Healthcare Coverage Cost Transparency

Offering access to high-value care while controlling healthcare costs is an important focus for Sutter Health Plus. That’s why we are committed to providing meaningful information, tools and resources to help members better understand their coverage and out-of-pocket costs.

Sutter Health Plus provides a real-time benefit cost estimator tool on the Member Portal. It helps members compare personalized out-of-pocket costs for covered in-network services with individual-specific accumulators. Please note, the tool only shows claims paid to date. Access it by logging into the Member Portal and clicking the Cost Estimator link.

Member Portal

Machine-Readable Files

Sutter Health Plus shares in-network provider rates and historical out-of-network charges in machine-readable files updated monthly.

Out-of-network provider historical allowed amounts and associated billed charges for IFP

Download JSON File

Out-of-network provider historical allowed amounts and associated billed charges for small group plans

Download JSON File

Out-of-network provider historical allowed amounts and associated billed charges for large group plans

Download JSON File

Members can refer to their benefit plan documents available on the Member Portal to better understand their out-of-pocket costs, such as copays, deductibles or coinsurance. Members may also call Sutter Health Plus Member Services for help in better understanding this information.

If you have additional questions, contact Sutter Health Plus Member Services weekdays, 8:00 am – 7:00 pm, at (855) 315-5800.

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Healthcare Coverage Cost Transparency

Cost Estimator

Machine-Readable Files

Sutter Health Index (JSON)

In-network provider negotiated rates for individual and family plans (IFP)

In-network provider negotiated rates for small group plans

In-network provider negotiated rates for large group plans

Out-of-network provider historical allowed amounts and associated billed charges for IFP

Out-of-network provider historical allowed amounts and associated billed charges for small group plans

Out-of-network provider historical allowed amounts and associated billed charges for large group plans

Supporting Our Members

For Members

Need Help Finding a Provider?

Accessing Care

Nurse Advice Line

Member Resources

Plan Partners

For Brokers

Comprehensive Coverage

Broker Resources

For Employers

Comprehensive Coverage

Employer Resources

For Providers

Provider Resources

About Sutter Health Plus

Quality

About Us

Healthcare Coverage Cost Transparency

Cost Estimator

Machine-Readable Files

Sutter Health Index (JSON)

In-network provider negotiated rates for individual and family plans (IFP)

In-network provider negotiated rates for small group plans

In-network provider negotiated rates for large group plans

Out-of-network provider historical allowed amounts and associated billed charges for IFP

Out-of-network provider historical allowed amounts and associated billed charges for small group plans

Out-of-network provider historical allowed amounts and associated billed charges for large group plans

Supporting Our Members