planHints can supply payer and plan details. Estimates come from insurers’ published rate files and Medicare’s fee schedules, and are not guarantees. The same lookups are served without login by the Pricing API, whose Agent guide explains every response field.
Insurers covered: Anthem, Blue Cross Blue Shield plans nationwide through BlueCard, Blue Shield of California, UnitedHealthcare (including UMR, Oxford, Surest), Cigna, Aetna, Blue Cross Blue Shield of Illinois, Texas, Oklahoma, New Mexico, and Montana, and Original Medicare. Medicare Advantage plans are declined with the reason.
search_care_prices
Searches nearby in-network options for one service. This is area discovery (“what does this cost around here”). For a named clinic, brand, or provider, use check_network_status first.
There is no free-text service input: the agent picks the code, because codes carry facts about the patient (age band, new or established, screening or diagnostic, body part). A code Arlo does not price returns a
code ask that says so, with related catalog codes in options. Use one only if it is the same service for the patient.
Results are grouped by place: facilities, each with the providers who bill there. sortBasis states the order: places with observed billing for the service first, each group cheapest first. Every facility has a name, and nameSource says what it is: organization_npi or site_organization (an organization at the address), billing_entity (the contracting group most clinicians there bill under), or clinician / clinicians (no organization found, so give the address too). On commercial plans, search leaves out VA, military and Indian Health Service sites; check_network_status still answers for a named one and adds federalSiteNote. Clinicians who likely work only by video for an out-of-state telehealth company carry telehealthOnly and sort lower. Relay disclaimer and every note-style field (note, any key ending in Note, rateAssessment).
Example response
check_network_status
Checks a named provider or facility against the patient’s plan and, with code, returns what they charge. Use it first for any named clinic or provider: the same brand can bill under different legal entities at very different rates, and only this tool shows which entities could bill.
How to read a match:
inNetwork: truemeans the plan’s network files list the provider. A provider can be in network withrate: null: the files list them but carry no usable price for the service (the contract may pay a percent of charges or per day). RelayrateNote.inNetwork: falsemeans “not found in the published files”, never a hard out-of-network verdict.otherPayerslists other insurers whose files do list the provider.billingCandidateslists each legal entity that could bill, strongest billing evidence first. The top-levelbillingOrgandratedescribe the first one;rateRangespans all of them. Never quote one number whilebillingOutlookispartitionedor carries awarning.- A provider name with no exact match and no location returns a
locationask instead of lookalikes from other states.
Example response
Plan matching
plan.matchTier says how exactly the plan was identified:
Relay each
needsMoreInfo ask and call again with the answer. Set planHints.unavailable to true when the patient cannot provide plan identifiers.
get_provider_evidence
Returns public-data evidence about one provider.
The result can include
provider, service, signals, medicareAnchors, signalDefinitions, methodology, corrections, needsMoreInfo, and disclaimer. Each signal’s display explains its source. Facility-level evidence describes the facility, not the clinician; absence of data is not negative evidence. An NPI that is not usable returns an npi ask that says why: the number is mistyped (wrong length or check digit), it is not active in the national NPI registry, or it is real but not in any insurer file Arlo holds.
Example response
Errors
A parameter with the wrong type or range (for example a non-numericlimit or latitude) returns an error result with error: "INVALID_PARAMETER", a message, and field naming the parameter. Fix the call rather than retrying it unchanged. The REST routes return the same body with HTTP 400. When the pricing service is unavailable, tell the patient and offer to retry shortly; never invent prices.