CMS Price Transparency Data
Upper endoscopy with biopsy
Facility: Saint Mary's Hospital
Billing Code: 43239 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 43239
- Insurance Median: $219
- Cash Discount Price: $1,626
- vs. Medicare Baseline: 0.24x Medicare
The contracted insurance negotiated median rate for a Upper endoscopy with biopsy at Saint Mary's Hospital is $219. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,626. Compared to the federal Medicare reimbursement reference rate of $926.63, this hospital’s rate is 0.24x the Medicare baseline. Located in 56 Franklin Street, Waterbury, CT.
Cash / Self-Pay
$1,626
Average discount available for prompt cash payment at this facility.
Insurance Median
$219
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$926.63
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $926.63 (100%)
Cash / Self-Pay: $1,626 (175%)
Insurance Median: $219 (24%)
Cash: $1,626 (175% of Medicare)
Ins. Median: $219 (24% of Medicare)
Understanding this gauge: We use the federal Medicare rate of $926.63 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 | $77 - $374 | 8% |
| Aetna | $82 - $1,066 | 9% |
| Albany County Correctional Facility | $82 - $105 | 9% |
| Ambetter / Centene | $82 - $105 | 9% |
| Amish Mennonite | $82 - $105 | 9% |
| Ascension St. Vincent Public Safety Medical | $82 - $105 | 9% |
| Bcccp-Michigan | $82 - $105 | 9% |
| Bccp | $82 - $105 | 9% |
| Blue Cross Blue Shield | $82 - $3,225 | 9% |
| Bmc Healthnet | $82 - $105 | 9% |
| Breast Grant-Connecticut | $82 - $105 | 9% |
| Broward County Dept of Health | $82 - $105 | 9% |
| California Health and Wellness | $82 - $105 | 9% |
| Can Community Health Inc | $82 - $105 | 9% |
| Cardinal Innovations Lme | $82 - $105 | 9% |
| Care Connections of Northern Iowa | $82 - $105 | 9% |
| Care Oregon Ohp | $82 - $105 | 9% |
| Cencal Health Plan | $82 - $105 | 9% |
| Cenpatico | $82 - $105 | 9% |
| Chhuny | $82 - $105 | 9% |
| Childrens Comm Health Plan | $82 - $105 | 9% |
| Childrens Medical Services Title 19 | $82 - $105 | 9% |
| Cigna | $82 - $1,098 | 9% |
| City of Philadelphia | $82 - $105 | 9% |
| Cmh Allegan County | $82 - $105 | 9% |
| Cmh Ausable Valley | $82 - $105 | 9% |
| Cmh Barry County | $82 - $105 | 9% |
| Cmh Bay-Arenac County | $82 - $105 | 9% |
| Cmh Berrien County | $82 - $105 | 9% |
| Cmh Cass County | $82 - $105 | 9% |
| Cmh Central Mi County | $82 - $105 | 9% |
| Cmh Clinton-Eaton-Ingham County | $82 - $105 | 9% |
| Cmh Detroit Wayne Integrated Health Network | $82 - $105 | 9% |
| Cmh Genesee County | $82 - $105 | 9% |
| Cmh Ionia County | $82 - $105 | 9% |
| Cmh Jackson County/Lifeways | $82 - $105 | 9% |
| Cmh Kalamazoo | $82 - $105 | 9% |
| Cmh Kent County | $82 - $105 | 9% |
| Cmh Lenawee County | $82 - $105 | 9% |
