The Departments of the Treasury, Labor, and Health and Human Services (the Departments) issued the Transparency in Coverage Final Rules (85 FR 72158) on November 12, 2020. The final rules, requiring payers to publish machine-readable files containing in-network and out-of-network rates for providers in North Carolina and other states, went into effect for non-grandfathered group health plans and health insurance issuers in the individual and group markets (plans and issuers) on July 1, 2022.
Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is committed to consumer transparency and agrees that transparency can help consumers. In compliance with the federal Transparency in Coverage rule enforcement deadline, Blue Cross NC published machine-readable files on July 1, 2022.
Blue Cross NC will update machine-readable files monthly.
Last updated 01/01/2023.
Select one of the groups below to view the list of links:
Non-ASO Groups
ASO Groups
- 3 fish inc
- a american electric
- aalberts integrated piping systems americas inc
- abc phones of north carolina inc dba victra
- abco automation inc
- abx innovative packaging solutions llc
- ac corporation
- accelogix llc
- ace academy
- aceavant concrete construction
- acn inc
- adams beverages of north carolina llc
- adams howell sizemore adams p a
- advanced water systems inc
- air t inc
- akg north america inc
- alexander county
- alexander ricks pllc
- alford mechanical inc
- ali group north america corporation
- allegacy federal credit union
- alleghany county
- allen industries inc
- alliance health
- amergent hospitality group inc
- american asset corporation
- american radio television cable inc
- american roller bearing company
- american security mortgage corporation
- amv holdings llc
- aptus group
- arcatech systems
- asahi kasei america inc
- ascend leadership academy
- asheville chevrolet inc
- asheville kombucha mamas llc dba buchi
- atlantic casualty insurance company
- atlantic coast cabinets
- atlantic coast toyotalift
- autobell car wash llc
- avid solutions inc
- avl technologies
- baebies inc
- baker interiors furniture company
- baker roofing company inc
- bakersville community medical clinic inc
- bakkavor foods usa inc
- barnhill contracting company
- barton college group health plan
- bb logistics llc
- beard hardwoods inc
- belk stores services inc
- benton roofing inc
- bernhardt furniture company
- bestco llc
- bethel free will baptist church
- bgf industries inc
- biltmore workforce management llc
- biocryst pharmaceuticals inc
- bitting electric inc
- blue cross and blue shield of north carolina
- blue ridge community health services
- blue ridge companies inc
- blum inc
- bmrs llc
- boer brothers heating and cooling llc
- bojangles of wnc llc
- boon edam inc
- border concepts inc
- brick haulers inc
- brightly software inc
- brock scott pllc
- bruce allen construction
- brumit restaurant group
- brunswick county government
- buhler inc
- builders mutual insurance company
- buncombe county government
- burke county
- burkert usa corp
- butterball llc
- buy sod usa
- ca lewis inc
- caffey distributing co
- calyx
- camp electric company inc
- campbell university incorporated
- campbell brown inc
- capitol broadcasting company inc
- captiveaire systems inc
- carl rose sons inc
- carlie c s operation center inc
- carlson environmental consultants pc
- carolina air conditioning co inc
- carolina comfort air inc
- carolina day school
- carolina dealerships inc
- carolina family health centers inc
- carolina glove company
- carolina home medical
- carolina meadows inc
- carolina premium beverage
- carolinas telco federal credit union
- carroll companies inc
- carson industries inc
- caswell county government
- catawba college
- catawba county employees
- ce rental inc
- century contractors inc
- chadmark inc dba hand stone
- chai pani restaurant group
- chalk gibbs inc
- chandler concrete company inc
- channeladvisor corporation
- chapel hill retirement community dba carol woods retirement community
- charlotte latin school
- charlotte mechanical llc
- charlotte pipe foundry company
- charter medical llc
- city fire and safety inc
- city of brevard
- city of charlotte
- city of cherryville
- city of concord
- city of gastonia
- city of graham
- city of henderson
- city of hickory
- city of kannapolis
- city of kinston
- city of newton
- city of oxford
- city of raleigh
- city of roxboro
- city of salisbury
- city of sanford
- city of thomasville
- city of washington
- city of wilson
- clancy theys construction company
- clariant corporation
- clarks printing service inc
- cleveland county
- cloudfactory usa llc
- coastal beverage company inc
- coastal carolina health care pa
- coats american inc
- cognitect inc
