Free hosted MCP server: US healthcare procedure cost estimates and provider pricing. No API key.
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Stateless insurance math: given an allowed amount and a plan snapshot (deductible, coinsurance, OOP max), returns exact patient responsibility, plan payment, and the breakdown, plus p25/p75 scenarios. Use when you already have a dollar amount (e.g. from an EOB or a prior estimate).
Annual out-of-pocket maximum in dollars
Annual deductible in dollars
Coinsurance as a fraction, e.g. 0.2 for 20%
Negotiated/allowed amount in dollars
Flat copay, if the plan uses one
Out-of-pocket already met this year
Deductible already met this year
True if ACA preventive $0 cost-sharing applies
Stateless insurance math: given an allowed amount and a plan snapshot (deductible, coinsurance, OOP max), returns exact patient responsibility, plan payment, and the breakdown, plus p25/p75 scenarios. Use when you already have a dollar amount (e.g. from an EOB or a prior estimate).
| Argument | Type | Description |
|---|---|---|
| copay | number | Flat copay, if the plan uses one |
| oop_max* | number | Annual out-of-pocket maximum in dollars |
| oop_met | number | Out-of-pocket already met this year |
| deductible* | number | Annual deductible in dollars |
| coinsurance* | number | Coinsurance as a fraction, e.g. 0.2 for 20% |
| allowed_amount* | number | Negotiated/allowed amount in dollars |
| deductible_met | number | Deductible already met this year |
| preventive_exception | boolean | True if ACA preventive $0 cost-sharing applies |
{
"type": "object",
"$schema": "http://json-schema.org/draft-07/schema#",
"required": [
"allowed_amount",
"deductible",
"coinsurance",
"oop_max"
],
"properties": {
"copay": {
"type": "number",
"description": "Flat copay, if the plan uses one"
},
"oop_max": {
"type": "number",
"description": "Annual out-of-pocket maximum in dollars"
},
"oop_met": {
"type": "number",
"description": "Out-of-pocket already met this year"
},
"deductible": {
"type": "number",
"description": "Annual deductible in dollars"
},
"coinsurance": {
"type": "number",
"description": "Coinsurance as a fraction, e.g. 0.2 for 20%"
},
"allowed_amount": {
"type": "number",
"description": "Negotiated/allowed amount in dollars"
},
"deductible_met": {
"type": "number",
"description": "Deductible already met this year"
},
"preventive_exception": {
"type": "boolean",
"description": "True if ACA preventive $0 cost-sharing applies"
}
},
"additionalProperties": false
}Screen a household for hospital financial assistance (charity care): returns income as a percent of the federal poverty guidelines, the typical range hospital policies cover, what federal rules (IRS 501(r)) do and do not guarantee, and next steps. Use when a user asks whether they might qualify for help paying a hospital bill. It is a screening estimate, not an eligibility decision: each hospital sets its own limits. Needs household size and annual household income; do not ask for names, account numbers or bill details.
| Argument | Type | Description |
|---|---|---|
| state | string | 2-letter US state code; only Alaska and Hawaii change the poverty guideline |
| household_size* | integer | Number of people in the household, including the patient |
| annual_household_income* | number | Total annual household income before taxes, in dollars |
{
"type": "object",
"$schema": "http://json-schema.org/draft-07/schema#",
"required": [
"household_size",
"annual_household_income"
],
"properties": {
"state": {
"type": "string",
"maxLength": 2,
"minLength": 2,
"description": "2-letter US state code; only Alaska and Hawaii change the poverty guideline"
},
"household_size": {
"type": "integer",
"maximum": 20,
"minimum": 1,
"description": "Number of people in the household, including the patient"
},
"annual_household_income": {
"type": "number",
"maximum": 10000000,
"minimum": 0,
"description": "Total annual household income before taxes, in dollars"
}
},
"additionalProperties": false
}Compares one dollar amount from a medical bill or explanation of benefits with the typical allowed-amount range (low, median, high) for the same procedure in the same US state, and says whether it is below, within or above that range, with questions worth asking the billing office. Pass amount_type 'billed' for the charge on the bill or 'allowed' for the insurer's allowed amount. Billed charges are usually higher than allowed amounts, so a high billed charge alone is not an error. Needs only the procedure, state and amount; do not send names, dates, account or member numbers.
| Argument | Type | Description |
|---|---|---|
| state* | string | 2-letter US state code, e.g. 'TX' |
| amount* | number | The dollar amount from the bill or EOB |
| procedure* | string | Procedure slug or plain name, e.g. 'colonoscopy'. Resolve plain names with resolve_procedure. |
| amount_type* | string | 'billed' = the charge on the bill; 'allowed' = the amount the insurer allowed |
{
"type": "object",
"$schema": "http://json-schema.org/draft-07/schema#",
"required": [
"procedure",
"state",
"amount",
"amount_type"
],
"properties": {
"state": {
"type": "string",
"maxLength": 2,
"minLength": 2,
"description": "2-letter US state code, e.g. 'TX'"
},
"amount": {
"type": "number",
"maximum": 10000000,
"minimum": 0,
"description": "The dollar amount from the bill or EOB"
},
"procedure": {
"type": "string",
"description": "Procedure slug or plain name, e.g. 'colonoscopy'. Resolve plain names with resolve_procedure."