| Cmh Livingston County | $82 - $105 | 9% |
| Cmh Macomb | $82 - $105 | 9% |
| Cmh Misc | $82 - $105 | 9% |
| Cmh Monroe County | $82 - $105 | 9% |
| Cmh Montcalm County | $82 - $105 | 9% |
| Cmh Muskegon County | $82 - $105 | 9% |
| Cmh Newaygo County | $82 - $105 | 9% |
| Cmh North Country | $82 - $105 | 9% |
| Cmh Northern Lakes County | $82 - $105 | 9% |
| Cmh Oakland County | $82 - $105 | 9% |
| Cmh Ottawa County | $82 - $105 | 9% |
| Cmh Van Buren County | $82 - $105 | 9% |
| Cmh Washtenaw County | $82 - $105 | 9% |
| Cmh Wayne County/Carelink | $82 - $105 | 9% |
| Cmh Wayne Cty/Com Liv Svcs | $82 - $105 | 9% |
| Cmh West Mi County | $82 - $105 | 9% |
| Community Benefit Health | $82 - $105 | 9% |
| Community Care Behavorial Health | $82 - $105 | 9% |
| Community Care Partners | $82 - $105 | 9% |
| Community Health Choice | $82 - $105 | 9% |
| Connections Csp | $82 - $105 | 9% |
| County Coroner | $82 - $105 | 9% |
| County Funding Generic | $82 - $105 | 9% |
| Covid19 Hrsa Uninsured Testing and Treatment Fund | $82 - $105 | 9% |
| Dean Wi Badgercare | $82 - $105 | 9% |
| Delaware County Department of Health | $82 - $105 | 9% |
| Delaware First Health | $82 - $105 | 9% |
| Dph Tb Program | $82 - $105 | 9% |
| Dscc | $82 - $105 | 9% |
| Eastpointe Lme | $82 - $105 | 9% |
| Family Health Network | $82 - $105 | 9% |
| Freedom First Healthcare | $82 - $105 | 9% |
| Fresno County Ccs | $82 - $105 | 9% |
| Ghc Scw Wi Badgercare | $82 - $105 | 9% |
| Harbor Health | $82 - $105 | 9% |
| Health Safety Net | $82 - $105 | 9% |
| Healthy Blue Ne | $82 - $105 | 9% |
| Hennepin Health | $82 - $105 | 9% |
| Humana | $82 - $219 | 9% |
| Id County Ada | $82 - $105 | 9% |
| Id County Canyon | $82 - $105 | 9% |
| Id County Cat Fund | $82 - $105 | 9% |
| Id County Other | $82 - $105 | 9% |
| Id County Payette | $82 - $105 | 9% |
| Idaho Dept Health and Wellfare | $82 - $105 | 9% |
| Idaho Womens Health Check | $82 - $105 | 9% |
| Indiana Breast Cervical Cancer | $82 - $105 | 9% |
| Inland Empire Health Plan | $82 - $105 | 9% |
| Intercommunity Health Ohp | $82 - $105 | 9% |
| Iowa Total Care | $82 - $105 | 9% |
| Jai Medical System | $82 - $105 | 9% |
| Kern Family Health Plan | $82 - $105 | 9% |
| Keystone First | $82 - $105 | 9% |
| Keystone First Chip | $82 - $105 | 9% |
| La Care Health Plan | $82 - $105 | 9% |
| Lakeland Care Inc | $82 - $105 | 9% |
| Managed Health Services - Indiana | $82 - $105 | 9% |
| Maryland Breast & Cervical Program | $82 - $105 | 9% |
| Maryland Healthy Smiles - Scion Dental | $82 - $105 | 9% |
| Maryland Physicians Care | $82 - $105 | 9% |
| Massachusetts Behavioral Health Partnership | $82 - $105 | 9% |
| Mdwise | $82 - $105 | 9% |
| Medi-Cal | $82 - $105 | 9% |
| Medi-Cal Healthnet | $82 - $105 | 9% |
| Medstar Dc Healthy Family | $82 - $105 | 9% |
