In-network Rates & Allowed Amounts Files

Medical Mutual will generate machine-readable files for its various plans and group health plan clients as part of compliance with the Transparency in Coverage (TIC) rule. These files contain specific information about covered items and services for in- and out-of-network provider rates.

We are continually adding additional files to the site. Please check back for frequently made updates.

These files are not designed as a consumer tool. Members are encouraged to use the cost estimator tool available through My Health Plan, or reach out to customer service. These files are not a guarantee of coverage, nor a guarantee of the reimbursement rate that will be applied for any procedure. The claims reimbursement process is subject to a variety of factors that are not addressed in these files, including eligibility, medical necessity determinations, utilization management requirements, exclusions and other plan terms. These files also do not offer any information on a member's out-of-pocket charges. The information in these files is accurate as of the date noted for each file and is subject to change without notice.