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Bluebook is a quality-cost information navigation solution that enables patients to see the Fair Price for procedures in their area, along with quality rankings for doctors and facilities.

Bluebook’s Fair Price™ is the reasonable amount you should expect to pay for a medical service. It’s calculated from an independent nationwide database of medical payment data and customized to your geographic area.

Bluebook uses a simple green-yellow-red color-coded system to guide users to procedure costs in their market that are at, below), or above Bluebook's Fair Price.

Green = Fair Price

Yellow = slightly above the Fair Price

Red = highest cost

Bluebook determines the Fair Price for a given procedure by evaluating the allowed amounts (or discounted amounts) from medical claims and pricing.

We include a variety of data sources to provide members with very accurate Fair Price information for healthcare services in their market. This system is used to develop the Fair Price and provider rankings in markets across the country.

Bluebook provides price "ratings" instead of exact prices because, in some cases during the appointment, additional services may need to be provided, which may change the overall cost.

However, our color ratings provide you with confidence that you are choosing a Fair Price provider, and that your services will be provided at or below the Bluebook Fair Price regardless of the exact set of services you receive during the visit.

Color-coded cost symbols denote cost rankings for facilities to help you easily identify where a facility falls in comparison to the Fair Price. Providers are listed in order of lowest price to highest price.

Green circle = at or below the Fair Price

Yellow triangle = slightly above the Fair Price

Red stop sign = significantly above the Fair Price.

Many surgical procedures, such as a hip replacement or knee surgery, have multiple components and are based on a standard procedure without complications.

The three major cost categories for most surgical procedures are:

1. Facility: Depending on the procedure, this may include items such as overnight stay, nursing, supplies, devices and medications.
2. Physician: Includes the fees for the physician performing the procedure and post-operative care.
3. Anesthesia: Includes the fees for the anesthesiologist and anesthesia and is based on the length of the surgery.

Cost information is updated monthly.

The procedure may not include a facility fee, which is typically the factor that creates the large cost variance from place to place. Bluebook does not rate facilities for procedures that have little cost variation or for procedures a doctor is likely to perform in-office.

If you search for a procedure and do not see facilities listed, you can still use our Fair Price information to ensure you don't overpay.

Bluebook owns the largest quality-cost dataset in the U.S., which covers billions of claim lines for millions of procedures across millions of lives each year.

Our data are validated against federal and commercial claims databases, in addition to our own database, and are refreshed on a monthly basis. The information is then risk- and volume-adjusted for accuracy to ensure the quality of our data.

Finally, the data are converted into simple terms using our same color-coded green-yellow-red methodology to indicate levels of quality for doctors and facilities.

With the purchase of the provider quality division of Quantros, Inc., Bluebook now owns the largest healthcare quality and cost dataset in the U.S. and the only one of its kind.

Hospital and physician quality rankings use data from CMS (Centers for Medicare and Medicaid Services), all-payor databases and the Agency for Healthcare Research and Quality (AHRQ).

Rankings are calculated for each clinical area by assessing performance by the hospital or physician in several areas: patient complications, patient safety, mortality, and unplanned re-admissions. All metrics are risk and volume adjusted.

Coming soon, both outpatient and inpatient data will be combined to provide an unprecedented line of sight into the strengths and areas needing improvement for hospitals, systems, and physicians across the continuum of care.