Beginning July 1, 2022, as a part of the Transparency in Coverage regulation, the Tri-Agencies (U.S. Departments of Health and Human Services, Labor, and Treasury) require health plans (including self-funded group health plans and insurers offering coverage in the individual and group markets) to publish negotiated rates for all items and services for Commercial coverage (In-Network files) and historical payments to, and billed charges from, Out-of-Network providers (Out-of-Network files) in the form of machine-readable files made publicly available on an internet website.
This information will be updated monthly. The data in these files is based on the requirements of the Transparency in Coverage (TIC) regulation. We believe this information to be an accurate representation of the required data as of the date the information was extracted but the data is subject to change before the next monthly file update. This data is provided solely for the purposes set out in the TIC regulation. Use of the information in this database for any other purpose by a third party is at the third party's risk, and Empire assumes no responsibility for how the information in these files is used or interpreted by third parties.
Note: These are comprehensive files as defined by the requirements provided by CMS. They are large in size and individual computer performance can impact the time and ability to download the files.
Members can log in to empireblue.com or download the Sydney Health app and use our cost transparency tools such as Find Care and Virtual Care to shop for health services and understand how costs differ from doctor to doctor.
These files are identified by Employer Identification Number (EIN) for group business or Health Insurance Oversight System (HIOS) number for individual business.