| Medstar Md Health Choice | $82 - $105 | 9% |
| Mo Home State Health Plan | $82 - $105 | 9% |
| Molina Centennial Care | $82 - $105 | 9% |
| Nascentia Health Options | $82 - $105 | 9% |
| Nebraska Total Care | $82 - $105 | 9% |
| New York Cancer Services Program | $82 - $105 | 9% |
| Nextlevel Health | $82 - $105 | 9% |
| Oregon Screenwise | $82 - $105 | 9% |
| Pace of Southwest Michigan | $82 - $219 | 9% |
| Paramount Advantage | $82 - $105 | 9% |
| Parkland Community Health Plan | $82 - $105 | 9% |
| Partners Behavioral Lme | $82 - $105 | 9% |
| Peach State Healthplan | $82 - $105 | 9% |
| Philadelphia County Funding | $82 - $105 | 9% |
| Presbyterian Centennial Care | $82 - $105 | 9% |
| Prestige Health Choice | $82 - $105 | 9% |
| Priority Partners | $82 - $105 | 9% |
| Robert F Sing Program | $82 - $105 | 9% |
| Rx 340B Pass Along | $82 - $105 | 9% |
| Rx Assistance/Rx Manufacturer Assistance 0 Copay | $82 - $105 | 9% |
| Rx Medi-Cal | $82 - $105 | 9% |
| Rx Meridian Rx | $82 - $105 | 9% |
| Ryan White Florida Mssrp | $82 - $105 | 9% |
| Sandhills Center Lme | $82 - $105 | 9% |
| Screening for Life | $82 - $105 | 9% |
| St Joseph County Hlth Dpt | $82 - $105 | 9% |
| Stephenson Cty Health | $82 - $105 | 9% |
| Sunshine State Health Plan | $82 - $105 | 9% |
| Superior Health | $82 - $105 | 9% |
| Tenncare | $82 - $105 | 9% |
| Texas Children's Health Plan | $82 - $105 | 9% |
| Trillium Community Ohp | $82 - $105 | 9% |
| Tufts Health Public Plans | $82 - $105 | 9% |
| UnitedHealthcare | $82 - $1,066 | 9% |
| Vaya Health Lme | $82 - $105 | 9% |
| Washtenaw Health Plan | $82 - $105 | 9% |
| Wellsense Health Plan | $82 - $105 | 9% |
| Wi Womens Wellness | $82 - $105 | 9% |
| Align Senior Care | $105 - $219 | 11% |
| Ally Align Care Adv | $105 - $219 | 11% |
| American Health Advantage of Idaho | $105 - $219 | 11% |
| American Health Plan | $105 - $219 | 11% |
| Aurora Special Needs | $105 - $219 | 11% |
| Blue Care Network Advantage | $105 - $219 | 11% |
| Blue Shield - De (Highmark) Medciare Advantage | $105 - $219 | 11% |
| Care Dimensions | $105 - $219 | 11% |
| Care Improvement Plus | $105 - $219 | 11% |
| Care Resources Pace | $105 - $219 | 11% |
| Careplus Health Plans | $105 - $219 | 11% |
| Cca - Zing Health | $105 - $219 | 11% |
| Central Valley Medical Services Corp Pace | $105 - $219 | 11% |
| Champion Health Plan McR Advantage | $105 - $219 | 11% |
| Clear Spring Health | $105 - $219 | 11% |
| Clover Health | $105 - $219 | 11% |
| Commonwealth Care Alliance | $105 - $238 | 11% |
| Community Pace at Home | $105 - $219 | 11% |
| Eddy Senior Care-Pace | $105 - $219 | 11% |
| Eddy Seniorcare Pace | $105 - $219 | 11% |
| Elementcare | $105 - $219 | 11% |
| Evercare | $105 - $219 | 11% |
| Everence | $105 - $219 | 11% |