},
"amount_type": {
"enum": [
"billed",
"allowed"
],
"type": "string",
"description": "'billed' = the charge on the bill; 'allowed' = the amount the insurer allowed"
}
},
"additionalProperties": false
}Static sample cost estimate (colonoscopy in Connecticut) from the CostKits API. Works with NO API key — use it to verify connectivity and see the response shape.
No arguments.
{
"type": "object",
"$schema": "http://json-schema.org/draft-07/schema#",
"properties": {}
}Returns the typical allowed-amount range (low, median, high) for one medical procedure in one US state, the usual billing components (facility, physician, anesthesia, pathology), and the data vintage. If the user chooses to give their own deductible, coinsurance and out-of-pocket figures, it also returns an estimated patient share. These are estimates of typical prices from hospital price transparency and Medicare data, not quotes. Only the procedure and state are required; ZIP code and plan figures are optional and are used only for this one calculation.
| Argument | Type | Description |
|---|---|---|
| state* | string | 2-letter US state code, e.g. 'CT'. Prices are state-level. |
| zip_code | string | Optional 5-digit ZIP, used only to refine the local estimate |
| plan_type | string | Insurance plan type (default commercial) |
| procedure* | string | Procedure slug or plain name, e.g. 'colonoscopy' or 'mri-knee'. A plain name that is not an exact slug can be matched with resolve_procedure. |
| oop_remaining | number | Dollars left to the member's out-of-pocket max |
| coinsurance_pct | number | Coinsurance percentage, e.g. 20 for 20% |
Lists up to 5 facilities in one US state that perform a procedure, with name, address and a pricing_status field: 'observed' means a negotiated rate is published in that facility's price transparency data, 'estimated' means only a state-level benchmark applies, 'none' means no price data. Dollar amounts are not returned. The list is partial and is not a ranking or a recommendation.
| Argument | Type | Description |
|---|---|---|
| limit | integer | Max results, 1 to 5 (default 5) |
| state* | string | 2-letter US state code, e.g. 'CT' |
| procedure* | string | Procedure slug or plain name, e.g. 'colonoscopy' |
{
"type": "object",
"$schema": "http://json-schema.org/draft-07/schema#",
"required": [
"procedure",
"state"
],
"properties": {
"limit": {
"type": "integer",
"maximum": 5,
"minimum": 1,
"description": "Max results, 1 to 5 (default 5)"
},
"state": {
"type": "string",
"description": "2-letter US state code, e.g. 'CT'"
},
"procedure": {
"type": "string",
"description": "Procedure slug or plain name, e.g. 'colonoscopy'"
}
},
"additionalProperties": false
}One call chaining procedure ontology + cost + providers + patient liability. Cheapest way (one metered request) to get the complete picture. Use `fields` to request a subset; liability requires the plan_* inputs.
| Argument | Type | Description |
|---|---|---|
| state* | string | 2-letter US state code |
| fields | array | Which services to include (default: all) |
| procedure* | string | Procedure slug or plain name |
| plan_oop_max | number | |
| plan_oop_met | number | |
| plan_deductible | number | |
| plan_coinsurance | number | Fraction, e.g. 0.2 |
| plan_deductible_met | number |
{
"type": "object",
"$schema": "http://json-schema.org/draft-07/schema#",
"required": [
"procedure",
"state"
],
"properties": {
"state": {
"type": "string",
"description": "2-letter US state code"
},
"fields": {
"type": "array",
"items": {
"enum": [
"procedure",
"cost",
"providers",
"liability"
],
"type": "string"
},
"description": "Which services to include (default: all)"
},
"procedure": {
"type": "string",
"description": "Procedure slug or plain name"
},
"plan_oop_max": {
"type": "number"
},
"plan_oop_met": {
"type": "number"
},
"plan_deductible": {
"type": "number"
},
"plan_coinsurance": {
"type": "number",
"description": "Fraction, e.g. 0.2"
},
"plan_deductible_met": {
"type": "number"
}
},
"additionalProperties": false
}Insurance coverage rules for a procedure/carrier combination. aspect: 'summary' (status + plain English), 'prior-auth', 'cost-sharing' (deductible/coinsurance/ACA preventive), 'frequency' (how often covered, age rules), or 'triggers' (Pro plan: billing events that flip a $0 preventive claim to diagnostic — the highest-signal aspect).
