CMS Price Transparency Data
Echocardiogram (heart ultrasound)
Facility: Johnson Memorial Hospital
Billing Code: 93306 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 93306
- Insurance Median: $177
- Cash Discount Price: $592
- vs. Medicare Baseline: 0.32x Medicare
The contracted insurance negotiated median rate for a Echocardiogram (heart ultrasound) at Johnson Memorial Hospital is $177. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $592. Compared to the federal Medicare reimbursement reference rate of $558.25, this hospital’s rate is 0.32x the Medicare baseline. Located in 201 Chestnut Hill Road, Stafford Springs, CT.
Cash / Self-Pay
$592
Average discount available for prompt cash payment at this facility.
Insurance Median
$177
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$558.25
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $558.25 (100%)
Cash / Self-Pay: $592 (106%)
Insurance Median: $177 (32%)
Cash: $592 (106% of Medicare)
Ins. Median: $177 (32% of Medicare)
Understanding this gauge: We use the federal Medicare rate of $558.25 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.
Out-of-Pocket Cost Estimator
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicaid / KanCare | $43 - $1,100 | 8% |
| Aetna | $45 - $1,843 | 8% |
| Albany County Correctional Facility | $45 - $177 | 8% |
| Ambetter / Centene | $45 - $177 | 8% |
| Amish Mennonite | $45 - $177 | 8% |
| Ascension St. Vincent Public Safety Medical | $45 - $177 | 8% |
| Bcccp-Michigan | $45 - $177 | 8% |
| Bccp | $45 - $177 | 8% |
| Blue Cross Blue Shield | $45 - $982 | 8% |
| Bmc Healthnet | $45 - $177 | 8% |
| Breast Grant-Connecticut | $45 - $177 | 8% |
| Broward County Dept Of Health | $45 - $177 | 8% |
| California Health And Wellness | $45 - $177 | 8% |
| Can Community Health Inc | $45 - $177 | 8% |
| Cardinal Innovations Lme | $45 - $177 | 8% |
| Care Connections Of Northern Iowa | $45 - $177 | 8% |
| Care Oregon Ohp | $45 - $177 | 8% |
| Cencal Health Plan | $45 - $177 | 8% |
| Cenpatico | $45 - $177 | 8% |
| Chhuny | $45 - $177 | 8% |
| Childrens Comm Health Plan | $45 - $177 | 8% |
| Childrens Medical Services Title 19 | $45 - $177 | 8% |
| Cigna | $45 - $2,156 | 8% |
| City Of Philadelphia | $45 - $177 | 8% |
| Cmh Allegan County | $45 - $177 | 8% |
| Cmh Ausable Valley | $45 - $177 | 8% |
| Cmh Barry County | $45 - $177 | 8% |
| Cmh Bay-Arenac County | $45 - $177 | 8% |
| Cmh Berrien County | $45 - $177 | 8% |
| Cmh Cass County | $45 - $177 | 8% |
| Cmh Central Mi County | $45 - $177 | 8% |
| Cmh Clinton-Eaton-Ingham County | $45 - $177 | 8% |
| Cmh Detroit Wayne Integrated Health Network | $45 - $177 | 8% |
| Cmh Genesee County | $45 - $177 | 8% |
| Cmh Ionia County | $45 - $177 | 8% |
| Cmh Jackson County/Lifeways | $45 - $177 | 8% |
| Cmh Kalamazoo | $45 - $177 | 8% |
| Cmh Kent County | $45 - $177 | 8% |
| Cmh Lenawee County | $45 - $177 | 8% |
| Cmh Livingston County | $45 - $177 | 8% |
