CMS Price Transparency Data
Ultrasound, pelvis
Facility: Johnson Memorial Hospital
Billing Code: 76856 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 76856
- Insurance Median: $73
- Cash Discount Price: $274
- vs. Medicare Baseline: 0.68x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Johnson Memorial Hospital is $73. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $274. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.68x the Medicare baseline. Located in 201 Chestnut Hill Road, Stafford Springs, CT.
Cash / Self-Pay
$274
Average discount available for prompt cash payment at this facility.
Insurance Median
$73
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$106.81
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $106.81 (100%)
Cash / Self-Pay: $274 (257%)
Insurance Median: $73 (68%)
Cash: $274 (257% of Medicare)
Ins. Median: $73 (68% of Medicare)
Understanding this gauge: We use the federal Medicare rate of $106.81 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 |
|---|---|---|
| Aetna | $20 - $264 | 19% |
| Albany County Correctional Facility | $20 - $67 | 19% |
| Ambetter / Centene | $20 - $67 | 19% |
| Amish Mennonite | $20 - $67 | 19% |
| Ascension St. Vincent Public Safety Medical | $20 - $67 | 19% |
| Bcccp-Michigan | $20 - $67 | 19% |
| Bccp | $20 - $67 | 19% |
| Blue Cross Blue Shield | $20 - $273 | 19% |
| Bmc Healthnet | $20 - $67 | 19% |
| Breast Grant-Connecticut | $20 - $67 | 19% |
| Broward County Dept Of Health | $20 - $67 | 19% |
| California Health And Wellness | $20 - $67 | 19% |
| Can Community Health Inc | $20 - $67 | 19% |
| Cardinal Innovations Lme | $20 - $67 | 19% |
| Care Connections Of Northern Iowa | $20 - $67 | 19% |
| Care Oregon Ohp | $20 - $67 | 19% |
| Cencal Health Plan | $20 - $67 | 19% |
| Cenpatico | $20 - $67 | 19% |
| Chhuny | $20 - $67 | 19% |
| Childrens Comm Health Plan | $20 - $67 | 19% |
| Childrens Medical Services Title 19 | $20 - $67 | 19% |
| Cigna | $20 - $815 | 19% |
| City Of Philadelphia | $20 - $67 | 19% |
| Cmh Allegan County | $20 - $67 | 19% |
| Cmh Ausable Valley | $20 - $67 | 19% |
| Cmh Barry County | $20 - $67 | 19% |
| Cmh Bay-Arenac County | $20 - $67 | 19% |
| Cmh Berrien County | $20 - $67 | 19% |
| Cmh Cass County | $20 - $67 | 19% |
| Cmh Central Mi County | $20 - $67 | 19% |
| Cmh Clinton-Eaton-Ingham County | $20 - $67 | 19% |
| Cmh Detroit Wayne Integrated Health Network | $20 - $67 | 19% |
| Cmh Genesee County | $20 - $67 | 19% |
| Cmh Ionia County | $20 - $67 | 19% |
| Cmh Jackson County/Lifeways | $20 - $67 | 19% |
| Cmh Kalamazoo | $20 - $67 | 19% |
| Cmh Kent County | $20 - $67 | 19% |
| Cmh Lenawee County | $20 - $67 | 19% |
| Cmh Livingston County | $20 - $67 | 19% |
| Cmh Macomb | $20 - $67 | 19% |
| Cmh Misc | $20 - $67 | 19% |
| Cmh Monroe County | $20 - $67 | 19% |
| Cmh Montcalm County | $20 - $67 | 19% |