| Gateway Health Plan | $105 - $219 | 11% |
| Genesys Pace of Genesee County | $105 - $219 | 11% |
| Georgia Health Advantage | $105 - $219 | 11% |
| Gold Advantage | $105 - $219 | 11% |
| Gpa Croell Redi Mix | $105 - $219 | 11% |
| Health America Advantra | $105 - $219 | 11% |
| Highmark Health Options Dual Plan | $105 - $219 | 11% |
| Hope Select Pace | $105 - $219 | 11% |
| Horizon Nj Total Care | $105 - $219 | 11% |
| Hudson Headwaters Pace | $105 - $219 | 11% |
| Huron Valley Pace | $105 - $219 | 11% |
| Innovative Integrated Health Community Plans | $105 - $219 | 11% |
| Iowa Health Advantage | $105 - $219 | 11% |
| Johns Hopkins Advantage Md | $105 - $219 | 11% |
| Lasso Healthcare Msa | $105 - $219 | 11% |
| Life St Marys Pace | $105 - $219 | 11% |
| Lifecircles Pace | $105 - $219 | 11% |
| Longevity Health Plan | $105 - $219 | 11% |
| Longevity IPA of Michigan LLC Health Plan Isnp | $105 - $219 | 11% |
| Martins Point Generations Advantage | $105 - $219 | 11% |
| Mass General Brigham McR Adv | $105 - $219 | 11% |
| Medicare (plans) | $105 - $1,109 | 11% |
| Medipak Advantage | $105 - $219 | 11% |
| Mercy Life | $105 - $219 | 11% |
| Mercyone Cedar Valley | $105 - $219 | 11% |
| Meridian Complete | $105 - $219 | 11% |
| Michigan Complete Health | $105 - $219 | 11% |
| Nascentia Health Plus | $105 - $219 | 11% |
| New Centry Health Careplus | $105 - $219 | 11% |
| Osu Prime Care Advantage | $105 - $219 | 11% |
| Pace Cny | $105 - $219 | 11% |
| Pace Iowa Immanuel Pathways | $105 - $219 | 11% |
| Pace Southeast | $105 - $219 | 11% |
| Pace-Trinity Health | $105 - $219 | 11% |
| Peak Pace Solutions | $105 - $219 | 11% |
| Perennial Advantage | $105 - $219 | 11% |
| Preferred Care Partners | $105 - $219 | 11% |
| Presbyterian Senior Plan | $105 - $219 | 11% |
| Provider Partners Health Plan of Illinois | $105 - $219 | 11% |
| Provider Partners Health Plan of Indiana | $105 - $219 | 11% |
| Pruitthealth Premier | $105 - $219 | 11% |
| Reliance Community Care Partners Care Resources Pace | $105 - $219 | 11% |
| Rx Allwin | $105 - $219 | 11% |
| Rx Grane Grnmedd | $105 - $219 | 11% |
| Rx Retiree Rx Care | $105 - $219 | 11% |
| Scan Health Plan McR IPA Meritage Oon | $105 - $219 | 11% |
| Secure Horizons Ma Pffs | $105 - $219 | 11% |
| Serenity Pace | $105 - $219 | 11% |
| Siouxland Pace | $105 - $219 | 11% |
| Solis Health Plans | $105 - $219 | 11% |
| Sunnyview-Pace Finance Dept | $105 - $219 | 11% |
| Texan Plus | $105 - $219 | 11% |
| The Health Plan | $105 - $219 | 11% |
| Thome Pace | $105 - $219 | 11% |
| Todays Options | $105 - $219 | 11% |
| Tribute Health Plans | $105 - $219 | 11% |
| Um Health Advantage | $105 - $219 | 11% |
| Union Health Service | $105 - $219 | 11% |
| Welbe Health | $105 - $219 | 11% |
| Wellmed | $105 - $219 | 11% |