| Cmh Macomb | $45 - $177 | 8% |
| Cmh Misc | $45 - $177 | 8% |
| Cmh Monroe County | $45 - $177 | 8% |
| Cmh Montcalm County | $45 - $177 | 8% |
| Cmh Muskegon County | $45 - $177 | 8% |
| Cmh Newaygo County | $45 - $177 | 8% |
| Cmh North Country | $45 - $177 | 8% |
| Cmh Northern Lakes County | $45 - $177 | 8% |
| Cmh Oakland County | $45 - $177 | 8% |
| Cmh Ottawa County | $45 - $177 | 8% |
| Cmh Van Buren County | $45 - $177 | 8% |
| Cmh Washtenaw County | $45 - $177 | 8% |
| Cmh Wayne County/Carelink | $45 - $177 | 8% |
| Cmh Wayne Cty/Com Liv Svcs | $45 - $177 | 8% |
| Cmh West Mi County | $45 - $177 | 8% |
| Community Benefit Health | $45 - $177 | 8% |
| Community Care Behavorial Health | $45 - $177 | 8% |
| Community Care Partners | $45 - $177 | 8% |
| Community Health Choice | $45 - $177 | 8% |
| Connections Csp | $45 - $177 | 8% |
| County Coroner | $45 - $177 | 8% |
| County Funding Generic | $45 - $177 | 8% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund | $45 - $177 | 8% |
| Dean Wi Badgercare | $45 - $177 | 8% |
| Delaware County Department Of Health | $45 - $177 | 8% |
| Delaware First Health | $45 - $177 | 8% |
| Dph Tb Program | $45 - $177 | 8% |
| Dscc | $45 - $177 | 8% |
| Eastpointe Lme | $45 - $177 | 8% |
| Family Health Network | $45 - $177 | 8% |
| Freedom First Healthcare | $45 - $177 | 8% |
| Fresno County Ccs | $45 - $177 | 8% |
| Ghc Scw Wi Badgercare | $45 - $177 | 8% |
| Harbor Health | $45 - $177 | 8% |
| Health Safety Net | $45 - $177 | 8% |
| Healthy Blue Ne | $45 - $177 | 8% |
| Hennepin Health | $45 - $177 | 8% |
| Humana | $45 - $205 | 8% |
| Id County Ada | $45 - $177 | 8% |
| Id County Canyon | $45 - $177 | 8% |
| Id County Cat Fund | $45 - $177 | 8% |
| Id County Other | $45 - $177 | 8% |
| Id County Payette | $45 - $177 | 8% |
| Idaho Dept Health And Wellfare | $45 - $177 | 8% |
| Idaho Womens Health Check | $45 - $177 | 8% |
| Indiana Breast Cervical Cancer | $45 - $177 | 8% |
| Inland Empire Health Plan | $45 - $177 | 8% |
| Intercommunity Health Ohp | $45 - $177 | 8% |
| Iowa Total Care | $45 - $177 | 8% |
| Jai Medical System | $45 - $177 | 8% |
| Kern Family Health Plan | $45 - $177 | 8% |
| Keystone First | $45 - $177 | 8% |
| Keystone First Chip | $45 - $177 | 8% |
| La Care Health Plan | $45 - $177 | 8% |
| Lakeland Care Inc | $45 - $177 | 8% |
| Managed Health Services - Indiana | $45 - $177 | 8% |
| Maryland Breast & Cervical Program | $45 - $177 | 8% |
| Maryland Healthy Smiles - Scion Dental | $45 - $177 | 8% |
| Maryland Physicians Care | $45 - $177 | 8% |
| Massachusetts Behavioral Health Partnership | $45 - $177 | 8% |
| Mdwise | $45 - $177 | 8% |
| Medi-Cal | $45 - $177 | 8% |
| Medi-Cal Healthnet | $45 - $177 | 8% |
| Medstar Dc Healthy Family | $45 - $177 | 8% |
| Medstar Md Health Choice | $45 - $177 | 8% |
| Mo Home State Health Plan | $45 - $177 | 8% |
| Molina Centennial Care | $45 - $177 | 8% |