| Cmh Muskegon County | $20 - $67 | 19% |
| Cmh Newaygo County | $20 - $67 | 19% |
| Cmh North Country | $20 - $67 | 19% |
| Cmh Northern Lakes County | $20 - $67 | 19% |
| Cmh Oakland County | $20 - $67 | 19% |
| Cmh Ottawa County | $20 - $67 | 19% |
| Cmh Van Buren County | $20 - $67 | 19% |
| Cmh Washtenaw County | $20 - $67 | 19% |
| Cmh Wayne County/Carelink | $20 - $67 | 19% |
| Cmh Wayne Cty/Com Liv Svcs | $20 - $67 | 19% |
| Cmh West Mi County | $20 - $67 | 19% |
| Community Benefit Health | $20 - $67 | 19% |
| Community Care Behavorial Health | $20 - $67 | 19% |
| Community Care Partners | $20 - $67 | 19% |
| Community Health Choice | $20 - $67 | 19% |
| Connections Csp | $20 - $67 | 19% |
| County Coroner | $20 - $67 | 19% |
| County Funding Generic | $20 - $67 | 19% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund | $20 - $67 | 19% |
| Dean Wi Badgercare | $20 - $67 | 19% |
| Delaware County Department Of Health | $20 - $67 | 19% |
| Delaware First Health | $20 - $67 | 19% |
| Dph Tb Program | $20 - $67 | 19% |
| Dscc | $20 - $67 | 19% |
| Eastpointe Lme | $20 - $67 | 19% |
| Family Health Network | $20 - $67 | 19% |
| Freedom First Healthcare | $20 - $67 | 19% |
| Fresno County Ccs | $20 - $67 | 19% |
| Ghc Scw Wi Badgercare | $20 - $67 | 19% |
| Harbor Health | $20 - $67 | 19% |
| Health Safety Net | $20 - $67 | 19% |
| Healthy Blue Ne | $20 - $67 | 19% |
| Hennepin Health | $20 - $67 | 19% |
| Humana | $20 - $110 | 19% |
| Id County Ada | $20 - $67 | 19% |
| Id County Canyon | $20 - $67 | 19% |
| Id County Cat Fund | $20 - $67 | 19% |
| Id County Other | $20 - $67 | 19% |
| Id County Payette | $20 - $67 | 19% |
| Idaho Dept Health And Wellfare | $20 - $67 | 19% |
| Idaho Womens Health Check | $20 - $67 | 19% |
| Indiana Breast Cervical Cancer | $20 - $67 | 19% |
| Inland Empire Health Plan | $20 - $67 | 19% |
| Intercommunity Health Ohp | $20 - $67 | 19% |
| Iowa Total Care | $20 - $67 | 19% |
| Jai Medical System | $20 - $67 | 19% |
| Kern Family Health Plan | $20 - $67 | 19% |
| Keystone First | $20 - $67 | 19% |
| Keystone First Chip | $20 - $67 | 19% |
| La Care Health Plan | $20 - $67 | 19% |
| Lakeland Care Inc | $20 - $67 | 19% |
| Managed Health Services - Indiana | $20 - $67 | 19% |
| Maryland Breast & Cervical Program | $20 - $67 | 19% |
| Maryland Healthy Smiles - Scion Dental | $20 - $67 | 19% |
| Maryland Physicians Care | $20 - $67 | 19% |
| Massachusetts Behavioral Health Partnership | $20 - $67 | 19% |
| Mdwise | $20 - $67 | 19% |
| Medi-Cal | $20 - $67 | 19% |
| Medi-Cal Healthnet | $20 - $67 | 19% |
| Medicaid / KanCare | $20 - $284 | 19% |
| Medstar Dc Healthy Family | $20 - $67 | 19% |
| Medstar Md Health Choice | $20 - $67 | 19% |
| Mo Home State Health Plan | $20 - $67 | 19% |
| Molina Centennial Care | $20 - $67 | 19% |
| Nascentia Health Options | $20 - $67 | 19% |
