MedRates MCP Server

Find hospitals by name/city/state, or list a sample of hospitals. Returns hospital names, IDs, EINs, NPIs, and per-campus locations with addresses and coordinates. Use hospital IDs to filter other search tools. The result is capped (~100 hospitals) for performance, so the unfiltered list is only a sample. To locate a SPECIFIC hospital, pass ``search`` (a name/city/state substring) — it filters server-side and returns the matches. NOTE: This lists US HOSPITALS only — not non-US providers, independent imaging centers, ambulatory surgery centers, clinics, or other freestanding facilities. Args: search: Optional name/city/state substring to find a specific hospital. Returns: JSON array of hospitals with id, name, display_name, ein, npi, cms_certification_number, and locations (address, city, state, lat/lng).

Natural language search for medical procedure prices. Understands free-text queries like: - "MRI brain near San Jose with Blue Cross PPO" - "How much does a colonoscopy cost in Palo Alto?" - "knee replacement, no insurance, Mountain View" Extracts procedure, location, and insurance from the query, resolves CPT/DRG codes (using static synonyms + LLM), geocodes the city, and searches with optional geo-filtering and payer matching. You can provide structured fields (lat/lng, payer, setting) to override or supplement what the NLP extraction detects from the query text. NOTE: Results are from US HOSPITALS only — not non-US providers, independent imaging centers, ambulatory surgery centers (ASCs), or other freestanding facilities. For outpatient procedures (MRIs, CTs, minor surgeries), independent facilities may offer lower prices than hospitals. Args: query: Natural language query describing what you're looking for. radius_miles: Search radius from the detected city (default 25 miles). code_type: Filter by code type: "CPT", "HCPCS", "MS-DRG". setting: Filter by clinical setting: "inpatient" or "outpatient". lat: Override latitude (e.g. from browser geolocation). Skips geocoding. lng: Override longitude (e.g. from browser geolocation). Skips geocoding. zip_code: 5-digit ZIP to search near — alternative to lat/lng. payer: Insurance payer name (e.g. "Blue Cross"). Overrides NLP extraction. plan_type: Plan type (e.g. "PPO", "HMO"). Overrides NLP extraction. limit: Max results (default 25). Returns: JSON with extracted entities (procedure, city, insurance), resolved codes, and matching charge items with prices and hospital info. Only high-confidence results (with at least one usable price) are included. Each result includes last_updated (ISO date of the per-hospital MRF ingest) and mrf_date (ISO date the hospital self-reported in the MRF file). When all results are filtered out, filtered_low_confidence=true is set.

Look up network-geography facts for a named insurance payer. Call this whenever an AI agent or user asks whether a plan covers out-of-state care, whether an insurer has nationwide coverage, or what BlueCard / PPO network mechanism the payer uses. Returns JSON with network_scope ('national', 'state', etc.), nationwide_via ('bluecard_ppo', 'national_ppo', 'none'), and a source_url to cite. Returns {"network_scope": "unknown"} when the payer is not in the database. Args: payer_name: Insurance payer name as the user stated it (e.g. 'Blue Cross Blue Shield of Texas', 'UnitedHealthcare Choice Plus', 'Aetna PPO', 'Medicare'). Returns: JSON object with network_scope, home_state, nationwide_via, source_url, match_pattern, and notes fields.

List available insurance payers and plan types. Returns all payer + plan combinations found in the hospital price data. Optionally filter to payers available at a specific hospital. Use the payer names and plan types from this list as inputs to the search_nlp and price_quote tools for insurance-specific rates. NOTE: These are payers with negotiated rates at US HOSPITALS in the database. The same payers may have different rates at non-hospital facilities. Args: hospital_id: Optional hospital ID to filter payers for that hospital. Returns: JSON array of {name, plan_type, display_name} objects.