| Nascentia Health Options | $45 - $177 | 8% |
| Nebraska Total Care | $45 - $177 | 8% |
| New York Cancer Services Program | $45 - $177 | 8% |
| Nextlevel Health | $45 - $177 | 8% |
| Oregon Screenwise | $45 - $177 | 8% |
| Pace Of Southwest Michigan | $45 - $205 | 8% |
| Paramount Advantage | $45 - $177 | 8% |
| Parkland Community Health Plan | $45 - $177 | 8% |
| Partners Behavioral Lme | $45 - $177 | 8% |
| Peach State Healthplan | $45 - $177 | 8% |
| Philadelphia County Funding | $45 - $177 | 8% |
| Presbyterian Centennial Care | $45 - $177 | 8% |
| Prestige Health Choice | $45 - $177 | 8% |
| Priority Partners | $45 - $177 | 8% |
| Robert F Sing Program | $45 - $177 | 8% |
| Rx 340B Pass Along | $45 - $177 | 8% |
| Rx Assistance/Rx Manufacturer Assistance 0 Copay | $45 - $177 | 8% |
| Rx Medi-Cal | $45 - $177 | 8% |
| Rx Meridian Rx | $45 - $177 | 8% |
| Ryan White Florida Mssrp | $45 - $177 | 8% |
| Sandhills Center Lme | $45 - $177 | 8% |
| Screening For Life | $45 - $177 | 8% |
| St Joseph County Hlth Dpt | $45 - $177 | 8% |
| Stephenson Cty Health | $45 - $177 | 8% |
| Sunshine State Health Plan | $45 - $177 | 8% |
| Superior Health | $45 - $177 | 8% |
| Tenncare | $45 - $177 | 8% |
| Texas Children'S Health Plan | $45 - $177 | 8% |
| Trillium Community Ohp | $45 - $177 | 8% |
| Tufts Health Public Plans | $45 - $177 | 8% |
| UnitedHealthcare | $45 - $2,363 | 8% |
| Vaya Health Lme | $45 - $177 | 8% |
| Washtenaw Health Plan | $45 - $177 | 8% |
| Wellsense Health Plan | $45 - $177 | 8% |
| Wi Womens Wellness | $45 - $177 | 8% |
| Health New England | $63 - $1,536 | 11% |
| Champva | $65 - $194 | 12% |
| Tricare | $65 - $194 | 12% |
| Triwest Health Alliance | $65 - $194 | 12% |
| Veterans Eval Services | $65 - $194 | 12% |
| Us Family Health Plan | $68 - $443 | 12% |
| Align Senior Care | $69 - $205 | 12% |
| Ally Align Care Adv | $69 - $205 | 12% |
| American Health Advantage Of Idaho | $69 - $205 | 12% |
| American Health Plan | $69 - $205 | 12% |
| Aurora Special Needs | $69 - $205 | 12% |
| Blue Care Network Advantage | $69 - $205 | 12% |
| Blue Shield - De (Highmark) Medciare Advantage | $69 - $205 | 12% |
| Care Dimensions | $69 - $205 | 12% |
| Care Improvement Plus | $69 - $205 | 12% |
| Care Resources Pace | $69 - $205 | 12% |
| Careplus Health Plans | $69 - $205 | 12% |
| Cca - Zing Health | $69 - $205 | 12% |
| Central Valley Medical Services Corp Pace | $69 - $205 | 12% |
| Champion Health Plan Mcr Advantage | $69 - $205 | 12% |
| Clear Spring Health | $69 - $205 | 12% |
| Clover Health | $69 - $205 | 12% |
| Commonwealth Care Alliance | $69 - $223 | 12% |
| Community Pace At Home | $69 - $205 | 12% |
| Eddy Senior Care-Pace | $69 - $205 | 12% |
| Eddy Seniorcare Pace | $69 - $205 | 12% |
| Elementcare | $69 - $205 | 12% |
| Evercare | $69 - $205 | 12% |
| Everence | $69 - $205 | 12% |
| Gateway Health Plan | $69 - $205 | 12% |
| Genesys Pace Of Genesee County | $69 - $205 | 12% |