| Health New England | $106 - $416 | 11% |
| Veterans Administration | $107 - $224 | 12% |
| Cca Senior Care Options | $110 - $1,087 | 12% |
| Champva | $113 - $185 | 12% |
| Tricare | $113 - $185 | 12% |
| Triwest Health Alliance | $113 - $185 | 12% |
| Veterans Eval Services | $113 - $185 | 12% |
| Fallon Health | $134 - $475 | 14% |
| Unicare | $169 - $3,225 | 18% |
| Wellpoint | $169 - $3,225 | 18% |
| Mass General Brigham Health Plan | $170 - $451 | 18% |
| Claimdoc | $188 - $2,283 | 20% |
| Innovative Health Plan II | $188 - $2,283 | 20% |
| Healthscope | $225 - $470 | 24% |
| Bcn Domestic | $238 - $3,225 | 26% |
| Blue Benefit Administrators of Massachusetts | $238 - $3,225 | 26% |
| Blue Care Network | $238 - $3,225 | 26% |
| Blue Distinction Transplant | $238 - $3,225 | 26% |
| Blue Shield - Ca | $238 - $3,225 | 26% |
| Blue Shield - Id (Regence) | $238 - $3,225 | 26% |
| Blue Shield - Ny Highmark Northeastern | $238 - $3,225 | 26% |
| Blue Shield - Ny Highmark Western | $238 - $3,225 | 26% |
| Blue Shield - PA (Highmark) | $238 - $3,225 | 26% |
| Blue Shield - Wa (Regence) | $238 - $3,225 | 26% |
| Health Choices | $238 - $3,225 | 26% |
| Kaiser Domestic | $238 - $3,225 | 26% |
| Pre-Employment | $238 - $3,225 | 26% |
| Wc Domestic | $238 - $3,225 | 26% |
| Tufts Health Plan | $243 - $409 | 26% |
| Us Family Health Plan | $243 - $409 | 26% |
| Connecticare | $244 - $3,196 | 26% |
| Centivo | $247 - $2,175 | 27% |
| Harvard Pilgrim Healthcare | $256 - $411 | 28% |
| Prime Health Services | $257 - $537 | 28% |
| Andrie Inc | $286 - $491 | 31% |
| East Greenbush Central School District | $286 - $491 | 31% |
| Genex Wc | $286 - $491 | 31% |
| Healthsmart Workers Comp | $286 - $491 | 31% |
| Jag Source | $286 - $491 | 31% |
| Multiplan | $286 - $468 | 31% |
| New York State Insurance Fund | $286 - $491 | 31% |
| Njm Insurance Group | $286 - $491 | 31% |
| Rx Heatlhcomp | $286 - $491 | 31% |
| Rx Restat | $286 - $491 | 31% |
| Rx Saif Opdp Wc | $286 - $491 | 31% |
| Rx Worker's Comp | $286 - $491 | 31% |
| Wc Accident Fund | $286 - $491 | 31% |
| Wc Ace | $286 - $491 | 31% |
| Wc Acs Federal Employees | $286 - $491 | 31% |
| Wc Acuity | $286 - $491 | 31% |
| Wc Advantage | $286 - $491 | 31% |
| Wc Aegis | $286 - $491 | 31% |
| Wc Aig | $286 - $491 | 31% |
| Wc Aims | $286 - $491 | 31% |
| Wc Alaska National Ins | $286 - $491 | 31% |
| Wc Align Network | $286 - $491 | 31% |
| Wc Allied | $286 - $491 | 31% |
| Wc Am Trust N America | $286 - $491 | 31% |
| Wc American Claims Mgmt | $286 - $491 | 31% |
| Wc Amerisure | $286 - $491 | 31% |
| Wc Amtrust | $286 - $491 | 31% |
| Wc Asu Risk Mgt | $286 - $491 | 31% |
| Wc Benetech | $286 - $491 | 31% |
| Wc Berkley Admin | $286 - $491 | 31% |
| Wc Broadspire | $286 - $491 | 31% |
| Wc Broward County | $286 - $491 | 31% |
