Orchard - Unchanged

Machine Readable Files

This page provides machine readable files regarding information on the costs of PEHP covered services in compliance with the federal Transparency in Coverage rules. Although prices listed in these files was accurate as of the date it was posted, prices may have changed since that date.  Files will be updated on a monthly basis.  The prices contained in these files are not a guarantee of any particular payment for a service, are not an estimate of expected costs to members, and may not match amounts that are billed by providers or allowed by PEHP.  Costs to members will vary depending on the eligibility of the member, the member’s plan cost sharing provisions, and the terms of the PEHP provider contracts.  In addition, prices for specific codes may vary when a billing modifier is correctly billed and applies or when certain plan conditions are applicable.  See the applicable PEHP Master Policy for additional plan details.