| Georgia Health Advantage | $69 - $205 | 12% |
| Gold Advantage | $69 - $205 | 12% |
| Gpa Croell Redi Mix | $69 - $205 | 12% |
| Health America Advantra | $69 - $205 | 12% |
| Highmark Health Options Dual Plan | $69 - $205 | 12% |
| Hope Select Pace | $69 - $205 | 12% |
| Horizon Nj Total Care | $69 - $205 | 12% |
| Hudson Headwaters Pace | $69 - $205 | 12% |
| Huron Valley Pace | $69 - $205 | 12% |
| Innovative Integrated Health Community Plans | $69 - $205 | 12% |
| Iowa Health Advantage | $69 - $205 | 12% |
| Johns Hopkins Advantage Md | $69 - $205 | 12% |
| Lasso Healthcare Msa | $69 - $205 | 12% |
| Life St Marys Pace | $69 - $205 | 12% |
| Lifecircles Pace | $69 - $205 | 12% |
| Longevity Health Plan | $69 - $205 | 12% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $69 - $205 | 12% |
| Martins Point Generations Advantage | $69 - $205 | 12% |
| Mass General Brigham Mcr Adv | $69 - $205 | 12% |
| Medicare (plans) | $69 - $675 | 12% |
| Medipak Advantage | $69 - $205 | 12% |
| Mercy Life | $69 - $205 | 12% |
| Mercyone Cedar Valley | $69 - $205 | 12% |
| Meridian Complete | $69 - $205 | 12% |
| Michigan Complete Health | $69 - $205 | 12% |
| Nascentia Health Plus | $69 - $205 | 12% |
| New Centry Health Careplus | $69 - $205 | 12% |
| Osu Prime Care Advantage | $69 - $205 | 12% |
| Pace Cny | $69 - $205 | 12% |
| Pace Iowa Immanuel Pathways | $69 - $205 | 12% |
| Pace Southeast | $69 - $205 | 12% |
| Pace-Trinity Health | $69 - $205 | 12% |
| Peak Pace Solutions | $69 - $205 | 12% |
| Perennial Advantage | $69 - $205 | 12% |
| Preferred Care Partners | $69 - $205 | 12% |
| Presbyterian Senior Plan | $69 - $205 | 12% |
| Provider Partners Health Plan Of Illinois | $69 - $205 | 12% |
| Provider Partners Health Plan Of Indiana | $69 - $205 | 12% |
| Pruitthealth Premier | $69 - $205 | 12% |
| Reliance Community Care Partners Care Resources Pace | $69 - $205 | 12% |
| Rx Allwin | $69 - $205 | 12% |
| Rx Grane Grnmedd | $69 - $205 | 12% |
| Rx Retiree Rx Care | $69 - $205 | 12% |
| Scan Health Plan Mcr Ipa Meritage Oon | $69 - $205 | 12% |
| Secure Horizons Ma Pffs | $69 - $205 | 12% |
| Serenity Pace | $69 - $205 | 12% |
| Siouxland Pace | $69 - $205 | 12% |
| Solis Health Plans | $69 - $205 | 12% |
| Sunnyview-Pace Finance Dept | $69 - $205 | 12% |
| Texan Plus | $69 - $205 | 12% |
| The Health Plan | $69 - $205 | 12% |
| Thome Pace | $69 - $205 | 12% |
| Todays Options | $69 - $205 | 12% |
| Tribute Health Plans | $69 - $205 | 12% |
| Um Health Advantage | $69 - $205 | 12% |
| Union Health Service | $69 - $205 | 12% |
| Welbe Health | $69 - $205 | 12% |
| Wellmed | $69 - $205 | 12% |
| Veterans Administration | $70 - $210 | 13% |
| Cca Senior Care Options | $74 - $655 | 13% |
| Fallon Health | $90 - $852 | 16% |
| Mass General Brigham Health Plan | $100 - $457 | 18% |
| Unicare | $112 - $982 | 20% |
| Wellpoint | $112 - $982 | 20% |
| Claimdoc | $123 - $1,376 | 22% |