| Argument | Type | Description |
|---|---|---|
| aspect | string | Default 'summary' |
| carrier* | string | Carrier key, e.g. 'aetna', 'cigna', 'bcbs', 'medicare' — see list_carriers |
| plan_type | string | |
| procedure* | string | Procedure slug, e.g. 'colonoscopy' |
{
"type": "object",
"$schema": "http://json-schema.org/draft-07/schema#",
"required": [
"procedure",
"carrier"
],
"properties": {
"aspect": {
"enum": [
"summary",
"prior-auth",
"cost-sharing",
"frequency",
"triggers"
],
"type": "string",
"description": "Default 'summary'"
},
"carrier": {
"type": "string",
"description": "Carrier key, e.g. 'aetna', 'cigna', 'bcbs', 'medicare' — see list_carriers"
},
"plan_type": {
"enum": [
"commercial",
"medicare",
"medicaid"
],
"type": "string"
},
"procedure": {
"type": "string",
"description": "Procedure slug, e.g. 'colonoscopy'"
}
},
"additionalProperties": false
}Structured knowledge about one procedure. aspect='facts' returns LLM-ready billing rules and cost drivers (best for grounding an answer); 'bundle' explains which separate bills to expect (facility, physician, anesthesia...); 'full' returns the complete ontology.
| Argument | Type | Description |
|---|---|---|
| slug* | string | Canonical procedure slug, e.g. 'colonoscopy' |
| aspect | string | Default 'facts' |
{
"type": "object",
"$schema": "http://json-schema.org/draft-07/schema#",
"required": [
"slug"
],
"properties": {
"slug": {
"type": "string",
"description": "Canonical procedure slug, e.g. 'colonoscopy'"
},
"aspect": {
"enum": [
"full",
"bundle",
"facts"
],
"type": "string",
"description": "Default 'facts'"
}
},
"additionalProperties": false
}Public profile for a single provider by 10-digit NPI number: name, specialty, address, entity type.
| Argument | Type | Description |
|---|---|---|
| npi* | string | 10-digit NPI number |
{
"type": "object",
"$schema": "http://json-schema.org/draft-07/schema#",
"required": [
"npi"
],
"properties": {
"npi": {
"type": "string",
"description": "10-digit NPI number"
}
},
"additionalProperties": false
}All insurance carrier keys supported by the coverage tools (aetna, cigna, bcbs, medicare, ...). Works on the Free plan — also a good API-key sanity check.
No arguments.
{
"type": "object",
"$schema": "http://json-schema.org/draft-07/schema#",
"properties": {}
}The full CostKits catalog: 30 procedures with slugs, display names, categories, and CPT codes (paginated).
| Argument | Type | Description |
|---|---|---|
| limit | integer | |
| cursor | string | next_cursor from a previous response |
{
"type": "object",
"$schema": "http://json-schema.org/draft-07/schema#",
"properties": {
"limit": {
"type": "integer",
"maximum": 200,
"minimum": 1
},
"cursor": {
"type": "string",
"description": "next_cursor from a previous response"
}
},
"additionalProperties": false
}Maps a free-text procedure name ('knee mri', 'gallbladder removal') to a CostKits catalog slug with a confidence score. Returns best_match and alternatives; best_match is null when the procedure is not in the catalog.
| Argument | Type | Description |
|---|---|---|
| query* | string | Free-text procedure name |
{
"type": "object",
"$schema": "http://json-schema.org/draft-07/schema#",
"required": [
"query"
],
"properties": {
"query": {
"type": "string",
"description": "Free-text procedure name"
}
},
"additionalProperties": false
}| deductible_remaining |
| number |
| Dollars left on the member's deductible |
{
"type": "object",
"$schema": "http://json-schema.org/draft-07/schema#",
"required": [
"procedure",
"state"
],
"properties": {
"state": {
"type": "string",
"description": "2-letter US state code, e.g. 'CT'. Prices are state-level."
},
"zip_code": {
"type": "string",
"description": "Optional 5-digit ZIP, used only to refine the local estimate"
},
"plan_type": {
"enum": [
"commercial",
"medicare",
"medicaid"
],
"type": "string",
"description": "Insurance plan type (default commercial)"
},
"procedure": {
"type": "string",
"description": "Procedure slug or plain name, e.g. 'colonoscopy' or 'mri-knee'. A plain name that is not an exact slug can be matched with resolve_procedure."
},
"oop_remaining": {
"type": "number",
"description": "Dollars left to the member's out-of-pocket max"
},
"coinsurance_pct": {
"type": "number",
"description": "Coinsurance percentage, e.g. 20 for 20%"
},
"deductible_remaining": {
"type": "number",
"description": "Dollars left on the member's deductible"
}
},
"additionalProperties": false
}