| Nebraska Total Care | $20 - $67 | 19% |
| New York Cancer Services Program | $20 - $67 | 19% |
| Nextlevel Health | $20 - $67 | 19% |
| Oregon Screenwise | $20 - $67 | 19% |
| Pace Of Southwest Michigan | $20 - $110 | 19% |
| Paramount Advantage | $20 - $67 | 19% |
| Parkland Community Health Plan | $20 - $67 | 19% |
| Partners Behavioral Lme | $20 - $67 | 19% |
| Peach State Healthplan | $20 - $67 | 19% |
| Philadelphia County Funding | $20 - $67 | 19% |
| Presbyterian Centennial Care | $20 - $67 | 19% |
| Prestige Health Choice | $20 - $67 | 19% |
| Priority Partners | $20 - $67 | 19% |
| Robert F Sing Program | $20 - $67 | 19% |
| Rx 340B Pass Along | $20 - $67 | 19% |
| Rx Assistance/Rx Manufacturer Assistance 0 Copay | $20 - $67 | 19% |
| Rx Medi-Cal | $20 - $67 | 19% |
| Rx Meridian Rx | $20 - $67 | 19% |
| Ryan White Florida Mssrp | $20 - $67 | 19% |
| Sandhills Center Lme | $20 - $67 | 19% |
| Screening For Life | $20 - $67 | 19% |
| St Joseph County Hlth Dpt | $20 - $67 | 19% |
| Stephenson Cty Health | $20 - $67 | 19% |
| Sunshine State Health Plan | $20 - $67 | 19% |
| Superior Health | $20 - $67 | 19% |
| Tenncare | $20 - $67 | 19% |
| Texas Children'S Health Plan | $20 - $67 | 19% |
| Trillium Community Ohp | $20 - $67 | 19% |
| Tufts Health Public Plans | $20 - $67 | 19% |
| UnitedHealthcare | $20 - $1,045 | 19% |
| Vaya Health Lme | $20 - $67 | 19% |
| Washtenaw Health Plan | $20 - $67 | 19% |
| Wellsense Health Plan | $20 - $67 | 19% |
| Wi Womens Wellness | $20 - $67 | 19% |
| Health New England | $30 - $679 | 28% |
| Champva | $32 - $105 | 30% |
| Tricare | $32 - $105 | 30% |
| Triwest Health Alliance | $32 - $105 | 30% |
| Veterans Eval Services | $32 - $105 | 30% |
| Align Senior Care | $33 - $110 | 31% |
| Ally Align Care Adv | $33 - $110 | 31% |
| American Health Advantage Of Idaho | $33 - $110 | 31% |
| American Health Plan | $33 - $110 | 31% |
| Aurora Special Needs | $33 - $110 | 31% |
| Blue Care Network Advantage | $33 - $110 | 31% |
| Blue Shield - De (Highmark) Medciare Advantage | $33 - $110 | 31% |
| Care Dimensions | $33 - $110 | 31% |
| Care Improvement Plus | $33 - $110 | 31% |
| Care Resources Pace | $33 - $110 | 31% |
| Careplus Health Plans | $33 - $110 | 31% |
| Cca - Zing Health | $33 - $110 | 31% |
| Cca Senior Care Options | $33 - $125 | 31% |
| Central Valley Medical Services Corp Pace | $33 - $110 | 31% |
| Champion Health Plan Mcr Advantage | $33 - $110 | 31% |
| Clear Spring Health | $33 - $110 | 31% |
| Clover Health | $33 - $110 | 31% |
| Commonwealth Care Alliance | $33 - $112 | 31% |
| Community Pace At Home | $33 - $110 | 31% |
| Eddy Senior Care-Pace | $33 - $110 | 31% |
| Eddy Seniorcare Pace | $33 - $110 | 31% |
| Elementcare | $33 - $110 | 31% |
| Evercare | $33 - $110 | 31% |
| Everence | $33 - $110 | 31% |
| Gateway Health Plan | $33 - $110 | 31% |
| Genesys Pace Of Genesee County | $33 - $110 | 31% |
| Georgia Health Advantage | $33 - $110 | 31% |
| Gold Advantage | $33 - $110 | 31% |
| Gpa Croell Redi Mix | $33 - $110 | 31% |
| Health America Advantra | $33 - $110 | 31% |
| Highmark Health Options Dual Plan | $33 - $110 | 31% |
| Hope Select Pace | $33 - $110 | 31% |
| Horizon Nj Total Care | $33 - $110 | 31% |
| Hudson Headwaters Pace | $33 - $110 | 31% |
| Huron Valley Pace | $33 - $110 | 31% |
| Innovative Integrated Health Community Plans | $33 - $110 | 31% |
| Iowa Health Advantage | $33 - $110 | 31% |
| Johns Hopkins Advantage Md | $33 - $110 | 31% |
| Lasso Healthcare Msa | $33 - $110 | 31% |
| Life St Marys Pace | $33 - $110 | 31% |
| Lifecircles Pace | $33 - $110 | 31% |
| Longevity Health Plan | $33 - $110 | 31% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $33 - $110 | 31% |
| Martins Point Generations Advantage | $33 - $110 | 31% |
| Mass General Brigham Mcr Adv | $33 - $110 | 31% |
| Medicare (plans) | $33 - $129 | 31% |
| Medipak Advantage | $33 - $110 | 31% |
| Mercy Life | $33 - $110 | 31% |
| Mercyone Cedar Valley | $33 - $110 | 31% |
| Meridian Complete | $33 - $110 | 31% |
| Michigan Complete Health | $33 - $110 | 31% |
| Nascentia Health Plus | $33 - $110 | 31% |
| New Centry Health Careplus | $33 - $110 | 31% |
| Osu Prime Care Advantage | $33 - $110 | 31% |
| Pace Cny | $33 - $110 | 31% |
| Pace Iowa Immanuel Pathways | $33 - $110 | 31% |
| Pace Southeast | $33 - $110 | 31% |
| Pace-Trinity Health | $33 - $110 | 31% |
| Peak Pace Solutions | $33 - $110 | 31% |
| Perennial Advantage | $33 - $110 | 31% |
| Preferred Care Partners | $33 - $110 | 31% |
| Presbyterian Senior Plan | $33 - $110 | 31% |
| Provider Partners Health Plan Of Illinois | $33 - $110 | 31% |
| Provider Partners Health Plan Of Indiana | $33 - $110 | 31% |
| Pruitthealth Premier | $33 - $110 | 31% |
| Reliance Community Care Partners Care Resources Pace | $33 - $110 | 31% |
| Rx Allwin | $33 - $110 | 31% |
| Rx Grane Grnmedd | $33 - $110 | 31% |
| Rx Retiree Rx Care | $33 - $110 | 31% |
| Scan Health Plan Mcr Ipa Meritage Oon | $33 - $110 | 31% |
| Secure Horizons Ma Pffs | $33 - $110 | 31% |
| Serenity Pace | $33 - $110 | 31% |
| Siouxland Pace | $33 - $110 | 31% |
| Solis Health Plans | $33 - $110 | 31% |
| Sunnyview-Pace Finance Dept | $33 - $110 | 31% |
| Texan Plus | $33 - $110 | 31% |
| The Health Plan | $33 - $110 | 31% |
| Thome Pace | $33 - $110 | 31% |
| Todays Options | $33 - $110 | 31% |
| Tribute Health Plans | $33 - $110 | 31% |
| Um Health Advantage | $33 - $110 | 31% |
| Union Health Service | $33 - $110 | 31% |
| Us Family Health Plan | $33 - $248 | 31% |
| Welbe Health | $33 - $110 | 31% |
| Wellmed | $33 - $110 | 31% |
| Veterans Administration | $34 - $113 | 32% |
| Fallon Health | $43 - $239 | 40% |
| Bcn Domestic | $46 - $273 | 43% |
