Estimating Costs of Care
Presbyterian Health Plan individual or employer group members can estimate costs for a procedure or service using the Treatment Cost Estimator tool to help better understand what they may pay for certain services.
Access the Treatment Cost Estimator
Log into the myPRES portal
Select Benefits & Coverage
Choose Estimate My Costs
Important Information for Members: You can also call the Presbyterian Customer Service Center using the number on the back of your Member ID Card to find out how much they may be charged for a medical procedure or other service.
Applicable Rates
The Centers for Medicare & Medicaid Services (CMS) require health plans to publish In-Network Negotiated Rates and Billed Out of Network Allowed Amounts using machine-readable files. A machine-readable file is a digital data format that computers can process automatically, ensuring no loss of meaning. Access to this file type is limited for most users. Please use the Treatment Cost Estimator listed above for cost estimates.
The following machine-readable JavaScript Object Notation (JSON) files are available in accordance with CMS requirements: