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Our Machine Readable Files will be added in early July, please check back to find the files for your group and/or network. Once all files are available, they will be updated monthly.

Machine Readable Files

We want to help you better understand the costs of your healthcare. To help do this, we're sharing something called Machine Readable Files. The files below provide helpful information, including:

These files will tell you the prices providers charge for care. We use these amounts and apply your benefits to see how to pay the claim, including what we owe and what you owe, if anything.

Sharing this information can help you see the cost of care and can help you see ways to save money, such as staying in-network or choosing a provider that charges a lower billed charge.

Moda Health will update machine-readable files monthly. Last updated July 1, 2022.

Non-ASO Groups

  • Moda Health Connexus

ASO Groups

  • Central Peninsula Hospital
  • Cherry City Metals
  • City of Portland
  • Emerging Health
  • Leatherman Tool Group, Inc.
  • Moda Partners, Inc.
  • Salem Health Hospitals and Clinics
  • Sause Bros
  • Tuality Healthcare

To help you know if you are a Non-ASO Group or an ASO Group, please call our customer service team at 888-217-2363.

Journey to transparency

Sharing these files is just step 1 in our commitment to deliver cost transparency for our members. In 2023, we will incorporate this information into our Healthcare Cost Estimator tool, making it easier to find the information catered to your benefits and providers. Thank you for your patience as we take this journey to price transparency.

Here's the legal language that talks through Machine Readable Files.

The Departments of the Treasury, Labor, and Health and Human Services issued the Transparency in Coverage final rules on November 12, 2020. The rules require health insurance issuers in the individual and group markets (plans and issuers) to disclose certain pricing information. Under the final rules a plan or issuer must disclose in-network negotiated rates and out-of-network billed and allowed rates through two machine-readable files posted on an internet website.

Understanding the Data

Machine-readable files published by Moda Health conform to the technical implementation guide and schema version 1.0.0 published by CMS at https://github.com/CMSgov/price-transparency-guide

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