2024 Price Comparison Tool Goes Live

The Transparency in Coverage final rule requires Premera to build a tool that gives members an estimate of their cost-sharing responsibility for a specific item or service from a specific provider. The rule adopted a phased-in approach for implementation, requiring the tool to include 500 specific services beginning January 1, 2023, and all items and services, including prescription drugs, starting January 1, 2024.

The 2024 Price Comparison tool, which expands the number of searchable billing codes from 500 to over 18,000, went live on December 20, 2023. The update expands the number of searchable billing codes from 500 to over 18,000. To provide cost estimates, the tool uses in-network negotiated rates from 76 machine-readable files that are refreshed monthly and over 30 unique network configurations. Due to the size and complexity of the tool, we anticipate the need for ongoing maintenance and performance updates. Premera is committed to the continued testing and refinement of the tool throughout 2024 and beyond, as needed.

Express Scripts (ESI) created a separate tool for members with carved in pharmacy benefits that was deployed on January 1, 2024, as anticipated.

Please note that members must be logged into their secure Premera member portal to access both tools.