CMS Price Transparency Data
CT scan, chest (no contrast)
Facility: Mercyone Des Moines Medical Center
Billing Code: 71250 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 71250
- Insurance Median: $56
- Cash Discount Price: $184
- vs. Medicare Baseline: 0.52x Medicare
The contracted insurance negotiated median rate for a CT scan, chest (no contrast) at Mercyone Des Moines Medical Center is $56. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $184. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.52x the Medicare baseline. Located in 1111 6Th Ave, Des Moines, IA.
Cash / Self-Pay
$184
Average discount available for prompt cash payment at this facility.
Insurance Median
$56
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: $184 (172%)
Insurance Median: $56 (52%)
Cash: $184 (172% of Medicare)
Ins. Median: $56 (52% 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 |
|---|---|---|
| Medicaid / KanCare | $32 - $184 | 30% |
| Aetna | $45 - $912 | 42% |
| Wc Corvel | $45 | 42% |
| Align Senior Care | $46 | 43% |
| Ally Align Care Adv | $46 | 43% |
| American Health Advantage Of Idaho | $46 | 43% |
| Aurora Special Needs | $46 | 43% |
| Blue Care Network Advantage | $46 | 43% |
| Blue Cross Blue Shield | $46 - $115 | 43% |
| Blue Shield - De (Highmark) Medciare Advantage | $46 | 43% |
| Care Dimensions | $46 | 43% |
| Care Improvement Plus | $46 | 43% |
| Care Resources Pace | $46 | 43% |
| Careplus Health Plans | $46 | 43% |
| Cca - Zing Health | $46 | 43% |
| Cca Senior Care Options | $46 | 43% |
| Central Valley Medical Services Corp Pace | $46 | 43% |
| Champion Health Plan Mcr Advantage | $46 | 43% |
| Cigna | $46 - $1,576 | 43% |
| Clear Spring Health | $46 | 43% |
| Clover Health | $46 | 43% |
| Commonwealth Care Alliance | $46 | 43% |
| Community Pace At Home | $46 | 43% |
| Eddy Senior Care-Pace | $46 | 43% |
| Eddy Seniorcare Pace | $46 | 43% |
| Elementcare | $46 | 43% |
| Evercare | $46 | 43% |
| Everence | $46 | 43% |
| Gateway Health Plan | $46 | 43% |
| Genesys Pace Of Genesee County | $46 | 43% |
| Georgia Health Advantage | $46 | 43% |
| Gold Advantage | $46 | 43% |
| Gpa Croell Redi Mix | $46 | 43% |
| Health America Advantra | $46 | 43% |
| Highmark Health Options Dual Plan | $46 | 43% |
| Hope Select Pace | $46 | 43% |
| Horizon Nj Total Care | $46 | 43% |
| Hudson Headwaters Pace | $46 | 43% |
| Humana | $46 - $75 | 43% |
| Huron Valley Pace | $46 | 43% |
| Innovative Integrated Health Community Plans | $46 | 43% |
| Johns Hopkins Advantage Md | $46 | 43% |
| Lasso Healthcare Msa | $46 | 43% |
| Life St Marys Pace | $46 | 43% |
| Lifecircles Pace | $46 | 43% |
| Longevity Health Plan | $46 | 43% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $46 | 43% |
| Martins Point Generations Advantage | $46 | 43% |
| Mass General Brigham Mcr Adv | $46 | 43% |
| Medicare (plans) | $46 - $103 | 43% |
| Medipak Advantage | $46 | 43% |
| Mercy Life | $46 | 43% |
| Mercyone Cedar Valley | $46 | 43% |
| Meridian Complete | $46 | 43% |
| Michigan Complete Health | $46 | 43% |
| Nascentia Health Plus | $46 | 43% |
| New Centry Health Careplus | $46 | 43% |
| Osu Prime Care Advantage | $46 | 43% |
| Pace Cny | $46 | 43% |
| Pace Iowa Immanuel Pathways | $46 | 43% |
| Pace Of Southwest Michigan | $46 - $56 | 43% |
| Pace Southeast | $46 | 43% |
| Pace-Trinity Health | $46 | 43% |
| Peak Pace Solutions | $46 | 43% |
| Perennial Advantage | $46 | 43% |
| Preferred Care Partners | $46 | 43% |
| Presbyterian Senior Plan | $46 | 43% |
| Provider Partners Health Plan Of Illinois | $46 | 43% |
| Provider Partners Health Plan Of Indiana | $46 | 43% |
