Directory › Availity
Availity: pricing signals, access, and small-practice fit
The largest provider-payer network in the US. The Essentials web portal is free for transactions to sponsored payers (plans fund the network). There IS a self-serve, auto-approved API 'Demo' plan — but the production API is contract-gated with no published dollar pricing. That production-pricing gap is the r/healthIT complaint.
What it does
270/271 Eligibility & benefits837 Claim submission835 ERA / remittance276/277 Claim status278 Prior authorization
- 270/271 Eligibility & benefits — Real-time check of whether a patient's coverage is active and what it covers (X12 270 request / 271 response).
- 837 Claim submission — Submit professional/institutional/dental claims to payers (X12 837P/837I/837D).
- 835 ERA / remittance — Electronic remittance advice — how the payer adjudicated a claim and what it paid (X12 835).
- 276/277 Claim status — Ask a payer the status of a submitted claim (X12 276 request / 277 response).
- 278 Prior authorization — Request/inquire on prior authorization for a service (X12 278).
Real-time: yes · Batch: yes
Known pricing signals
| Item | What's public |
|---|---|
| portalFree | published Free Essentials portal for transactions to sponsored payers (plans pay Availity) Source: https://www.availity.com/ — Essentials positioning · verified 2026-06-22 |
| essentialsPlus | reported / estimate ~$25/mo Essentials Plus: adds non-sponsored payers, ~250 included transactions/mo (overage rate not public) Third-party reported; confirm current figure and overage rate with Availity. Source: verifytx.com Availity pricing writeup, corroborated by Availity blog · verified 2026-06-22 |
| apiDemo | published API 'Demo' plan: free, self-serve, auto-approved; capped 5 txn/sec, 500/day Source: https://developer.availity.com/ — Demo plan · verified 2026-06-22 |
| apiProduction | no public price API 'Standard' (production) plan requires contracting with Trading Partner Management; dollar pricing routes to Contact Sales — no public number. This is the opacity the directory exists to surface. No public source — vendor quotes per account. |
| resellerSheet | reported / estimate Reseller sheet (NOT Availity's own): ~$59.95/provider/mo unlimited claims; ~$89.90 claims+remits Reseller pricing, not Availity-published. Source: FastEMC reseller PDF (fastemc.com) · verified 2026-06-22 |
Access requirements
Free self-serve Essentials signup → 2FA → identity verification, then per-payer transaction enrollment. The API Demo plan is genuinely self-serve; production API access is contract-gated through Trading Partner Management with no published price.
Best-for-small-practice
Excellent for the free portal (sponsored payers). For a developer it's evaluation-friendly (free Demo plan + sandbox) but procurement-hostile: you can build and test, but can't learn production cost without a sales process.
The r/healthIT 'won't pursue if it's $5000' signal could not be located/dated (Reddit not crawlable). What IS confirmable: production API pricing is contract-gated and unpublished. We do NOT state '$5000' as a price.
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Find the right one →Independent transparency directory. Pricing and access details are compiled from public vendor pages and practitioner reports and are dated and confidence-tagged — published = vendor's own public page, reported = third-party/forum estimate, no public price = none found. We do not invent numbers. Last verified 2026-06-22. Not affiliated with any vendor; verify current terms directly before contracting. Some outbound links may be referral links.