- community based care llc
- community public charter school
- compass group usa inc
- concord abc board
- connectivity llc
- connelly springs electric inc
- consolidated management of greenville inc
- contract erectors inc
- cook boardman llc
- cooper electrical construction company inc
- cooperriis inc
- counter culture coffee inc
- county of chatham
- county of cumberland
- county of franklin
- county of granville
- county of harnett
- county of henderson a body corporate and politic
- county of jackson
- county of lee
- county of sampson
- county of swain
- county of wilson
- cpi security systems inc
- cross technologies inc dba cross company
- d f consolidated inc dba car mel products
- daumar corporation
- david allen company
- david pruitt electrical company inc
- davidson college
- davidson county government
- davidson funeral home
- davie county
- dd enterprises of greensboro inc
- delta mold inc
- dh griffin wrecking company inc
- digestive health specialists
- direct distributors inc
- drake software llc
- driven brands inc
- duke university
- duplin county
- e2 mechanical industrial refrigeration llc
- eastern band of cherokee indians
- eastern radiologists and er imaging
- eastpointe human services
- ecmd inc
- ej pope son inc
- electric glass fiber america llc dba neg us
- elevate textiles inc
- eller residential inc
- elomi dba piedmont machine manufacturing
- elon university
- envicor enterprises llc
- environamics inc
- epic games inc
- exela pharma sciences
- ezzell trucking inc
- facility systems services llc
- fairfield chair company
- fairystone fabrics llc
- family services inc
- fathom holdings inc
- fhcl inc
- finpoint insurance group
- first bancorp
- first citizens bank trust company
- fisher textiles inc
- flores associatesllc
- flow companies llc
- foster caviness company inc
- franchi trucking inc
- frontier yarns inc
- fsc ii llc dba fred smith company
- fuller co construction llc
- g w equipment inc
- g l wilson building company
- galloway ridge inc
- gaston county government
- gha autism supports
- glen raven inc
- global textile alliance inc
- goldsboro milling company
- goodwill industries of eastern nc inc
- goodwill industries of the southern piedmont
- goshen medical center inc
- grady white boats
- green ford llc
- grubb ventures services llc
- guilford college
- guilford medical associates pa
- haeco americas llc
- haire plumbing mechanical co inc
- halifax county
- hallman foundry llc
- hawthorne residential partners llc
- hertford county
- hickory grove baptist church
- high performance technologies
- hillcrest convalescent center inc
- hoffer flow controls inc
- hometrust bank
- horizon tool inc
- hornets basketball llc
- hospice palliative care charlotte region
- hunter corporation
- hurricanes holdings llc
- huscusson business properties inc
- husqvarna professional products inc
- hutchens law firm llp
- hyde park partners inc
- ideal fastener corp
- ifb solutions
- imaflex usa
- implus footcare llc
- intersection logistics llc
- iredell county
- isolved
- isometrics inc
- j p thomas company inc
- jack b wooten company
- jaggaer llc
- james m pleasants company inc
- jj gouge son oil co
- joe gibbs racing inc
- joflowe grading co llc
- john c campbell folk school
- john e jenkins inc
- jordan lumber supply inc
- journey personal care holdings ltd dba attindas
- jsmith civil llc
- jteam emp llc dba johnstone supply
- k flex usa llc
- katalyst network group
- kayser roth corporation
- kennon craver pllc
- kinetic systems inc
- kintegra health
- kline franchising inc dba burn boot camp
- klingspor abrasives inc
- kontane logistics inc
- kontoor brands inc
- l harvey and son company affiliates
- laboratory corporation of america holdings
- land rover cape fear llc
- lc industries
- lending tree
- leviton manufacturing co inc
- life inc
- lincoln county
- lindys homemade llc
- live oak bancshares inc
- lj construction inc
- loparex llc
- lost time control west inc
- louisburg college
- lumbee river electric membership corporation
- mabe trucking company inc
- mackenzie ryan holding company
- macon county
- marine chevrolet company
- mark iii brokerage inc
- marsh furniture company
- martin marietta materials inc
- mayne pharma inc
- mckee homes llc
- mcmichael mills inc
- measurement incorporated
- mechanical contractors inc
- mecklenburg county government
- medi usa lpmedi mfg inc
- meduit
- meherrin agricultural chemical company
- methodist university inc
- mid atlantic christian university
- mig usa llc
- mina charter school
- mint hill dentistry llp
- morganite industries inc
- mosaic group llc
- moto group llc dba rinehart racing
- mountain credit union
- mt olive pickle company inc
- mtm ventures llc
- murphy family ventures llc