| Blue Benefit Administrators Of Massachusetts | $46 - $273 | 43% |
| Blue Care Network | $46 - $273 | 43% |
| Blue Distinction Transplant | $46 - $273 | 43% |
| Blue Shield - Ca | $46 - $273 | 43% |
| Blue Shield - Id (Regence) | $46 - $273 | 43% |
| Blue Shield - Ny Highmark Northeastern | $46 - $273 | 43% |
| Blue Shield - Ny Highmark Western | $46 - $273 | 43% |
| Blue Shield - Pa (Highmark) | $46 - $273 | 43% |
| Blue Shield - Wa (Regence) | $46 - $273 | 43% |
| Health Choices | $46 - $273 | 43% |
| Kaiser Domestic | $46 - $273 | 43% |
| Pre-Employment | $46 - $273 | 43% |
| Wc Domestic | $46 - $273 | 43% |
| Mass General Brigham Health Plan | $47 - $246 | 44% |
| Unicare | $54 - $273 | 51% |
| Wellpoint | $54 - $273 | 51% |
| Connecticare | $56 - $562 | 52% |
| Claimdoc | $59 - $263 | 55% |
| Innovative Health Plan Ii | $59 - $263 | 55% |
| Multiplan | $65 - $867 | 61% |
| Health Smart | $70 - $888 | 66% |
| Wc Corvel | $70 - $241 | 66% |
| Healthscope | $71 - $237 | 66% |
| Tufts Health Plan | $71 - $248 | 66% |
| Harvard Pilgrim Healthcare | $72 - $234 | 67% |
| Andrie Inc | $73 - $245 | 68% |
| East Greenbush Central School District | $73 - $245 | 68% |
| Genex Wc | $73 - $245 | 68% |
| Healthsmart Workers Comp | $73 - $245 | 68% |
| Jag Source | $73 - $245 | 68% |
| New York State Insurance Fund | $73 - $245 | 68% |
| Njm Insurance Group | $73 - $245 | 68% |
| Rx Heatlhcomp | $73 - $245 | 68% |
| Rx Restat | $73 - $245 | 68% |
| Rx Saif Opdp Wc | $73 - $245 | 68% |
| Rx Worker'S Comp | $73 - $245 | 68% |
| Wc Accident Fund | $73 - $245 | 68% |
| Wc Ace | $73 - $245 | 68% |
| Wc Acs Federal Employees | $73 - $245 | 68% |
| Wc Acuity | $73 - $245 | 68% |
| Wc Advantage | $73 - $245 | 68% |
| Wc Aegis | $73 - $245 | 68% |
| Wc Aig | $73 - $245 | 68% |
| Wc Aims | $73 - $245 | 68% |
| Wc Alaska National Ins | $73 - $245 | 68% |
| Wc Align Network | $73 - $245 | 68% |
| Wc Allied | $73 - $245 | 68% |
| Wc Am Trust N America | $73 - $245 | 68% |
| Wc American Claims Mgmt | $73 - $245 | 68% |
| Wc Amerisure | $73 - $245 | 68% |
| Wc Amtrust | $73 - $245 | 68% |
| Wc Asu Risk Mgt | $73 - $245 | 68% |
| Wc Benetech | $73 - $245 | 68% |
| Wc Berkley Admin | $73 - $245 | 68% |
| Wc Broadspire | $73 - $245 | 68% |
| Wc Broward County | $73 - $245 | 68% |
| Wc Bunch & Associates | $73 - $245 | 68% |
| Wc California State Comp Ins | $73 - $245 | 68% |
| Wc California State Ins Fund | $73 - $245 | 68% |
| Wc Capitol Area Health Consortium | $73 - $245 | 68% |
| Wc Ccmsi | $73 - $245 | 68% |
| Wc Chartis | $73 - $245 | 68% |
| Wc Chubb | $73 - $245 | 68% |
| Wc Cirma | $73 - $245 | 68% |
| Wc City Of Albany | $73 - $245 | 68% |
| Wc City Of Sioux City | $73 - $245 | 68% |
| Wc Claims Mgmt Inc | $73 - $245 | 68% |
| Wc Cna | $73 - $245 | 68% |
| Wc Comp One Admin C/O Manageability | $73 - $245 | 68% |
| Wc Compone Admin | $73 - $245 | 68% |
