Payerset
Payerset processes and normalizes U.S. healthcare price transparency machine-readable files (MRFs), offering Rate Explorer and Data Lake products on annual subscriptions to health systems, consultants, payers, and health tech firms for payer-provider rate benchmarking.
- Company typePrivate
- Founded2023
- HeadquartersRed Bank, United States
- Headcount11–50
- GTM typeB2B
- OfferingSoftware
What Payerset does
Payerset LLC is a U.S.-based healthcare data company founded in 2023 that processes and normalizes healthcare price transparency machine-readable files (MRFs) published by payers and hospitals under federal Transparency in Coverage and hospital price transparency rules. Its core platform ingests every payer MRF for every plan and every compliant hospital MRF, then enriches the raw negotiated-rate data with NPI-to-TIN mapping, healthcare organization (HCO) affiliations, employer-to-plan coverage, and linkage to all-payer claims and remittance data to identify ghost or phantom rates. Payerset's technology addresses the engineering burden of handling hundreds of terabytes of inconsistently formatted, duplicative MRF data monthly, producing analyzable datasets across 10+ trillion records per quarter and 1.7 million care-delivery NPIs.
The company operates two core commercial products on an annual subscription basis: Rate Explorer, a self-service no-code web platform for instant payer-provider-code rate benchmarking, and Data Lake, an enterprise data delivery product available via Snowflake Marketplace, AWS S3, or REST API with quarterly refresh cadence. Customers include health systems (Northwell Health, Prisma Health, Cone Health, WakeMed, Buffalo Medical Group), behavioral health providers (LunaJoy), large professional services firms (Forvis Mazars, Huron, Eide Bailly), health technology companies (PurpleLab, IntelliMed, Mployer), and government institutions (Library of Congress). Payerset sells primarily through direct sales led by managed-care-experienced founders and supplements demand generation through the Price Transparency Project content initiative, the Payer Compliance Scorecard covering 100+ payers, HFMA conference presence, and a Snowflake Marketplace listing that offers free sample datasets as a trial mechanism. Strategic partnerships include PurpleLab (combining MRF data with 330+ million patient lives of claims data) and the official Snowflake Marketplace integration.
Payerset firmographics
Firmographics- Name
- Payerset
- Legal name
- Payerset LLC
- Website
- https://payerset.com
- Company type
- Private
- Founded year
- 2023
- Operating status
- Operating
- Headcount range
- 11–50 employees
- Short description
- Payerset processes and normalizes U.S. healthcare price transparency machine-readable files (MRFs), offering Rate Explorer and Data Lake products on annual subscriptions to health systems, consultants, payers, and health tech firms for payer-provider rate benchmarking.
- Ownership category
- akta.pro rank
Payerset industry classification
Industry- Product category
- Healthcare Price Transparency Data & Analytics
- NAICS
- Computing Infrastructure Providers, Data Processing, Web Hosting, and Related Services (51821), Computing Infrastructure Providers, Data Processing, Web Hosting, and Related Services (518)
- SIC
- Services-Prepackaged Software (7372), Services-Computer Processing & Data Preparation (7374)
- akta.pro primary industry
- Price Transparency, Estimates & Patient Financial Clearance (HLACACAK)
- akta.pro secondary industries
- Payer-Provider Data Exchange (X12, prior auth, claims/clinical attachment) (HLACABAK), Patient Financial Engagement (Estimates, Billing Presentment, Payments) (HLACAEAI), Healthcare Billing & Patient Payments Presentment (FSAMAJAH)
Keywords
Where Payerset is headquartered
LocationHeadquarters
- HQ city
- Red Bank
- HQ country
- United States
- HQ region
- North America
Markets served
Payerset business model
Business model- GTM type
- B2B
- Offering type
- Software
- Cost components
- Personnel, Technology or R&D, Marketing or Sales, Operations, Infrastructure
Revenue model
- Subscription - Rate Explorer: Self-service web platform subscription providing access to payer-provider negotiated rate comparisons, claims-linked benchmarking, and historical rate data. Delivered as an annual subscription.
- Data Lake / Enterprise Data Integration: Enterprise-grade data delivery via Snowflake Marketplace, cloud storage (S3), or REST API. Includes enriched NPI-to-TIN mapping, HCO affiliations, employer-to-plan coverage mapping. Priced by data scope (payer coverage, geography, data types) and delivery mechanism.
- Annual Subscription Model: Service is provided through annual subscriptions. Full subscription fee is required before access is granted. Subscriptions auto-renew at the end of each period unless 60-day written cancellation notice is provided.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Subscription | Annual | Rate Explorer - Self-service web platform |
| Subscription | Annual | Data Lake - Enterprise data integration |
Go-to-market motion2 records
Distribution channels5 records
Marketing channels8 records
Payerset product offering
Product offeringCore offering
Payerset processes and normalizes healthcare price transparency machine-readable files (MRFs) from payers and hospitals, transforming raw negotiated-rate data into analyzable, enriched datasets. Its commercial offering consists of two products: Rate Explorer, a self-service web platform enabling instant comparison of payer-provider negotiated rates across any combination of payers, providers, and billing codes, and Data Lake, an enterprise data delivery product that delivers enriched, normalized price transparency data into customer data environments via Snowflake Marketplace, AWS S3, or REST API. Both products support quarterly data refreshes and link rate data to all-payer claims and remits to surface actual amounts paid.
Product overview
Payerset offers a unified healthcare price transparency platform with two core products: Rate Explorer (self-service web platform) and Data Lake (enterprise data delivery via REST API, cloud storage, and Snowflake Marketplace). Both products provide access to all payer-provider negotiated rates enriched with NPI-to-TIN mapping, HCO affiliations, claims validation, and historical rate trending. The platform processes machine-readable files (MRFs) published by payers and hospitals, normalizing inconsistent schemas and removing phantom/ghost rates to deliver actionable reimbursement benchmarking data. Additional offerings include the Price Transparency Project (educational content initiative) and the Payer Compliance Scorecard (quarterly payer grading).
Differentiator
Problem solved
Functional benefit
Brands
- Rate Explorer: Self-service web platform for comparing payer-provider negotiated rates across any combination of payers, providers, and billing codes.
- Data Lake
- Price Transparency Project
Products and services
- Rate Explorer Self-service web platform that enables instant comparison of payer-provider negotiated rates across any combination of payers, providers, and billing codes, with claims data, historical rate access, and Medicare fee schedule benchmarking. No IT integration is required, and access is provided via annual subscription. Targeted at mid-market health systems, physician groups, benefits consultants, and other organizations seeking immediate rate intelligence.
- Data Lake Enterprise data delivery product that delivers enriched, normalized healthcare price transparency data directly into customer data environments via Snowflake Marketplace, AWS S3, or REST API. Includes NPI-to-TIN mapping, HCO affiliations, employer-to-plan coverage mapping, all-payer claims linkage, ghost-rate elimination, and quarterly refreshes. Priced by data scope (payer coverage, geography, data types) and delivered as an annual subscription. Targeted at health tech companies, analytics firms, payers, and large health systems building transparency-powered products.
Quantifiable outcome
- UofL Health achieved a 33% increase in reimbursement for spine fusion procedures using Payerset data to power contract negotiations.
- +4 more outcomes
Companies that use Payerset
Customer profileNamed customers13 records
Segments6 records
Ideal customer profiles3 records
Payerset technology and API
TechnologyTechnology focussed Yes
API detail
- Has API
- Yes
- API docs
- API detail
Core technology
AI maturity
App detail
Integration2 records
Feature6 records
Payerset partnerships and signals
Strategic signalPartnerships
Two partnerships are on record, tiered core and flagship.
- PurpleLabcorePayerset and PurpleLab announced a strategic partnership to launch a trusted price intelligence solution suite, combining Payerset's payer price transparency MRF data with PurpleLab's database of 330+ million patient lives and 2.3 million healthcare providers. The integration creates a 360-degree view of the healthcare payer and provider landscape. The partnership serves health systems, payers, pharmaceutical companies, and clinical care organizations with actionable pricing intelligence, payer coverage insights, and historical pricing trend analysis.
- SnowflakeflagshipPayerset is officially listed on the Snowflake Marketplace, making payer price transparency datasets accessible within the Snowflake ecosystem. Available sample datasets include Kaiser Permanente, Elevance (Anthem), UnitedHealthcare, Cigna, and Sentara. This listing enables Snowflake customers to directly access and query Payerset's enriched rate data within their existing Snowflake environment, supporting healthcare data analytics and transparency initiatives.
Scale indicators5 records
Recent moves6 records
Expansion highlights6 records
Payerset competitors and assessment
Company assessmentBroad incumbents
- Waystar: Large-scale healthcare revenue cycle technology provider serving health systems with claims management, patient billing, and analytics. Broader portfolio but addresses adjacent reimbursement benchmarking and payer relationship workflows.