- mw industries
- myers and chapman
- nash johnson sons farms
- national coatings supplies inc
- national equipment dealers llc
- nc bankers association health benefit trust
- nc communications inc
- nc conference of the united methodist church
- nc solar now
- nelon cole termite pest control
- nestventure llc
- new hanover county government
- new page companies
- next glass inc
- nn inc
- noel group llc
- north american roofing inc
- north carolina bar association
- north carolina farm bureau federation inc
- north carolina medical society
- north carolina museum of art foundation inc
- north carolina state health plan
- north state consulting llc
- northampton county
- northside millwork inc
- nova credit union
- nutkao usa inc
- obrien and west dmd pllc
- odyssey mechanical llc
- okaya shinnichi corp of america
- olameter corporation
- omara incorporated
- one source communications
- onslow county
- onslow county hospital authority
- onslow grading paving inc
- opendoor international inc
- orange county
- orano usa llc
- pamlico yachtworks llc
- paragon medical
- park construction of nc inc
- parkdale america llc
- parkdale inc
- parkdale mills inc
- parks heating cooling inc
- pathologist medical laboratory
- penske performance inc
- pepsi cola bottling company of hickory nc inc
- petra energy holdings llc
- pfaffs incorportated
- phillips towing service inc
- piedmont advantage credit union
- piedmont plastics
- piedmont triad regional council
- pike enterprises llc
- pine gate renewables llc
- pinehurst medical clinic
- pinehurst surgical
- pinnacle corrugated llc
- pitt county hospitalization fund
- plaza associates inc
- polivka international company
- precision fabrics group inc
- precision franchising inc
- precision walls inc
- premier magnesia llc
- presbyterian homes inc
- prescient national insurance services llc
- printful inc
- progressive service company
- protech mechanical inc
- protochips inc
- puryear tank lines inc
- pyxus holdings inc
- qrc inc
- quality chemical laboratories
- quality equipment llc
- quality oil company llc
- quan services inc
- race city steel inc
- raleigh durham medical group pa
- raleigh neurology associates pa
- raleigh neurosurgical clinic inc
- raleigh orthopaedic clinic pa
- ravenscroft school
- raybow usa
- rcr enterprises llc
- real magic inc
- regional materials recovery inc
- registry partners incorporated
- relay inc
- residential services inc
- reynolds american inc
- riccobene central services inc
- riverwild llc
- rmg leather usa llc
- roanoke chowan community health center
- robert e mason and associates inc
- robeson county
- robinett enterprises
- rodgers builders inc
- roush fenway keselowski racing llc
- rowan county
- rusco fixture company inc
- s s services group llc
- saf technologies inc
- salem academy and college
- salem electric company inc
- sampson bladen oil company inc
- sas institute inc
- schaefer plastics north america llc
- schaefer systems international inc
- schneider mills inc
- scope anesthesia of nc pllc
- scottmadden inc
- sealed air corporation
- seaside vacations
- security plus electrical inc
- self help services corporation
- sentinel risk advisors llc
- sepi engineering construction inc
- sharp transit llc
- shield engineering inc
- sibelco north america inc
- sigma family of companies dba sigma engineered solutions
- signature plumbing inc
- skyla credit union
- smith setzer sons inc
- smith rowe llc
- sonic automotive inc
- southco distributing company
- southeast tubular products inc
- southeastern architectural systems
- southminster inc
- southwestern child development commission
- spectraforce technologies inc
- spectrum consultants inc
- spx corporation
- spx flow inc
- st wooten corporation
- stabella inc
- stabilus inc
- stanly county
- state employees credit union
- steelfab inc
- stewart haas racing llc
- stock car steel aluminum llc
- summit hospitality group ltd
- swaim inc
- swim club management group
- swissport north america inc
- systel business equipment co inc
- t k utilities inc
- t c corriher implement co inc
- t1v
- ta loving company
- target pharmasolutions inc
- taylor motor company
- tech electric corporation
- technimark llc
- telamon corporation
- temperature control solutions inc
- tennoca construction company
- tergus pharma
- tesa tape inc
- tex tech industries
- the east group pa
- the fidelity bank
- the home center
- the hunstad kortesis center pa
- the john r mcadams company inc
- the law offices of james scott farrin
- the n2 company
- the quartz corporation
- thompson gordon shook engineers inc
- tops for shoes
- town of ahoskie
- town of boone
- town of cary
- town of hillsborough
- town of holly springs
- town of kernersville
- town of landis
