Privenox

Documentation

Understand how Privenox compares healthcare procedure prices, or integrate our comparison engine into your application via the REST API.

Quickstart

Search for a procedure and compare prices across nearby facilities in under 2 minutes.

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Price Percentile Engine

How we compute P10/P25/P50/P75/P90 price distributions from CMS V3.0 hospital data.

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Quality-Adjusted Cost Score

QACS methodology: combining price rank, CMS Stars, patient experience, and clinical outcomes.

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Out-of-Pocket Calculator

How we model your insurance plan benefit design to estimate true patient cost.

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Geographic Variance

Price fairness index and travel-worthy savings detection across metro areas.

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Data Sources

CMS OPPS/IPPS, Hospital Compare, HCAHPS, NPPES, and GPCI datasets.

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API Endpoints

GET/v1/procedures/search
GET/v1/procedures/:code/prices
GET/v1/facilities/:id
POST/v1/compare
POST/v1/report
POST/v1/signup
POST/v1/checkout

Authentication

All API requests require an API key via the X-API-Key header.

curl https://privenox-api.smarttechinvest.com/v1/procedures/search?q=knee \
  -H "X-API-Key: pvx_your_api_key_here"

Price Percentile Engine

We ingest CMS V3.0 machine-readable files from 6,000+ hospitals. For each procedure code and geographic radius, we compute P10, P25, P50 (median), P75, and P90 price percentiles. Facilities above P90 are flagged as outliers with explanatory context.

Quality-Adjusted Cost Score (QACS)

A weighted composite combining four dimensions:

  • Price Rank (40%) -- where the facility falls in the regional price distribution
  • CMS Star Rating (30%) -- overall hospital quality rating (1-5 stars)
  • Patient Experience (20%) -- HCAHPS survey scores
  • Clinical Outcomes (10%) -- complication and readmission rates

Out-of-Pocket Calculator

We apply your insurance plan's benefit design rules to estimate your true patient cost: deductible remaining is consumed first, then coinsurance applies to the remainder, capped at your out-of-pocket maximum minus year-to-date spend. Handles in-network vs. out-of-network differentials and facility fee + professional fee splits.

Data Sources

  • CMS Hospital Price Transparency -- V3.0 machine-readable files (negotiated rates)
  • CMS Hospital Compare -- quality ratings, HCAHPS, outcomes
  • CMS OPPS/IPPS -- Medicare fee schedules
  • NPPES -- physician and facility registry
  • CMS GPCI -- Geographic Practice Cost Index

All sources are free, publicly available federal datasets.