| Innovative Health Plan Ii | $123 - $1,376 | 22% |
| Health Smart | $131 - $2,009 | 23% |
| Andrie Inc | $136 - $410 | 24% |
| East Greenbush Central School District | $136 - $410 | 24% |
| Genex Wc | $136 - $410 | 24% |
| Healthsmart Workers Comp | $136 - $410 | 24% |
| Jag Source | $136 - $410 | 24% |
| New York State Insurance Fund | $136 - $410 | 24% |
| Njm Insurance Group | $136 - $410 | 24% |
| Rx Heatlhcomp | $136 - $410 | 24% |
| Rx Restat | $136 - $410 | 24% |
| Rx Saif Opdp Wc | $136 - $410 | 24% |
| Rx Worker'S Comp | $136 - $410 | 24% |
| Wc Accident Fund | $136 - $410 | 24% |
| Wc Ace | $136 - $410 | 24% |
| Wc Acs Federal Employees | $136 - $410 | 24% |
| Wc Acuity | $136 - $410 | 24% |
| Wc Advantage | $136 - $410 | 24% |
| Wc Aegis | $136 - $410 | 24% |
| Wc Aig | $136 - $410 | 24% |
| Wc Aims | $136 - $410 | 24% |
| Wc Alaska National Ins | $136 - $410 | 24% |
| Wc Align Network | $136 - $410 | 24% |
| Wc Allied | $136 - $410 | 24% |
| Wc Am Trust N America | $136 - $410 | 24% |
| Wc American Claims Mgmt | $136 - $410 | 24% |
| Wc Amerisure | $136 - $410 | 24% |
| Wc Amtrust | $136 - $410 | 24% |
| Wc Asu Risk Mgt | $136 - $410 | 24% |
| Wc Benetech | $136 - $410 | 24% |
| Wc Berkley Admin | $136 - $410 | 24% |
| Wc Broadspire | $136 - $410 | 24% |
| Wc Broward County | $136 - $410 | 24% |
| Wc Bunch & Associates | $136 - $410 | 24% |
| Wc California State Comp Ins | $136 - $410 | 24% |
| Wc California State Ins Fund | $136 - $410 | 24% |
| Wc Capitol Area Health Consortium | $136 - $410 | 24% |
| Wc Ccmsi | $136 - $410 | 24% |
| Wc Chartis | $136 - $410 | 24% |
| Wc Chubb | $136 - $410 | 24% |
| Wc Cirma | $136 - $410 | 24% |
| Wc City Of Albany | $136 - $410 | 24% |
| Wc City Of Sioux City | $136 - $410 | 24% |
| Wc Claims Mgmt Inc | $136 - $410 | 24% |
| Wc Cna | $136 - $410 | 24% |
| Wc Comp One Admin C/O Manageability | $136 - $410 | 24% |
| Wc Compone Admin | $136 - $410 | 24% |
| Wc Ct Healthcare Trust | $136 - $410 | 24% |
| Wc Donegal Insurance Group | $136 - $410 | 24% |
| Wc Emc Insurance Company | $136 - $410 | 24% |
| Wc Employee Mutual | $136 - $410 | 24% |
| Wc Enablecomp | $136 - $410 | 24% |
| Wc Encore Health Network | $136 - $410 | 24% |
| Wc Erie | $136 - $410 | 24% |
| Wc Esis | $136 - $410 | 24% |
| Wc Evolutions | $136 - $410 | 24% |
| Wc Fcci | $136 - $410 | 24% |
| Wc Fed Ex | $136 - $410 | 24% |
| Wc Federal Black Lung | $136 - $410 | 24% |
| Wc Federated | $136 - $410 | 24% |
| Wc Finley Occupational Health | $136 - $410 | 24% |
| Wc First Agency/Occunet | $136 - $410 | 24% |
| Wc Ford Motor | $136 - $410 | 24% |
| Wc Fresno Unified Emp | $136 - $410 | 24% |
| Wc Gallagher Bassett | $136 - $410 | 24% |
| Wc General Motors | $136 - $410 | 24% |
| Wc Generic | $136 - $410 | 24% |
| Wc Genex Care For Ohio | $136 - $410 | 24% |
| Wc Great West Casualty | $136 - $410 | 24% |
| Wc Guarantee Insurance | $136 - $410 | 24% |