| Wc Bunch & Associates | $286 - $491 | 31% |
| Wc California State Comp Ins | $286 - $491 | 31% |
| Wc California State Ins Fund | $286 - $491 | 31% |
| Wc Capitol Area Health Consortium | $286 - $491 | 31% |
| Wc Ccmsi | $286 - $491 | 31% |
| Wc Chartis | $286 - $491 | 31% |
| Wc Chubb | $286 - $491 | 31% |
| Wc Cirma | $286 - $491 | 31% |
| Wc City of Albany | $286 - $491 | 31% |
| Wc City of Sioux City | $286 - $491 | 31% |
| Wc Claims Mgmt Inc | $286 - $491 | 31% |
| Wc Cna | $286 - $491 | 31% |
| Wc Comp One Admin C/O Manageability | $286 - $491 | 31% |
| Wc Compone Admin | $286 - $491 | 31% |
| Wc Ct Healthcare Trust | $286 - $491 | 31% |
| Wc Donegal Insurance Group | $286 - $491 | 31% |
| Wc Emc Insurance Company | $286 - $491 | 31% |
| Wc Employee Mutual | $286 - $491 | 31% |
| Wc Enablecomp | $286 - $491 | 31% |
| Wc Encore Health Network | $286 - $491 | 31% |
| Wc Erie | $286 - $491 | 31% |
| Wc Esis | $286 - $491 | 31% |
| Wc Evolutions | $286 - $491 | 31% |
| Wc Fcci | $286 - $491 | 31% |
| Wc Fed Ex | $286 - $491 | 31% |
| Wc Federal Black Lung | $286 - $491 | 31% |
| Wc Federated | $286 - $491 | 31% |
| Wc Finley Occupational Health | $286 - $491 | 31% |
| Wc First Agency/Occunet | $286 - $491 | 31% |
| Wc Ford Motor | $286 - $491 | 31% |
| Wc Fresno Unified Emp | $286 - $491 | 31% |
| Wc Gallagher Bassett | $286 - $491 | 31% |
| Wc General Motors | $286 - $491 | 31% |
| Wc Generic | $286 - $491 | 31% |
| Wc Genex Care for Ohio | $286 - $491 | 31% |
| Wc Great West Casualty | $286 - $491 | 31% |
| Wc Guarantee Insurance | $286 - $491 | 31% |
| Wc Guard Insurance Company | $286 - $491 | 31% |
| Wc Hab | $286 - $491 | 31% |
| Wc Hartford | $286 - $491 | 31% |
| Wc Hastings | $286 - $491 | 31% |
| Wc Health Management | $286 - $491 | 31% |
| Wc Heritage Summit | $286 - $491 | 31% |
| Wc Hireright | $286 - $491 | 31% |
| Wc Horizon | $286 - $491 | 31% |
| Wc Icw Group | $286 - $491 | 31% |
| Wc Idaho State Ins Fund | $286 - $491 | 31% |
| Wc Intercare Insurance | $286 - $491 | 31% |
| Wc Intermountain | $286 - $491 | 31% |
| Wc Johns Eastern | $286 - $491 | 31% |
| Wc Kemberton | $286 - $491 | 31% |
| Wc Key Ins & Benefit Solutions | $286 - $491 | 31% |
| Wc Liberty Mutual | $286 - $491 | 31% |
| Wc Mac Risk Management | $286 - $491 | 31% |
| Wc Massachusetts | $286 - $491 | 31% |
| Wc Mdia | $286 - $491 | 31% |
| Wc Meadowbrook Claim | $286 - $491 | 31% |
| Wc Medical Administrators | $286 - $491 | 31% |
| Wc Meijers | $286 - $491 | 31% |
| Wc Memic | $286 - $491 | 31% |
| Wc Mercy Workcare | $286 - $491 | 31% |
| Wc Michigan | $286 - $491 | 31% |
| Wc Michigan Millers Mutual | $286 - $491 | 31% |
| Wc Mitchell Frankenmuth | $286 - $491 | 31% |
| Wc Mra | $286 - $491 | 31% |
| Wc Nationwide | $286 - $491 | 31% |
