{"uid":"cap_6ZCQz6GW1djfQZDCPh6KL","slug":"clearcarepulse-out-of-pocket-cost-calculator-328cc855","name":"ClearCarePulse Out-of-Pocket Cost Calculator","description":"Out-of-pocket cost calculator for healthcare and consumer-health agents. Returns the exact patient cost given deductible, coinsurance, and OOP max for any procedure and plan.","url":"https://clearcarepulse.theaslangroupllc.com/api/care/oop?utm_source=zero.xyz","method":"GET","headers":{},"bodySchema":{"type":"object","properties":{"required":{"type":"string"},"properties":{"type":"string"}}},"responseSchema":{"type":"json","errors":{"400":{"example":{"error":"procedure parameter required"},"description":"Invalid or missing parameter(s) — required: procedure. Returned before the payment gate on paid requests, so a malformed call is never charged. JSON body: { error: <what is wrong and how to fix it> } plus usage hints."},"402":{"description":"Payment required — x402 v2 challenge; the accepts array lists scheme, network, and amount. Retry the same request with a PAYMENT-SIGNATURE (v2) or X-PAYMENT (v1) header. Verification is free."},"500":{"example":{"error":"upstream_failed"},"description":"Unexpected server error. If a payment settled without a usable result, contact info@theaslangroupllc.com with the settlement tx hash for a re-run or credit."}}},"example":null,"exampleRequest":null,"tags":["x402"],"displayCostAmount":"0.15","displayCostAsset":"USDC","priceDynamic":false,"priceHint":null,"priceStatus":"priced","priceSource":"probe","requiresHandshake":false,"reviewCount":0,"rating":{"score":"0.00","successRate":"0.00","reviews":0,"stars":null,"state":"unrated"},"availabilityStatus":"unknown","priceObserved":{"p10Cents":"15.0000","medianCents":"15.0000","p90Cents":"15.0000","minCents":"15.0000","maxCents":"15.0000","p95Cents":"15.0000","sampleCount":1,"varies":false,"failureChargeRate":1},"sessionDeposit":null,"pricing":{"kind":"static","summary":"$0.15/call","primary":{"kind":"static","protocol":"x402","network":"base","amountUsd":"0.15","per":"call","confidence":"exact"},"accepted":[{"kind":"static","protocol":"x402","network":"base","amountUsd":"0.15","per":"call","confidence":"exact"}]},"paymentMethods":[{"uid":"pm_WeZqOwhMyKgrT8vF0trBO","protocol":"x402","methodType":"crypto","chain":"base","mode":"charge","costAmount":"0.15","costPer":"request","priority":0,"asset":"0x833589fCD6eDb6E08f4c7C32D4f71b54bdA02913","unit":"request","depositMicros":null,"planRef":null}],"brandName":null,"brandSlug":null,"brandBaseUrl":null,"brandDocsUrl":null,"whatItDoes":"Calculates the exact patient out-of-pocket cost for a given procedure and insurance plan, accounting for deductible, coinsurance, and OOP maximum.","exampleAgentPrompt":"I have a $1,500 deductible (of which I've met $800), 20% coinsurance, and a $5,000 out-of-pocket max — can you calculate exactly what I'll owe out of pocket for a $3,200 knee arthroscopy under my plan?","exampleUseCases":[{"title":"Compare procedure costs across plan options","prompt":"I'm choosing between two health plans for open enrollment — one has a $1,000 deductible with 15% coinsurance and a $4,000 OOP max, the other has a $2,500 deductible with 10% coinsurance and a $6,500 OOP max. Can you calculate what I'd actually pay out of pocket for cataract surgery (estimated at $4,500) under each plan so I can figure out which is better for me?"},{"title":"Budget for scheduled surgery expenses","prompt":"I'm having hip replacement surgery scheduled for next month that's quoted at $18,000. I've already spent $2,200 toward my $3,000 annual deductible, my coinsurance is 25%, and my out-of-pocket maximum is $7,000. What's the total dollar amount I need to budget for my patient responsibility?"},{"title":"Understand recurring treatment costs","prompt":"I need to have quarterly physical therapy sessions, and each visit costs about $250. My plan has a $500 deductible I haven't met yet, 30% coinsurance, and a $4,000 OOP cap. Can you break down exactly how much I'll pay out of pocket for each of the four sessions across the year, accounting for how the deductible works?"}],"resultDescription":"Returns the exact patient out-of-pocket dollar amount for the requested procedure, broken down by how much applies to the remaining deductible, how much is subject to coinsurance, and whether the out-of-pocket maximum caps the total liability.","failureModes":["Missing required plan parameters (deductible, coinsurance rate, OOP max) — returns 400 with a field-level error","Procedure code not recognized — returns 404 or empty cost estimate","Invalid coinsurance percentage (e.g. >100%) — returns 422 validation error","Deductible already met exceeds total deductible — returns 400 logic error","Payment not completed (x402) — returns 402 Payment Required"],"whenToPreferThis":"Use this endpoint when you need a precise, rule-based calculation of what a patient will actually pay after insurance, given known plan parameters (deductible, coinsurance, OOP max). Prefer it over general cost-search endpoints when the user already knows their plan details and wants an exact figure rather than a market price range.","instructions":null,"reviewSummary":null,"reviewSummaryHighlights":null,"reviewSummaryConcerns":null,"reviewSummaryGeneratedAt":null,"activationCount":0,"lastUsedAt":null,"lastSuccessfullyRanAt":null,"lastHealthCheckAt":"2026-10-31T00:31:55.792Z","isFirstParty":false,"canonicalSlug":"clearcarepulse-out-of-pocket-cost-calculator-328cc855"}