| Wc Guard Insurance Company | $136 - $410 | 24% |
| Wc Hab | $136 - $410 | 24% |
| Wc Hartford | $136 - $410 | 24% |
| Wc Hastings | $136 - $410 | 24% |
| Wc Health Management | $136 - $410 | 24% |
| Wc Heritage Summit | $136 - $410 | 24% |
| Wc Hireright | $136 - $410 | 24% |
| Wc Horizon | $136 - $410 | 24% |
| Wc Icw Group | $136 - $410 | 24% |
| Wc Idaho State Ins Fund | $136 - $410 | 24% |
| Wc Intercare Insurance | $136 - $410 | 24% |
| Wc Intermountain | $136 - $410 | 24% |
| Wc Johns Eastern | $136 - $410 | 24% |
| Wc Kemberton | $136 - $410 | 24% |
| Wc Key Ins & Benefit Solutions | $136 - $410 | 24% |
| Wc Liberty Mutual | $136 - $410 | 24% |
| Wc Mac Risk Management | $136 - $410 | 24% |
| Wc Massachusetts | $136 - $410 | 24% |
| Wc Mdia | $136 - $410 | 24% |
| Wc Meadowbrook Claim | $136 - $410 | 24% |
| Wc Medical Administrators | $136 - $410 | 24% |
| Wc Meijers | $136 - $410 | 24% |
| Wc Memic | $136 - $410 | 24% |
| Wc Mercy Workcare | $136 - $410 | 24% |
| Wc Michigan | $136 - $410 | 24% |
| Wc Michigan Millers Mutual | $136 - $410 | 24% |
| Wc Mitchell Frankenmuth | $136 - $410 | 24% |
| Wc Mra | $136 - $410 | 24% |
| Wc Nationwide | $136 - $410 | 24% |
| Wc Nca Comp | $136 - $410 | 24% |
| Wc New York | $136 - $410 | 24% |
| Wc New York Special Funds | $136 - $410 | 24% |
| Wc North American Rishces | $136 - $410 | 24% |
| Wc Northeast Health | $136 - $410 | 24% |
| Wc Notre Dame | $136 - $410 | 24% |
| Wc Novanet | $136 - $410 | 24% |
| Wc O'Hara Corp | $136 - $410 | 24% |
| Wc Occ Health Allen | $136 - $410 | 24% |
| Wc Ohio Bureau | $136 - $410 | 24% |
| Wc One Call Medical | $136 - $410 | 24% |
| Wc Paradigm | $136 - $410 | 24% |
| Wc Peerless | $136 - $410 | 24% |
| Wc Pma | $136 - $410 | 24% |
| Wc Praxis Health Network | $136 - $410 | 24% |
| Wc Price Chopper | $136 - $410 | 24% |
| Wc Procura Management | $136 - $410 | 24% |
| Wc Qualcare | $136 - $410 | 24% |
| Wc Quiktrip | $136 - $410 | 24% |
| Wc Reny Company | $136 - $410 | 24% |
| Wc Rev Claims | $136 - $410 | 24% |
| Wc Risico | $136 - $410 | 24% |
| Wc Rural Mutual | $136 - $410 | 24% |
| Wc Saif Oregon | $136 - $410 | 24% |
| Wc Secura | $136 - $410 | 24% |
| Wc Sedgwick | $136 - $410 | 24% |
| Wc Sentry | $136 - $410 | 24% |
| Wc Sheakley Unicomp | $136 - $410 | 24% |
| Wc Smile Lodge | $136 - $410 | 24% |
| Wc Society | $136 - $410 | 24% |
| Wc Srs | $136 - $410 | 24% |
| Wc Taconic (Mro) | $136 - $410 | 24% |
| Wc Taconic Farms | $136 - $410 | 24% |
| Wc Travelers | $136 - $410 | 24% |
| Wc Triad Group | $136 - $410 | 24% |
| Wc Tristar | $136 - $410 | 24% |
| Wc Troy Ny | $136 - $410 | 24% |
| Wc Tyson | $136 - $410 | 24% |
| Wc Unified Health Services | $136 - $410 | 24% |
| Wc United Heartland | $136 - $410 | 24% |
| Wc Us Dept Of Labor | $136 - $410 | 24% |
| Wc Velocity | $136 - $410 | 24% |
| Wc Walmart | $136 - $410 | 24% |
| Wc West Bend | $136 - $410 | 24% |
| Wc West Bend Mutual/Argent | $136 - $410 | 24% |
