Publication | BRG Healthcare Transactions & Strategy

Variation in Professional Rates

Ashley Chilton, Ben Schaeffer, and Sarah Fox

January 2024

BRG researchers examined trends in commercial reimbursement across the nation to determine why variation in healthcare prices exists state by state.

Using 2022 commercial healthcare claims data, BRG benchmarked commercial reimbursement for top services (CPTs 99214, 99203) against Medicare to see distribution of prices across the nation. To explain the variation in commercial prices, BRG investigated market dynamics of key states including provider consolidation, recent mergers and acquisitions, and payor landscape.