| Wc Ct Healthcare Trust | $73 - $245 | 68% |
| Wc Donegal Insurance Group | $73 - $245 | 68% |
| Wc Emc Insurance Company | $73 - $245 | 68% |
| Wc Employee Mutual | $73 - $245 | 68% |
| Wc Enablecomp | $73 - $245 | 68% |
| Wc Encore Health Network | $73 - $245 | 68% |
| Wc Erie | $73 - $245 | 68% |
| Wc Esis | $73 - $245 | 68% |
| Wc Evolutions | $73 - $245 | 68% |
| Wc Fcci | $73 - $245 | 68% |
| Wc Fed Ex | $73 - $245 | 68% |
| Wc Federal Black Lung | $73 - $245 | 68% |
| Wc Federated | $73 - $245 | 68% |
| Wc Finley Occupational Health | $73 - $245 | 68% |
| Wc First Agency/Occunet | $73 - $245 | 68% |
| Wc Ford Motor | $73 - $245 | 68% |
| Wc Fresno Unified Emp | $73 - $245 | 68% |
| Wc Gallagher Bassett | $73 - $245 | 68% |
| Wc General Motors | $73 - $245 | 68% |
| Wc Generic | $73 - $245 | 68% |
| Wc Genex Care For Ohio | $73 - $245 | 68% |
| Wc Great West Casualty | $73 - $245 | 68% |
| Wc Guarantee Insurance | $73 - $245 | 68% |
| Wc Guard Insurance Company | $73 - $245 | 68% |
| Wc Hab | $73 - $245 | 68% |
| Wc Hartford | $73 - $245 | 68% |
| Wc Hastings | $73 - $245 | 68% |
| Wc Health Management | $73 - $245 | 68% |
| Wc Heritage Summit | $73 - $245 | 68% |
| Wc Hireright | $73 - $245 | 68% |
| Wc Horizon | $73 - $245 | 68% |
| Wc Icw Group | $73 - $245 | 68% |
| Wc Idaho State Ins Fund | $73 - $245 | 68% |
| Wc Intercare Insurance | $73 - $245 | 68% |
| Wc Intermountain | $73 - $245 | 68% |
| Wc Johns Eastern | $73 - $245 | 68% |
| Wc Kemberton | $73 - $245 | 68% |
| Wc Key Ins & Benefit Solutions | $73 - $245 | 68% |
| Wc Liberty Mutual | $73 - $245 | 68% |
| Wc Mac Risk Management | $73 - $245 | 68% |
| Wc Massachusetts | $73 - $245 | 68% |
| Wc Mdia | $73 - $245 | 68% |
| Wc Meadowbrook Claim | $73 - $245 | 68% |
| Wc Medical Administrators | $73 - $245 | 68% |
| Wc Meijers | $73 - $245 | 68% |
| Wc Memic | $73 - $245 | 68% |
| Wc Mercy Workcare | $73 - $245 | 68% |
| Wc Michigan | $73 - $245 | 68% |
| Wc Michigan Millers Mutual | $73 - $245 | 68% |
| Wc Mitchell Frankenmuth | $73 - $245 | 68% |
| Wc Mra | $73 - $245 | 68% |
| Wc Nationwide | $73 - $245 | 68% |
| Wc Nca Comp | $73 - $245 | 68% |
| Wc New York | $73 - $245 | 68% |
| Wc New York Special Funds | $73 - $245 | 68% |
| Wc North American Rishces | $73 - $245 | 68% |
| Wc Northeast Health | $73 - $245 | 68% |
| Wc Notre Dame | $73 - $245 | 68% |
| Wc Novanet | $73 - $245 | 68% |
| Wc O'Hara Corp | $73 - $245 | 68% |
| Wc Occ Health Allen | $73 - $245 | 68% |
| Wc Ohio Bureau | $73 - $245 | 68% |
| Wc One Call Medical | $73 - $245 | 68% |
| Wc Paradigm | $73 - $245 | 68% |
| Wc Peerless | $73 - $245 | 68% |
| Wc Pma | $73 - $245 | 68% |
| Wc Praxis Health Network | $73 - $245 | 68% |
| Wc Price Chopper | $73 - $245 | 68% |
| Wc Procura Management | $73 - $245 | 68% |
| Wc Qualcare | $73 - $245 | 68% |
| Wc Quiktrip | $73 - $245 | 68% |
