced search functionality with comprehensive MRF pricing and claims data. Supporting this core platform are MRF Analytics for analyzing machine-readable pricing files, a full Suite of API Services for custom integrations, and add-on modules including Member Experience (customization features for member-facing interfaces), Reporting (user insights and utilization analytics), and Client Portal (self-service configuration management). The company has evolved from a standalone price transparency tool (launched 2012) to a comprehensive platform with API capabilities, and was acquired by MacroHealth in 2025.

Differentiator

Problem solved

Functional benefit

Products and services

• Provider Search & Price Transparency Core platform combining advanced provider search functionality with high-quality MRF and claims-based pricing data. Enables category and dynamic search across 120+ specialties and 30+ facility types, compare results, drill down, and filter results for health plan members. For healthcare payers, self-insured employers, and benefits administrators.
• MRF Analytics Cutting-edge tools to analyze Machine Readable Files (MRFs) for understanding pricing dynamics across payers and providers. Enables network analytics, provider selection, payer evaluation, and contracting. For healthcare payers and provider network analysts.
• API Services Suite of customized API integrations including MRF Pricing API, Provider Directory API, Fair Price API, CMS Compliance API, Accumulator API, and Custom API development. Accepts NPI and Service ID combinations and returns total cost, member cost, and more. For client engineering teams integrating price transparency into their own applications.

Quantifiable outcome

• 3.5+ million users have used the platform
• +1 more outcomes

Segments3 records

Ideal customer profiles2 records

Technology focussed Yes

API detail

Has API

Yes

API docs

API detail

Core technology

AI maturity

App detail

Integration3 records

Feature10 records

Partnerships

One partnership is on record.

• MacroHealthcoreStrategic or Co-development Partner · 22 July 2025MacroHealth, a healthcare technology company enabling payers and health market partners to optimize and connect their healthcare ecosystems through a data-driven marketplace, acquired ClearCost Health in July 2025. The acquisition aims to enhance MacroHealth's healthcare marketplace platform with ClearCost's provider search and price transparency solutions, improving network optimization, member experience, and regulatory compliance for payers.

Scale indicators3 records

Recent moves7 records

Expansion highlights4 records

Direct peers

• Turquoise Health: Turquoise Health is a direct competitor operating a healthcare price transparency platform for payers, providers, and employers, with comparable MRF-based pricing analytics, contract negotiation tools, and payer-facing APIs. It is the most head-to-head competitor in the price transparency SaaS category.
• Kyruus: Kyruus (acquirer of HealthSparq) provides provider search, directory, and price transparency solutions to health plans, directly overlapping with ClearCost's provider search and member-facing transparency offerings. Both serve payer member-experience use cases with embedded provider data.
• HealthSparq: HealthSparq delivers price transparency, provider search, and treatment cost estimates to health plan members, closely mirroring ClearCost's core product. Now part of Kyruus, it represents an incumbent payer-facing transparency platform with similar APIs and member portal integrations.
• Castlight Health: Castlight Health pioneered employer- and payer-facing price transparency navigation tools and remains a comparable platform serving self-insured employers and health plans with cost estimation and provider selection features.
• Mpirical (formerly SmartShopper): Mpirical (formerly SmartShopper) provides healthcare shopping and price transparency incentives for health plan members and employers, closely matching ClearCost's member-facing cost comparison and provider search capabilities.

Broad incumbents

• Change Healthcare (Optum): Now part of Optum, Change Healthcare offers a broad portfolio of payer and provider solutions including claims, pricing, and analytics that overlap with ClearCost's MRF analytics and pricing APIs. As a much larger incumbent it competes for payer IT budget but is not focused exclusively on transparency.
• Health Catalyst: Health Catalyst is a healthcare data and analytics platform serving payers and providers with cost, quality, and network analytics that overlap with ClearCost's MRF analytics and network optimization use cases. Broader portfolio but comparable data-driven payer audience.
• Zelis: Zelis provides claims cost management, network analytics, and price transparency services to payers and employers, with adjacent capabilities in pricing analytics and member navigation that overlap with ClearCost's MRF analytics and member experience offerings.
• Epic Systems: Epic's payer-platform and provider directory capabilities are increasingly embedded into health plan workflows, creating indirect competitive pressure on ClearCost's provider search and pricing transparency APIs. A large incumbent with deep healthcare data integrations.

Emerging players

• AccuReg: AccuReg offers patient access, price estimation, and financial clearance tools for hospitals and health systems that overlap with ClearCost's patient financial clearance functionality. Focus is more provider-side but the price estimation core is highly comparable.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights7 records

Customer concentration

• LinkedInlinkedin.com/company/clearcost-health

Compliance4 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles7 records

Funding overview

Funding rounds1 record

Investors1 record

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about ClearCost Health