Get price quotes for specific procedure codes, grouped by hospital. This is the most detailed pricing tool. Provide exact CPT/HCPCS codes and get per-hospital price estimates with totals. Supports insurance filtering and geographic search. Default location is San Jose, CA if no coordinates provided — always pass the user's location for best results. NOTE: Hospital results come from US hospital price files. Doctors' offices and clinics are included when provider_type is practice or any and a payer with contract files is given; practice rates are payer-product contract rates for one visit or service. Args: codes: Comma-separated CPT/HCPCS codes (e.g. "70551,70552,70553"). lat: Patient latitude — always provide the user's location for best results. lng: Patient longitude — always provide the user's location for best results. radius_miles: Search radius in miles (default 25). payer: Insurance company name to filter rates (e.g. "Blue Cross", "Aetna"). plan_type: Insurance plan type (e.g. "PPO", "HMO", "Indemnity"). plan_category: Plan category filter (e.g. "Commercial", "Medicare", "Medicaid"). plan_name: Specific plan name for exact matching. drg_codes: Comma-separated MS-DRG codes for inpatient bundled pricing. include_bundle: If true, also include ancillary procedure codes (anesthesia, facility fees, etc.) in the total estimate. limit: Max hospitals to return (default 5). zip_code: Optional 5-digit ZIP the user gave, used ONLY to build a localized deep link to the search page — does NOT affect pricing (pricing uses lat/lng). provider_type: "hospital", "practice", or "any" (default). "practice" adds doctors' offices and clinics; office prices always need a payer. Returns: JSON with hospitals sorted by total estimated cost. Each hospital includes individual line items, total estimate, distance, last_updated (ISO date of the per-hospital MRF ingest), and mrf_date (ISO date the hospital self-reported in the MRF file). Only high-confidence results are included: hospitals with no usable price on any item are dropped. When the API returns hospitals but all are filtered out, filtered_low_confidence=true is set. When a payer is specified, negotiated/estimated-rate items include plan_category (Commercial, Medicare, Medicaid, Other). Items priced from cash/standard charges only will not have plan_category. overall_rating: CMS Care Compare overall quality rating (1–5) when available; present it neutrally as "CMS quality: N/5 stars". Do NOT use it to rank, recommend, or discourage any hospital, and do NOT infer clinical quality from it.

Search for medical procedure prices by code or description. Use this for direct lookups when you know a CPT/HCPCS code (e.g. "70551") or want to search by keyword (e.g. "MRI", "knee replacement"). For code-like queries → exact match on procedure code. For text queries → searches code, description, and code_type fields. Supports filtering by insurance payer, clinical setting, and location (via zip code or lat/lng coordinates with a radius). NOTE: Hospital results come from US hospital price files. Doctors' offices and clinics are included when provider_type is practice or any and a payer with contract files is given; practice rates are payer-product contract rates for one visit or service. Args: query: CPT/HCPCS code (e.g. "70551") or text search (e.g. "MRI brain"). Must be at least 2 characters. code_type: Filter by code type: "CPT", "HCPCS", "MS-DRG", "RC", etc. hospital_id: Filter to a specific hospital (use the hospitals tool to find IDs). payer_name: Filter by insurance payer name (e.g. "Blue Cross", "Aetna"). plan_name: Filter by plan name (e.g. "PPO", "HMO"). setting: Filter by clinical setting: "inpatient" or "outpatient". zip_code: US zip code for geographic filtering (alternative to lat/lng). lat: Latitude for geographic filtering (use with lng and radius_miles). lng: Longitude for geographic filtering (use with lat and radius_miles). radius_miles: Search radius in miles from the zip code or lat/lng location. page: Page number (default 1). page_size: Results per page (default 25, max 100). provider_type: "hospital", "practice", or "any" (default). "practice" adds doctors' offices and clinics; office prices always need a payer. Returns: JSON with matching charge items including procedure codes, descriptions, gross charges, cash prices, and negotiated rate ranges per hospital. Only high-confidence results (with at least one usable price) are included. Each result includes last_updated (ISO date of the per-hospital MRF ingest) and mrf_date (ISO date the hospital self-reported in the MRF file). When all results are filtered out, filtered_low_confidence=true is set so the agent can say "no high-confidence prices found" rather than asserting that no prices exist.