| Wc Reny Company | $73 - $245 | 68% |
| Wc Rev Claims | $73 - $245 | 68% |
| Wc Risico | $73 - $245 | 68% |
| Wc Rural Mutual | $73 - $245 | 68% |
| Wc Saif Oregon | $73 - $245 | 68% |
| Wc Secura | $73 - $245 | 68% |
| Wc Sedgwick | $73 - $245 | 68% |
| Wc Sentry | $73 - $245 | 68% |
| Wc Sheakley Unicomp | $73 - $245 | 68% |
| Wc Smile Lodge | $73 - $245 | 68% |
| Wc Society | $73 - $245 | 68% |
| Wc Srs | $73 - $245 | 68% |
| Wc Taconic (Mro) | $73 - $245 | 68% |
| Wc Taconic Farms | $73 - $245 | 68% |
| Wc Travelers | $73 - $245 | 68% |
| Wc Triad Group | $73 - $245 | 68% |
| Wc Tristar | $73 - $245 | 68% |
| Wc Troy Ny | $73 - $245 | 68% |
| Wc Tyson | $73 - $245 | 68% |
| Wc Unified Health Services | $73 - $245 | 68% |
| Wc United Heartland | $73 - $245 | 68% |
| Wc Us Dept Of Labor | $73 - $245 | 68% |
| Wc Velocity | $73 - $245 | 68% |
| Wc Walmart | $73 - $245 | 68% |
| Wc West Bend | $73 - $245 | 68% |
| Wc West Bend Mutual/Argent | $73 - $245 | 68% |
| Wc Winnebago Industries | $73 - $245 | 68% |
| Wc Yankee Trails | $73 - $245 | 68% |
| Wc York Risk | $73 - $245 | 68% |
| Wc Zenith | $73 - $245 | 68% |
| Wc Zurich | $73 - $245 | 68% |
| Centivo | $78 - $292 | 73% |
| Coventry | $80 - $264 | 75% |
| First Health | $80 - $264 | 75% |
| Guardian | $80 - $264 | 75% |
| Meritain | $80 - $264 | 75% |
| Prime Health Services | $81 - $836 | 76% |
| Delta Dental Ga | $82 - $284 | 77% |
| Delta Dental Mi | $82 - $284 | 77% |
| Delta Dental Mo | $82 - $284 | 77% |
| Delta Dental Nj | $82 - $284 | 77% |
| Delta Dental Ny | $82 - $284 | 77% |
| Delta Dental Oh | $82 - $284 | 77% |
| Delta Dental Or | $82 - $284 | 77% |
| Delta Dental Pa | $82 - $284 | 77% |
| Delta Dental Va | $82 - $284 | 77% |
| Delta Dental Wa | $82 - $284 | 77% |
| Liberty Dental | $82 - $284 | 77% |
| Connecticut Dept Of Correction | $116 | 109% |
| Geha | $179 | 168% |
| 1199 National Benefit Fund | $246 | 230% |
| Allied Benefit Systems | $246 | 230% |
| Gravie Admin Services | $246 | 230% |
| Hap | $246 | 230% |
| Luminare Health | $246 | 230% |
| Nippon Life Ins | $246 | 230% |
| Webtpa | $246 | 230% |
| Diversified Administrators | $263 | 246% |
| Allegiance | $593 | 555% |
| Health Partners | $593 | 555% |
| Magnacare | $593 | 555% |
| Allied National Global Care | $867 | 812% |
| Asrm - Reliance Standard Life Insurance | $867 | 812% |
| Christian Care Ministry | $867 | 812% |
| Dean Health | $867 | 812% |
| Family Life Insurance Company | $867 | 812% |
| Ghc Scw | $867 | 812% |
| International Benefit Administrators | $867 | 812% |
| Lifetime Benefit Solutions | $867 | 812% |
| Manhattan Life | $867 | 812% |
| Medi Share | $867 | 812% |
| Mvp | $867 | 812% |
| Pai | $867 | 812% |
| Pan-American Life | $867 | 812% |
| Paramount Hmo | $867 | 812% |
| Phcs | $867 | 812% |
| Trinity Health Share | $867 | 812% |
| United Behavioral Health Eap | $1,045 | 978% |