| Wc Nca Comp | $286 - $491 | 31% |
| Wc New York | $286 - $491 | 31% |
| Wc New York Special Funds | $286 - $491 | 31% |
| Wc North American Rishces | $286 - $491 | 31% |
| Wc Northeast Health | $286 - $491 | 31% |
| Wc Notre Dame | $286 - $491 | 31% |
| Wc Novanet | $286 - $491 | 31% |
| Wc O'Hara Corp | $286 - $491 | 31% |
| Wc Occ Health Allen | $286 - $491 | 31% |
| Wc Ohio Bureau | $286 - $491 | 31% |
| Wc One Call Medical | $286 - $491 | 31% |
| Wc Paradigm | $286 - $491 | 31% |
| Wc Peerless | $286 - $491 | 31% |
| Wc Pma | $286 - $491 | 31% |
| Wc Praxis Health Network | $286 - $491 | 31% |
| Wc Price Chopper | $286 - $491 | 31% |
| Wc Procura Management | $286 - $491 | 31% |
| Wc Qualcare | $286 - $491 | 31% |
| Wc Quiktrip | $286 - $491 | 31% |
| Wc Reny Company | $286 - $491 | 31% |
| Wc Rev Claims | $286 - $491 | 31% |
| Wc Risico | $286 - $491 | 31% |
| Wc Rural Mutual | $286 - $491 | 31% |
| Wc Saif Oregon | $286 - $491 | 31% |
| Wc Secura | $286 - $491 | 31% |
| Wc Sedgwick | $286 - $491 | 31% |
| Wc Sentry | $286 - $491 | 31% |
| Wc Sheakley Unicomp | $286 - $491 | 31% |
| Wc Smile Lodge | $286 - $491 | 31% |
| Wc Society | $286 - $491 | 31% |
| Wc Srs | $286 - $491 | 31% |
| Wc Taconic (Mro) | $286 - $491 | 31% |
| Wc Taconic Farms | $286 - $491 | 31% |
| Wc Travelers | $286 - $491 | 31% |
| Wc Triad Group | $286 - $491 | 31% |
| Wc Tristar | $286 - $491 | 31% |
| Wc Troy Ny | $286 - $491 | 31% |
| Wc Tyson | $286 - $491 | 31% |
| Wc Unified Health Services | $286 - $491 | 31% |
| Wc United Heartland | $286 - $491 | 31% |
| Wc Us Dept of Labor | $286 - $491 | 31% |
| Wc Velocity | $286 - $491 | 31% |
| Wc Walmart | $286 - $491 | 31% |
| Wc West Bend | $286 - $491 | 31% |
| Wc West Bend Mutual/Argent | $286 - $491 | 31% |
| Wc Winnebago Industries | $286 - $491 | 31% |
| Wc Yankee Trails | $286 - $491 | 31% |
| Wc York Risk | $286 - $491 | 31% |
| Wc Zenith | $286 - $491 | 31% |
| Wc Zurich | $286 - $491 | 31% |
| Coventry | $374 - $612 | 40% |
| First Health | $374 - $612 | 40% |
| Guardian | $374 - $612 | 40% |
| Meritain | $374 - $612 | 40% |
| Allegiance | $576 | 62% |
| Health Smart | $853 - $1,382 | 92% |
| Wc Corvel | $853 - $1,382 | 92% |
| Connecticut Dept of Correction | $1,004 | 108% |
| Delta Dental Ga | $1,004 - $1,626 | 108% |
| Delta Dental Mi | $1,004 - $1,626 | 108% |
| Delta Dental Mo | $1,004 - $1,626 | 108% |
| Delta Dental Nj | $1,004 - $1,626 | 108% |
| Delta Dental Ny | $1,004 - $1,626 | 108% |
| Delta Dental Oh | $1,004 - $1,626 | 108% |
| Delta Dental Or | $1,004 - $1,626 | 108% |
| Delta Dental PA | $1,004 - $1,626 | 108% |
| Delta Dental VA | $1,004 - $1,626 | 108% |
| Delta Dental Wa | $1,004 - $1,626 | 108% |
| Liberty Dental | $1,004 - $1,626 | 108% |
| Diversified Administrators | $2,283 | 246% |