MACHINE READABLE FILES

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Consistent with the requirements of the federal Transparency in Coverage final rule, this machine-readable file is publicly available and accessible free of charge without any condition. This file displays negotiated rates for all covered items and services between Aetna and in-network providers for the plans indicated by Health Insurance Company. Some in-network provider arrangements do not prescribe rates for all covered items and services. In those cases, the provider’s reimbursement might be determined in several different ways, but this file would not contain that information.

The MRF will contain in-network (INN) negotiated rate information except for providers with unique payment methodologies that may not be available.

This file is not designed as a consumer tool. Members are encouraged to use the more member-friendly price estimator tools available through Aetna.com. This file is not a guarantee of coverage, nor a guarantee of the reimbursement rate that will be applied for any procedure. The claims reimbursement process is subject to a variety of factors that are not addressed in this file, including eligibility, medical necessity determinations, utilization management requirements, exclusions, and other plan terms. This file also does not offer any information on a member’s out-of-pocket charges.

Consistent with the requirements of the federal Transparency in Coverage final rule, this file is publicly available and accessible free of charge without any condition. This file displays both billed charges and allowed amounts for all covered items and services of the non-participating providers for the plans indicated by Group Health Plan or the Health Insurance Issuer over a prescribed period under the rule.

The disclaimers are applicable to the following legal entities: Aetna Life Insurance Company, Aetna Health Inc., Aetna Health of California Inc., Aetna Health Insurance Company of New York, Aetna Health Insurance Company, Aetna HealthAssurance Pennsylvania Inc. and/or Aetna Life Insurance Company (Aetna). In Florida, by Aetna Health Inc. and/or Aetna Life Insurance Company. In Utah and Wyoming, by Aetna Health of Utah Inc. and Aetna Life Insurance Company. In Maryland, by Aetna Health Inc.; Texas Health + Aetna Health Plan Inc. & Texas Health + Aetna Health Insurance Company; Sutter Health and Aetna Administrative Services LLC; Innovation Health Insurance Company and Innovation Health Plan, Inc.; Allina Health and Aetna Insurance Company; and Banner Health and Aetna Health Insurance Company and Banner Health and Aetna Health Plan Inc.