Price Transparency – Machine Readable Files

In accordance with the Price Transparency Final Rule (85 FR 72158) set forth by the Department of the Treasury, the Internal Revenue Service, the Department of Labor, the Employee Benefits Security Administration, and the Department of Health and Human Services, health plans or issuers must disclose in-network negotiated rates and out-of-network allowed amount rates with certain medical providers through machine-readable files posted on a public facing internet website beginning July 1st, 2022.

  • The pricing information contained in the fee schedules is accurate as of the date it was accessed and is subject to change over time. Furthermore, pricing information is not a guarantee of coverage and payment and may not always reflect final member cost share amounts based on claim processing. Eligibility and benefit determinations are made when the claim is processed by Neighborhood and/or a Neighborhood delegate. The disclosed rate data is for informational purposes only and should not in any way direct, limit, or enhance care.
  • Data contained in the machine-readable files published by Neighborhood are based on the technical specifications set for by CMS in accordance with schema version 1.0.0 published by CMS at https://github.com/CMSgov/price-transparency-guide.
  • Medical In Network File – Coming Soon!
  • Medical Out of Network File – Coming Soon!
  • Behavioral Health In Network File
  • Behavioral Health Out of Network File

We understand that having access to price information is very important to you when using your health insurance.

  • Please call Neighborhood Member Services at 1-855-321-9244 to receive price information on the medical services listed here.
  • Please visit the Health Cost Estimator located in our Behavioral Health portal at: https://www.liveandworkwell.com/content/en/member.html for pricing information for most of your covered behavioral health services. You will need your member ID to create your account and access the Estimator.
  • For Developers/Data Analysts: If there is an issue with the files, please email Production Support @ ITPS@nhpri.org