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Definition

Negotiated rate

The price a health plan and a provider have agreed to for a specific service.

A negotiated rate is the contracted amount for a service between a plan and an in-network provider. It's usually far below the provider's list price, or chargemaster rate, and varies widely by provider, plan and region.

MRFs label each rate with a negotiated type: negotiated (a dollar amount), derived, fee schedule, percentage (of billed charges), or per diem (a daily rate, common for inpatient stays).

Your out-of-pocket cost is based on the negotiated rate and your plan's deductible, copay and coinsurance.

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