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Health Insurance MRFs

Transparency in Coverage Rule for Self-Funded Health Insurance Plans

In 2020, the Federal government released its Transparency in Coverage rule, which requires health insurers and self-funded plans to provide data on in- and out-of-network standard rates for their commercial and self-funded lines of business. The Transparency in Coverage Final Rule requires two components:

Machine-readable files (MRF), effective July 1, 2022: health plans publish “machine-readable” files of their pricing data for covered in-network items and services and allowed amounts for, and billed charges from, out-of-network providers.


Internet-based price comparison tool, effective January 1, 2023: health plans provide internet-based price comparison tools to allow an individual to receive an estimate of their cost-sharing responsibility for 500 shoppable services. As of January 1, 2024, health plans provide their price comparison tools for all items and services.

The links below lead to the most recent machine-readable files (MRFs) that are made available in response to the Federal Transparency in Coverage rule.   The files are compliant with the CMS-issued requirements and will be updated on a regular basis per the regulation.  These files are not intended for members to review but instead to be consumed into a computer and analyzed through its programs.  The machine-readable files are formatted in JSON format to allow researchers, regulators, and application developers to access and analyze data more easily.

MRF link: