Insurance Providers’ Pass Thru Fees
Below is a list of fees that various insurance providers may charge during transactions. This list is updated periodically, please check with your clearinghouse for the most up to date charges.
| CARRIER_NAME | CARRIER_CODE | LEGACY_CARRIER_CODE | PAYER_ID | TRANSACTION GROUP NAME | PASS_THROUGH_FEE_AMT |
|---|---|---|---|---|---|
| MS CHIP | CHIP | BCBSMSC | 89 | CLAIM INQUIRY | $0.0450 |
| HEALTH NET CA | SPHNH | HLTHNTC | 331 | CLAIM INQUIRY | $0.1800 |
| MANAGED CARE OF AMERICA | MGDCA | MGDCA | MGDCA | CLAIM INQUIRY | $0.0500 |
| MEDICAID NH | NH | NHMED | AID47 | CLAIM INQUIRY | $0.0500 |
| MEDICAID PR | ODSI | ODSIMED | AID60 | ELIGIBILITY | $0.0900 |
| MEDICAID FL | 36 | FLMED | AID01 | ELIGIBILITY | $0.0400 |
| ACCESS MED+ | AMP | MEDPLUS | 29 | ELIGIBILITY | $0.0450 |
| MEDICAID OK | OK | OKMED | AID32 | ELIGIBILITY | $0.0200 |
| HEALTH NET MEDI-CAL | SPHNM | HLTHNTMC | 330 | ELIGIBILITY | $0.1800 |
| BCBS MI | BCMIC | BCMIC | BCMIC | ELIGIBILITY | $0.0600 |
| BC OF NORTHEASTERN PA | BCNPC | BCNEPA | BCNPC | ELIGIBILITY | $0.1000 |
| MANAGED CARE OF AMERICA | MGDCA | MGDCA | MGDCA | ELIGIBILITY | $0.0500 |
| SAN JOAQUIN HEALTH PLAN | SJHP | SJHP | SJHP | ELIGIBILITY | $0.0100 |
| HORIZON NJ | HNJH | HNJH | HNJH | ELIGIBILITY | $0.0300 |
| AUTOMATED BENEFIT SERVICES | 38259 | 38259 | 38259 | ELIGIBILITY | $0.0700 |
| SUTTER AND AETNA INSURANCE COMPANY | 60624 | 60624 | 60624 | ELIGIBILITY | $0.0200 |
| HEALTHSCOPE BENEFITS | 71063 | 71063 | 71063 | ELIGIBILITY | $0.0100 |
| MEDICAID HI | HI | HIMED | AID53 | HEALTHCARE SERVICES | $0.0300 |
| MEDICAID MS | MS | MSMED | AID20 | HEALTHCARE SERVICES | $0.0525 |
| MEDICAID OK | OK | OKMED | AID32 | HEALTHCARE SERVICES | $0.0200 |
| HEALTH NET CA | SPHNH | HLTHNTC | 331 | HEALTHCARE SERVICES | $0.1800 |
| MEDICAID MT | MT | MTMED | AID57 | HEALTHCARE SERVICES | $0.0325 |
| HEALTH NET OR | SPHNO | HLTHNTOR | 332 | HEALTHCARE SERVICES | $0.1800 |
| MEDICAID PR | ODSI | ODSIMED | AID60 | CLAIM INQUIRY | $0.0900 |
| MEDICAID MS | MS | MSMED | AID20 | CLAIM INQUIRY | $0.0525 |
| MEDICAID TX | TX | TXMED | AID05 | CLAIM INQUIRY | $0.0750 |
| BS CA | SPBSC | SPBSC | 361 | CLAIM INQUIRY | $0.1000 |
| SIERRA HEALTH SERVICES | SPSHS | 351 | SPSHS | CLAIM INQUIRY | $0.1800 |
| MEDICAID MT | MT | MTMED | AID57 | CLAIM INQUIRY | $0.0325 |
| HEALTH NET OR | SPHNO | HLTHNTOR | 332 | CLAIM INQUIRY | $0.1800 |
| MEDICAID MS | MS | MSMED | AID20 | ELIGIBILITY | $0.0525 |
| WESTERN HEALTH ADVANTAGE | SPWHA | SPWHA | 356 | ELIGIBILITY | $0.1800 |
| HEALTH ALLIANCE PLAN OF MICHIGAN | HAPMI | HAPMI | HAPMI | ELIGIBILITY | $0.0500 |
| BOSTON MEDICAL CENTER HEALTH NET PLAN | 13337 | 13337 | 13337 | ELIGIBILITY | $0.0100 |
| DELAWARE MEDICAID (RELAY) | DWMCD | DWMCD | DWMCD | ELIGIBILITY | $0.0500 |
| MEDICAID KS | KS | KSMED | AID22 | ELIGIBILITY | $0.0400 |
| NEW YORK BLUE CROSS BLUE SHIELD NORTHEASTERN | 800 | 800 | 800 | ELIGIBILITY | $0.0700 |
| INTER VALLEY HEALTH PLAN | SPIVH | IVHP | 334 | ELIGIBILITY | $0.0100 |
| CAREMORE HEALTH PLAN | CARMO | CARMO | CARMO | ELIGIBILITY | $0.0100 |
| BRIGHT HEALTH - MEDICARE ADVANTAGE | BRT01 | BRT01 | BRT01 | ELIGIBILITY | $0.0200 |
| LIFEGUARD | SPLFG | SPLFG | SPLFG | HEALTHCARE SERVICES | $0.1800 |
| SIERRA HEALTH SERVICES | SPSHS | 351 | SPSHS | HEALTHCARE SERVICES | $0.1800 |
| HARVARD PILGRIM HEALTH CARE | HPHC | HPHC | HPHC | HEALTHCARE SERVICES | $0.1000 |
| MEDICAID FL | 36 | FLMED | AID01 | CLAIM INQUIRY | $0.0400 |
| ACCESS MED+ | AMP | MEDPLUS | 29 | CLAIM INQUIRY | $0.0450 |
| HEALTH NET MEDI-CAL | SPHNM | HLTHNTMC | 330 | CLAIM INQUIRY | $0.1800 |
| SCAN HMO | SPSCN | SPSCN | 350 | CLAIM INQUIRY | $0.1800 |
| MEDICAID TNCARE | TN | TNMED | AID13 | ELIGIBILITY | $0.0400 |
| MEDICAID WY | WY | WYMED | AID34 | ELIGIBILITY | $0.0325 |
| SCAN HMO | SPSCN | SPSCN | 350 | ELIGIBILITY | $0.1800 |
| MEDICAID NM | NM | NMMED | AID27 | ELIGIBILITY | $0.0325 |
| ALLWAYS HEALTH PARTNERS | 4293 | 4293 | 4293 | ELIGIBILITY | $0.0500 |
| SELECTHEALTH | SX107 | SX107 | SX107 | ELIGIBILITY | $0.0155 |
| STANISLAUS CO MIA | SPSCM | SPSCM | 352 | HEALTHCARE SERVICES | $0.1800 |
| BC WA PREMERA | BCWAC | BCWAC | BCWAC | HEALTHCARE SERVICES | $0.1000 |
| MEDICAID KS | KS | KSMED | AID22 | HEALTHCARE SERVICES | $0.0400 |
| NEW YORK BLUE CROSS BLUE SHIELD NORTHEASTERN | 800 | 800 | 800 | HEALTHCARE SERVICES | $0.0700 |
| MEDICAID IA | IA | IAMED | AID36 | CLAIM INQUIRY | $0.0800 |
| ALAMEDA ALLIANCE HEALTH | SPAAH | AAHP | 321 | CLAIM INQUIRY | $0.1800 |
| BC OF NORTHEASTERN PA | BCNPC | BCNEPA | BCNPC | CLAIM INQUIRY | $0.1000 |
| BC WA PREMERA | BCWAC | BCWAC | BCWAC | CLAIM INQUIRY | $0.1000 |
| MEDICAID NM | NM | NMMED | AID27 | CLAIM INQUIRY | $0.0325 |
| PARTNERSHIP HEALTH PLAN | SPPHP | PHPC | 343 | ELIGIBILITY | $0.0100 |
| MEDICAID TX | TX | TXMED | AID05 | ELIGIBILITY | $0.0750 |
| SIERRA HEALTH SERVICES | SPSHS | 351 | SPSHS | ELIGIBILITY | $0.1800 |
| STANISLAUS CO MIA | SPSCM | SPSCM | 352 | ELIGIBILITY | $0.1800 |
| ALAMEDA ALLIANCE HEALTH | SPAAH | AAHP | 321 | ELIGIBILITY | $0.1800 |
| MEDICAID MT | MT | MTMED | AID57 | ELIGIBILITY | $0.0325 |
| MS SEHP | SEHP | MSEMPOY | 82 | HEALTHCARE SERVICES | $0.0450 |
| MEMORIAL CARE TPA | SPMCT | MCTPA | 339 | HEALTHCARE SERVICES | $0.1800 |
| MEDICAID HI | HI | HIMED | AID53 | CLAIM INQUIRY | $0.0300 |
| WESTERN HEALTH ADVANTAGE | SPWHA | SPWHA | 356 | CLAIM INQUIRY | $0.1800 |
| LIFEGUARD | SPLFG | SPLFG | SPLFG | CLAIM INQUIRY | $0.1800 |
| BCBS MI | BCMIC | BCMIC | BCMIC | CLAIM INQUIRY | $0.0600 |
| DELAWARE MEDICAID (RELAY) | DWMCD | DWMCD | DWMCD | CLAIM INQUIRY | $0.0500 |
| HARVARD PILGRIM HEALTH CARE | HPHC | HPHC | HPHC | CLAIM INQUIRY | $0.1000 |
| MEDICAID KS | KS | KSMED | AID22 | CLAIM INQUIRY | $0.0400 |
| NEW YORK BLUE CROSS BLUE SHIELD NORTHEASTERN | 800 | 800 | 800 | CLAIM INQUIRY | $0.0700 |
| QUALCHOICE OF ARKANSAS | 35174 | 35174 | 35174 | ELIGIBILITY | $0.0100 |
| MEDICAID IA | IA | IAMED | AID36 | ELIGIBILITY | $0.0800 |
| MS CHIP | CHIP | BCBSMSC | 89 | ELIGIBILITY | $0.0450 |
| BS CA | SPBSC | SPBSC | 361 | ELIGIBILITY | $0.1000 |
| BC WA PREMERA | BCWAC | BCWAC | BCWAC | ELIGIBILITY | $0.1000 |
| SAN JOAQUIN HEALTH PLAN | SPSJH | SPSJH | 349 | ELIGIBILITY | $0.0100 |
| PARTNERSHIP HEALTH PLAN OF CA | PRTHP | PRTHP | PRTHP | ELIGIBILITY | $0.0100 |
| ROCKY MOUNTAIN HEALTH PLAN | RMHP | RMHP | 347 | ELIGIBILITY | $0.0300 |
| MEDICAID NH | NH | NHMED | AID47 | ELIGIBILITY | $0.0500 |
| MONTEFIORE CONTRACT MANAGEMENT ORGANIZATION | 13174 | 13174 | 13174 | ELIGIBILITY | $0.0700 |
| BCBS AR | BCARC | BCBSAR | BCARC | HEALTHCARE SERVICES | $0.1000 |
| HEALTH NET MEDI-CAL | SPHNM | HLTHNTMC | 330 | HEALTHCARE SERVICES | $0.1800 |
| BC OF NORTHEASTERN PA | BCNPC | BCNEPA | BCNPC | HEALTHCARE SERVICES | $0.1000 |
| ROCKY MOUNTAIN HEALTH PLAN | RMHP | RMHP | 347 | CLAIM INQUIRY | $0.0300 |
| MEDICAID HI | AID53 | AID53 | AID53 | ELIGIBILITY | $0.0300 |
| ALLWAYS HEALTH PARTNERS | NGHBHP | NGHBHP | NGHBHP | ELIGIBILITY | $0.0400 |
| BCBS AR | BCARC | BCBSAR | BCARC | ELIGIBILITY | $0.1000 |
| MEDICAID DC | DC | DCMED | AID52 | ELIGIBILITY | $0.0325 |
| MS SEHP | SEHP | MSEMPOY | 82 | ELIGIBILITY | $0.0450 |
| LIFEGUARD | SPLFG | SPLFG | SPLFG | ELIGIBILITY | $0.1800 |
| HEALTH NET OR | SPHNO | HLTHNTOR | 332 | ELIGIBILITY | $0.1800 |
| SCOTT & WHITE (RELAY) | TH002 | TH002 | TH002 | ELIGIBILITY | $0.0100 |
| MERIDIAN COMPLETE ILLINOIS | MCCIL | MCCIL | MCCIL | ELIGIBILITY | $0.0200 |
| MEDICAID FL | 36 | FLMED | AID01 | HEALTHCARE SERVICES | $0.0400 |
| MEDICAID TNCARE | TN | TNMED | AID13 | HEALTHCARE SERVICES | $0.0400 |
| MS CHIP | CHIP | BCBSMSC | 89 | HEALTHCARE SERVICES | $0.0450 |
| SCAN HMO | SPSCN | SPSCN | 350 | HEALTHCARE SERVICES | $0.1800 |