| Wc Winnebago Industries | $136 - $410 | 24% |
| Wc Yankee Trails | $136 - $410 | 24% |
| Wc York Risk | $136 - $410 | 24% |
| Wc Zenith | $136 - $410 | 24% |
| Wc Zurich | $136 - $410 | 24% |
| Connecticare | $143 - $779 | 26% |
| Tufts Health Plan | $144 - $443 | 26% |
| Healthscope | $147 - $440 | 26% |
| Harvard Pilgrim Healthcare | $150 - $1,475 | 27% |
| Bcn Domestic | $155 - $982 | 28% |
| Blue Benefit Administrators Of Massachusetts | $155 - $982 | 28% |
| Blue Care Network | $155 - $982 | 28% |
| Blue Distinction Transplant | $155 - $982 | 28% |
| Blue Shield - Ca | $155 - $982 | 28% |
| Blue Shield - Id (Regence) | $155 - $982 | 28% |
| Blue Shield - Ny Highmark Northeastern | $155 - $982 | 28% |
| Blue Shield - Ny Highmark Western | $155 - $982 | 28% |
| Blue Shield - Pa (Highmark) | $155 - $982 | 28% |
| Blue Shield - Wa (Regence) | $155 - $982 | 28% |
| Centivo | $155 - $1,526 | 28% |
| Coventry | $155 - $575 | 28% |
| Delta Dental Ga | $155 - $1,100 | 28% |
| Delta Dental Mi | $155 - $1,100 | 28% |
| Delta Dental Mo | $155 - $1,100 | 28% |
| Delta Dental Nj | $155 - $1,100 | 28% |
| Delta Dental Ny | $155 - $1,100 | 28% |
| Delta Dental Oh | $155 - $1,100 | 28% |
| Delta Dental Or | $155 - $1,100 | 28% |
| Delta Dental Pa | $155 - $1,100 | 28% |
| Delta Dental Va | $155 - $1,100 | 28% |
| Delta Dental Wa | $155 - $1,100 | 28% |
| First Health | $155 - $575 | 28% |
| Guardian | $155 - $575 | 28% |
| Health Choices | $155 - $982 | 28% |
| Kaiser Domestic | $155 - $982 | 28% |
| Liberty Dental | $155 - $1,100 | 28% |
| Meritain | $155 - $1,843 | 28% |
| Multiplan | $155 - $1,961 | 28% |
| Pre-Employment | $155 - $982 | 28% |
| Prime Health Services | $155 - $1,890 | 28% |
| Wc Domestic | $155 - $982 | 28% |
| Wc Corvel | $160 - $935 | 29% |
| Connecticut Dept Of Correction | $605 | 108% |
| Diversified Administrators | $1,376 | 246% |
| Geha | $1,475 | 264% |
| 1199 National Benefit Fund | $1,843 | 330% |
| Allied Benefit Systems | $1,843 | 330% |
| Gravie Admin Services | $1,843 | 330% |
| Hap | $1,843 | 330% |
| Luminare Health | $1,843 | 330% |
| Nippon Life Ins | $1,843 | 330% |
| Webtpa | $1,843 | 330% |
| Allied National Global Care | $1,961 | 351% |
| Asrm - Reliance Standard Life Insurance | $1,961 | 351% |
| Christian Care Ministry | $1,961 | 351% |
| Dean Health | $1,961 | 351% |
| Family Life Insurance Company | $1,961 | 351% |
| Ghc Scw | $1,961 | 351% |
| International Benefit Administrators | $1,961 | 351% |
| Lifetime Benefit Solutions | $1,961 | 351% |
| Manhattan Life | $1,961 | 351% |
| Medi Share | $1,961 | 351% |
| Mvp | $1,961 | 351% |
| Pai | $1,961 | 351% |
| Pan-American Life | $1,961 | 351% |
| Paramount Hmo | $1,961 | 351% |
| Phcs | $1,961 | 351% |
| Trinity Health Share | $1,961 | 351% |
| Allegiance | $2,156 | 386% |
| Health Partners | $2,156 | 386% |
| Magnacare | $2,156 | 386% |
| United Behavioral Health Eap | $2,363 | 423% |