> ## Documentation Index > Fetch the complete documentation index at: https://docs.arlohealth.ai/llms.txt > Use this file to discover all available pages before exploring further. # Public-data evidence about one provider (by NPI) > Public-data evidence about ONE specific provider: Medicare-derived experience, facility outcome context (facility-level, never the clinician's own outcome), Medicare payment anchors, or an explained absence. Use only once the conversation is focused on one provider. Anonymous limit: 60 requests per minute per IP. ## OpenAPI ````yaml /api-reference/pricing-openapi.yaml post /api/pricing.v1/provider-evidence openapi: 3.1.0 info: title: Arlo Health Pricing API version: 1.0.0 summary: >- US in-network cost estimates and provider network status from insurers' published rate files. No login or key required. description: >- Free, anonymous price-transparency API. Estimates come from insurers' machine-readable rate files and Medicare's fee schedules (Anthem, Blue Cross Blue Shield plans via BlueCard, Blue Shield of California, UnitedHealthcare, Cigna, Aetna, HCSC, Original Medicare) and public CMS data. Read the guide before relaying numbers to a person: https://api.arlohealth.ai/api/pricing.v1/guide.md What to get from the person, in order of impact: insurer name (required), location (for a named clinic, the clinic's city or ZIP), the exact service (age, new vs established, screening vs symptom, body part, contrast), employer or plan name from the card (turns ranges into exact rates), group number (Blue Cross Blue Shield IL/TX/OK/NM/MT only), provider name or NPI, and from a past bill or Explanation of Benefits the billing NPI and Tax ID (settles which entity bills). Three rules that apply to every response: 1. Relay `disclaimer` every time. Estimates are never guarantees, and the number is a negotiated rate, not out-of-pocket cost. 2. A named clinic, brand, or provider goes to `network-status` first. `search` is area discovery and does not resolve who bills. 3. Never quote a single number while the billing entity is unresolved (`billingOutlook.mode` = partitioned, `multiEntity` = true, or several `billingCandidates`). Data vintage: 2026-08 payer files. termsOfService: https://arlohealth.ai/tos contact: name: Arlo Health email: keaton@arlohealth.ai url: https://arlohealth.ai x-agent-guide: https://api.arlohealth.ai/api/pricing.v1/guide.md x-skill: https://api.arlohealth.ai/api/pricing.v1/skill.md x-disclaimer: >- Estimates come from the insurer's published machine-readable rate files (latest monthly data) and are not a guarantee of price. Actual billing can differ based on plan specifics, services performed, and your deductible status. Confirm cost and network status when scheduling. servers: - url: https://api.arlohealth.ai description: Production security: - {} - bearerAuth: [] tags: - name: Discovery description: >- Read these first: the guide, the contract, the service catalog, and the supported insurers. Cacheable for an hour. - name: Pricing description: >- The lookups. Anonymous calls are rate limited per IP per minute; a few are served at a time per caller. externalDocs: description: Agent guide (markdown) url: https://api.arlohealth.ai/api/pricing.v1/guide.md paths: /api/pricing.v1/provider-evidence: post: tags: - Pricing summary: Public-data evidence about one provider (by NPI) description: >- Public-data evidence about ONE specific provider: Medicare-derived experience, facility outcome context (facility-level, never the clinician's own outcome), Medicare payment anchors, or an explained absence. Use only once the conversation is focused on one provider. Anonymous limit: 60 requests per minute per IP. operationId: getProviderEvidence requestBody: required: true content: application/json: schema: type: object description: >- Public-data evidence about ONE specific provider: Medicare-derived experience, facility outcome context (facility-level, never the clinician's own outcome), Medicare payment anchors, or an explained absence. Use only once the conversation is focused on one provider. properties: npi: type: string description: >- The provider's 10-digit NPI. Resolve it first via network-status (name search) or from search results. code: type: string description: Optional catalog code to scope evidence to one service. required: - npi example: npi: '1003041625' code: '45378' responses: '200': description: Evidence card payload content: application/json: schema: type: object properties: provider: type: object properties: npi: type: number name: type: - string - 'null' entityType: type: string description: organization | individual city: type: - string - 'null' state: type: - string - 'null' required: - npi service: type: object description: >- Echo of the resolved service. VERIFY appliesTo against the actual patient before relaying any number. properties: code: type: string name: type: string category: type: string appliesTo: type: string description: >- The selection fact baked into this code (age band, new vs established, screening vs diagnostic, contrast, duration). priceNote: type: - string - 'null' description: >- Pricing semantics that change what the number means (per-unit billing, ACA preventive $0 cost-share, facility fee excludes the physician's separate bill). Relay whenever present. medicareNote: type: - string - 'null' description: >- Original Medicare responses only, on codes Medicare does not pay under this code (routine physicals, telemedicine-specific codes, anesthesia, contraceptive IUD): what Medicare covers instead and which code to use. Relay it and switch codes when it names one. relatedCodes: type: array description: >- Sibling codes selected by a different patient fact (age band, complexity, screening vs diagnostic). If one fits the patient better, re-call with it. items: type: object properties: code: type: string name: type: - string - 'null' when: type: string description: The patient fact that selects this sibling. signals: type: array description: >- Pre-gated evidence signals from public CMS data. Relay each signal's 'display' sentence as written; never compress into ranking or 'best doctor' language; never treat absence as negative (non-Medicare practices legitimately lack data). An 'exclusion' signal (federal OIG exclusion list) is a legal-status safety notice: always relay it plainly. items: type: object properties: type: type: string description: >- volume | outcome_context | optout | absence | exclusion hcpcs: type: string floor: type: number description: >- Volume floor: performed at least this many per year (Medicare). pctl: type: number description: >- National percentile. Present only when high (positives-only display). level: type: string description: >- 'facility' signals describe the facility, never the clinician. facility: type: string measure: type: string score: type: - number - 'null' ci: type: array items: type: - number - 'null' verdict: type: - string - 'null' denominator: type: - number - 'null' display: type: string description: >- Derivation sentence. Relay verbatim or summarize without changing meaning. required: - type - display medicareAnchors: type: array description: >- What Medicare actually paid this provider per service. Reference points from public data, not fair-price claims and not the patient's price. items: type: object properties: code: type: string setting: type: string description: facility | office service: type: - string - 'null' medicareAllowed: type: number year: type: number required: - code - medicareAllowed - year signalDefinitions: type: object methodology: type: string corrections: type: string disclaimer: type: string description: >- ALWAYS convey to the patient: estimates come from the insurer's published data and are not a price guarantee. needsMoreInfo: type: array description: >- Asks to relay to the patient. Answering them improves the estimate (ranges become the plan's exact rates). Each ask names the field, why it matters, and how to obtain it. A medicare_type ask means the numbers assume Original Medicare and the person must confirm they are not on a Medicare Advantage plan. items: type: object properties: field: type: string ask: type: string why: type: string how: type: string description: >- How to obtain it: ask the patient, read an EOB, or a public lookup (e.g. NPI registry). options: type: array items: type: string required: - field - ask headers: X-Arlo-Api-Version: schema: type: string description: Contract version (currently 1). Link: schema: type: string description: >- rel="service-doc" points at guide.md, rel="service-desc" at openapi.json. '429': description: >- Too many requests: the per-IP limit for this route was exceeded (RATE_LIMITED), or the service is busy (BUSY). Wait Retry-After seconds and try again. content: application/json: schema: type: object properties: error: type: string description: >- Machine-readable code: RATE_LIMITED | BUSY | PRICING_PUBLIC_DISABLED | NOT_FOUND | PRICING_SEARCH_FAILED | PRICING_NETWORK_STATUS_FAILED | PROVIDER_EVIDENCE_FAILED message: type: string retryAfterSeconds: type: number required: - error headers: Retry-After: schema: type: integer '503': description: Anonymous pricing is paused. Honor Retry-After. content: application/json: schema: type: object properties: error: type: string description: >- Machine-readable code: RATE_LIMITED | BUSY | PRICING_PUBLIC_DISABLED | NOT_FOUND | PRICING_SEARCH_FAILED | PRICING_NETWORK_STATUS_FAILED | PROVIDER_EVIDENCE_FAILED message: type: string retryAfterSeconds: type: number required: - error components: securitySchemes: bearerAuth: type: http scheme: bearer description: >- Optional. An Arlo account token adds linked-coverage plan matching and family-member patientId. Anonymous calls resolve the plan from planHints only. ````