- Definitive Healthcare: Public healthcare commercial intelligence company offering broader analytics on providers, payers, and industry trends. Larger and more diversified, but overlapping in serving healthcare strategy and business intelligence teams.
- Strata Decision Technology: Healthcare financial planning and analytics platform used by health systems for decision support, budgeting, and contract modeling. Adjacent in serving health system CFOs and managed care teams with rate intelligence.
- Komodo Health: Healthcare analytics platform combining claims, provider, and patient data for market intelligence. Overlaps in serving life sciences and payer/provider analytics buyers with combined claims and pricing intelligence.
- Phreesia: Public patient intake, engagement, and payment platform serving health systems and physician groups. Adjacent in addressing patient financial clearance, estimates, and billing workflows that intersect with Payerset's pricing intelligence.
- AKASA: AI-powered revenue cycle automation platform for health systems. Operates in the broader healthcare RCM space and overlaps with Payerset's health system customer base and contract negotiation workflows.
Direct peers
- Fair Health: Independent nonprofit maintaining a large national database of healthcare claims and charge data used for benchmarking and rate transparency. Comparable in serving rate intelligence to health systems, payers, and consultants.
- Turquoise Health: Direct competitor building a price transparency platform for payers, providers, and employers, with similar MRF ingestion, rate comparison, and contract negotiation use cases. Closest direct peer based on overlapping product functionality and target customer segments.
- Hospital Pricing Specialists: Specialized consulting and data firm focused on hospital price transparency, MRF compliance, and payer contract benchmarking — directly overlapping with Payerset's health system customer use cases.
Emerging players
- Rivet Health: Healthcare contract management and price transparency platform serving provider organizations with payer contract analysis. Smaller, narrower offering but directly comparable on payer contract benchmarking workflows.
Market position
Strengths4 records
Weaknesses4 records
Competitive moat6 records
Key risks5 records
Key highlights6 records
Customer concentration
Payerset social profiles
Digital presencePayerset compliance and trust
Trust signalCompliance1 record
Payerset financial estimates
Financial estimateRevenue estimate
Valuation estimate
Payerset leadership team
Management profileNumber of profiles
Profiles4 records
Payerset funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Payerset M&A and investment
M&A and investmentM&A
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about Payerset
What does Payerset do?
Payerset processes and normalizes healthcare price transparency machine-readable files (MRFs) from payers and hospitals, transforming raw negotiated-rate data into analyzable, enriched datasets. Its commercial offering consists of two products: Rate Explorer, a self-service web platform enabling instant comparison of payer-provider negotiated rates across any combination of payers, providers, and billing codes, and Data Lake, an enterprise data delivery product that delivers enriched, normalized price transparency data into customer data environments via Snowflake Marketplace, AWS S3, or REST API. Both products support quarterly data refreshes and link rate data to all-payer claims and remits to surface actual amounts paid.
Is Payerset a public or private company?
Payerset is a private company. It is classified as venture growth investor backed and is currently operating.
When was Payerset founded?
Payerset was founded in 2023. It employs 11 to 50 people.
Where is Payerset based?
Payerset is headquartered in Red Bank, United States, in the North America region.
How does Payerset make money?
Three revenue lines are on record. Subscription - Rate Explorer is the primary driver. The others are data Lake / Enterprise Data Integration and annual Subscription Model.
Who are Payerset's main competitors?
Broad incumbents on record are Waystar, Definitive Healthcare, Strata Decision Technology, Komodo Health, Phreesia and AKASA. Direct peers are Fair Health, Turquoise Health and Hospital Pricing Specialists. Rivet Health is listed as an emerging player.
Does Payerset have an API?
Yes. Payerset offers a REST API as part of its Data Lake product, enabling direct integration of healthcare price transparency data into customers' products and solutions. The API supports data share and direct integration capabilities, allowing enterprise teams to programmatically access enriched NPI to TIN mapping and full employer to health plan coverage data. Data is refreshed quarterly with automated updates. Developer documentation is at docs.payerset.com.
What industry is Payerset in?
Payerset's product category is Healthcare Price Transparency Data & Analytics. Its primary akta.pro industry code is HLACACAK, Price Transparency, Estimates & Patient Financial Clearance, with a secondary code of HLACABAK, Payer-Provider Data Exchange (X12, prior auth, claims/clinical attachment). Its NAICS code is 51821 and its SIC code is 7372.