- town of morehead city
- town of morrisville
- town of ramseur
- town of wake forest
- trackhouse entertainment group llc
- trader construction co
- trans world radio
- transportation insight and nolan transportation group
- transylvania county
- triad metal recyclers llc
- triangle mechanical contractor inc
- triangle urology associates pa
- tribal casino gaming enterprise
- triple r electric inc
- true homes llc
- truebridge capital partnersllc
- truist financial corporation
- truliant federal credit union
- tryon distributing llc
- two hawk employment service llc
- uchiyama manufacturing america llc
- unifi inc
- united methodist retirement homes inc
- us industrial piping inc
- us radiology specialists inc
- uwharrie lumber company
- valley radiology pa
- vance family medicine
- vaya health
- verner center for early learning
- veterinary emergency care pllc
- village family dental
- wake county board of alcohol control
- wake emergency physicians pa
- wake forest university
- walker and associates inc
- warren county
- washington alloy
- wastequip llc
- watson electrical construction company llc
- wayne brothers inc
- wayne county
- wb moore company of charlotte inc
- wc rouse llc dba wc rouse sons
- web don inc
- well spring services inc
- wells and associates pllc
- wells global llc
- western carolina digestive consultants pa
- wilbert inc
- wilkes county
- williams fire sprinkler co inc
- wilmington school of the arts
- wilson preparatory academy
- withersravenel
- wnc paving inc
- wolfspeed inc
- woodard ellis co llc
- workplace options llc
- wyndham capital mortgage inc
- wynn site development inc
- yadkin county employees
- yard nique inc
- york properties inc
- zepsa industries inc
- zippy shell incorporated
The requirement to provide machine-readable files is not a consumer-friendly solution and will not help people better understand the cost of their health care services.
The machine-readable files are intended for use by health care application developers to create tools and databases that will assist consumers in understanding health care costs across providers and health plan issuers.
Understanding the Data Included in the Machine-Readable Files
Machine-readable files published by Blue Cross NC conform to the technical implementation guide and schema version 1.0.0 published by CMS at https://github.com/CMSgov/price-transparency-guide.
The machine-readable files do:
- Include information on the rate insurers have negotiated with in-network providers for all covered items and services.
- Have a significant amount of data (estimated at 1 Terabyte per file), making it difficult to download using an average system or wireless connection.
The machine-readable files do NOT:
- Include meaningful information, such as an estimate of the cost members will be responsible for paying for an item or service. Individual costs vary depending upon the terms of the individual’s specific health insurance coverage or reimbursement arrangement.
- Guarantee payment and may not always reflect amounts on final claim processing documentation. Eligibility and benefit determinations are made when the claim is processed by Blue Cross NC.
Additional Disclosures:
- Pricing included in the fee schedule data is accurate as of the date it is pulled from system files and may be subject to change between the date the pricing data is pulled and the next update of the files.
- Rates for codes appearing in the file may vary when a given code rate has a modifier applied or when member benefit or treatment characteristics result in certain rate adjustments.
- Different code rates for the same codes may indicate that a modifier or some other type of member benefit or treatment characteristic applies.
- Billing codes that are not included in fee schedule data for in-network rates are not included in the file.
Blue Cross NC has an online tool designed specifically for consumers that includes cost estimates for the entire episode of care. Beyond what is available publicly, Blue Cross NC customers can use the tool to access specific, transparent pricing information based on their individual plans. This allows customers to see what they will pay for a procedure and compare prices by location and provider, so they can make informed health care decisions.
Price transparency can add significant value, but more action is needed to make quality, equitable health care more affordable. That is why we stay focused on developing and building on existing tools, like our cost estimator tool, to improve access to quality care, lower costs and provide members with meaningful information so they can make the best choices for their health care.
For member-specific benefit information, view our Transparency of Coverage information.