| BCBS MI | BCMIC | BCMIC | BCMIC | HEALTHCARE SERVICES | $0.0600 |
| MEDICAID NH | NH | NHMED | AID47 | HEALTHCARE SERVICES | $0.0500 |
| MEDICAID HI | AID53 | AID53 | AID53 | CLAIM INQUIRY | $0.0300 |
| MEDICAID TNCARE | TN | TNMED | AID13 | CLAIM INQUIRY | $0.0400 |
| HEALTH NET CA | SPHNH | HLTHNTC | 331 | ELIGIBILITY | $0.1800 |
| MEMORIAL CARE TPA | SPMCT | MCTPA | 339 | ELIGIBILITY | $0.1800 |
| ALASKA MEDICAID | AKMCD | AKMCD | AKMCD | ELIGIBILITY | $0.0600 |
| HEALTH ALLIANCE PLAN | HAPMC | HAP | HAPMC | ELIGIBILITY | $0.0500 |
| BOSTON MEDICAL CENTER HEALTHNET PLAN | BMCHLT | BMCHLT | BMCHLT | ELIGIBILITY | $0.0100 |
| STATE FARM INSURANCE COMPANIES | 31053 | 31053 | 31053 | ELIGIBILITY | $0.0155 |
| MEDICAID HI | AID53 | AID53 | AID53 | HEALTHCARE SERVICES | $0.0300 |
| ACCESS MED+ | AMP | MEDPLUS | 29 | HEALTHCARE SERVICES | $0.0450 |
| MEDICAID TX | TX | TXMED | AID05 | HEALTHCARE SERVICES | $0.0750 |
| MEDICAID WY | WY | WYMED | AID34 | HEALTHCARE SERVICES | $0.0325 |
| ALAMEDA ALLIANCE HEALTH | SPAAH | AAHP | 321 | HEALTHCARE SERVICES | $0.1800 |
| MANAGED CARE OF AMERICA | MGDCA | MGDCA | MGDCA | HEALTHCARE SERVICES | $0.0500 |
| ROCKY MOUNTAIN HEALTH PLAN | RMHP | RMHP | 347 | HEALTHCARE SERVICES | $0.0300 |
| MEDICAID NM | NM | NMMED | AID27 | HEALTHCARE SERVICES | $0.0325 |
| DELAWARE MEDICAID (RELAY) | DWMCD | DWMCD | DWMCD | HEALTHCARE SERVICES | $0.0500 |
| BCBS AR | BCARC | BCBSAR | BCARC | CLAIM INQUIRY | $0.1000 |
| MEDICAID DC | DC | DCMED | AID52 | CLAIM INQUIRY | $0.0325 |
| MEDICAID OK | OK | OKMED | AID32 | CLAIM INQUIRY | $0.0200 |
| MEDICAID WY | WY | WYMED | AID34 | CLAIM INQUIRY | $0.0325 |
| MS SEHP | SEHP | MSEMPOY | 82 | CLAIM INQUIRY | $0.0450 |
| MEMORIAL CARE TPA | SPMCT | MCTPA | 339 | CLAIM INQUIRY | $0.1800 |
| STANISLAUS CO MIA | SPSCM | SPSCM | 352 | CLAIM INQUIRY | $0.1800 |
| MEDICAID HI | HI | HIMED | AID53 | ELIGIBILITY | $0.0300 |
| HARVARD PILGRIM HEALTH CARE | HPHC | HPHC | HPHC | ELIGIBILITY | $0.1000 |
| BCBS OF WESTERN NY | SB801 | SB801 | SB801 | ELIGIBILITY | $0.0900 |
| THE LOOMIS COMPANY | 23223 | 23223 | 23223 | ELIGIBILITY | $0.0200 |
| BOON CHAPMAN ADMIN | 74238 | 74238 | 74238 | ELIGIBILITY | $0.0100 |
| MEDICAID PR | ODSI | ODSIMED | AID60 | HEALTHCARE SERVICES | $0.0900 |
| MEDICAID DC | DC | DCMED | AID52 | HEALTHCARE SERVICES | $0.0325 |
| MEDICAID IA | IA | IAMED | AID36 | HEALTHCARE SERVICES | $0.0800 |
| BS CA | SPBSC | SPBSC | 361 | HEALTHCARE SERVICES | $0.1000 |
| WESTERN HEALTH ADVANTAGE | SPWHA | SPWHA | 356 | HEALTHCARE SERVICES | $0.1800 |