| Pruitthealth Premier | $46 | 43% |
| Reliance Community Care Partners Care Resources Pace | $46 | 43% |
| Rx Allwin | $46 | 43% |
| Rx Grane Grnmedd | $46 | 43% |
| Rx Retiree Rx Care | $46 | 43% |
| Scan Health Plan Mcr Ipa Meritage Oon | $46 | 43% |
| Secure Horizons Ma Pffs | $46 | 43% |
| Serenity Pace | $46 | 43% |
| Siouxland Pace | $46 | 43% |
| Solis Health Plans | $46 | 43% |
| Sunnyview-Pace Finance Dept | $46 | 43% |
| Texan Plus | $46 | 43% |
| The Health Plan | $46 | 43% |
| Thome Pace | $46 | 43% |
| Todays Options | $46 | 43% |
| Tribute Health Plans | $46 | 43% |
| Um Health Advantage | $46 | 43% |
| Union Health Service | $46 | 43% |
| UnitedHealthcare | $46 - $2,627 | 43% |
| Welbe Health | $46 | 43% |
| Wellmed | $46 | 43% |
| Champva | $47 | 44% |
| Tricare | $47 | 44% |
| Triwest Health Alliance | $47 | 44% |
| Us Family Health Plan | $47 | 44% |
| Veterans Administration | $47 | 44% |
| Veterans Eval Services | $47 | 44% |
| American Health Plan | $49 | 46% |
| Iowa Health Advantage | $49 | 46% |
| Stephenson Cty Health | $52 | 49% |
| Albany County Correctional Facility | $56 | 52% |
| Ambetter / Centene | $56 - $170 | 52% |
| Amish Mennonite | $56 | 52% |
| Ascension St. Vincent Public Safety Medical | $56 | 52% |
| Bcccp-Michigan | $56 | 52% |
| Bccp | $56 | 52% |
| Bmc Healthnet | $56 | 52% |
| Breast Grant-Connecticut | $56 | 52% |
| Broward County Dept Of Health | $56 | 52% |
| California Health And Wellness | $56 | 52% |
| Can Community Health Inc | $56 | 52% |
| Cardinal Innovations Lme | $56 | 52% |
| Care Connections Of Northern Iowa | $56 | 52% |
| Care Oregon Ohp | $56 | 52% |
| Cencal Health Plan | $56 | 52% |
| Cenpatico | $56 | 52% |
| Chhuny | $56 | 52% |
| Childrens Comm Health Plan | $56 | 52% |
| Childrens Medical Services Title 19 | $56 | 52% |
| City Of Philadelphia | $56 | 52% |
| Cmh Allegan County | $56 | 52% |
| Cmh Ausable Valley | $56 | 52% |
| Cmh Barry County | $56 | 52% |
| Cmh Bay-Arenac County | $56 | 52% |
| Cmh Berrien County | $56 | 52% |
| Cmh Cass County | $56 | 52% |
| Cmh Central Mi County | $56 | 52% |
| Cmh Clinton-Eaton-Ingham County | $56 | 52% |
| Cmh Detroit Wayne Integrated Health Network | $56 | 52% |
| Cmh Genesee County | $56 | 52% |
| Cmh Ionia County | $56 | 52% |
| Cmh Jackson County/Lifeways | $56 | 52% |
| Cmh Kalamazoo | $56 | 52% |
| Cmh Kent County | $56 | 52% |
| Cmh Lenawee County | $56 | 52% |
| Cmh Livingston County | $56 | 52% |
| Cmh Macomb | $56 | 52% |
| Cmh Misc | $56 | 52% |
| Cmh Monroe County | $56 | 52% |
| Cmh Montcalm County | $56 | 52% |
| Cmh Muskegon County | $56 | 52% |
| Cmh Newaygo County | $56 | 52% |
| Cmh North Country | $56 | 52% |
| Cmh Northern Lakes County | $56 | 52% |
| Cmh Oakland County | $56 | 52% |
| Cmh Ottawa County | $56 | 52% |
| Cmh Van Buren County | $56 | 52% |
| Cmh Washtenaw County | $56 | 52% |
| Cmh Wayne County/Carelink | $56 | 52% |
| Cmh Wayne Cty/Com Liv Svcs | $56 | 52% |
| Cmh West Mi County | $56 | 52% |
| Community Benefit Health | $56 | 52% |
| Community Care Behavorial Health | $56 | 52% |
| Community Care Partners | $56 | 52% |
| Community Health Choice | $56 | 52% |
| Connections Csp | $56 | 52% |
| County Coroner | $56 | 52% |
| County Funding Generic | $56 | 52% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund | $56 | 52% |
| Dean Wi Badgercare | $56 | 52% |
| Delaware County Department Of Health | $56 | 52% |
| Delaware First Health | $56 | 52% |
| Delta Dental Nj | $56 | 52% |
| Dph Tb Program | $56 | 52% |
| Dscc | $56 | 52% |
| Eastpointe Lme | $56 | 52% |
| Family Health Network | $56 | 52% |
| Freedom First Healthcare | $56 | 52% |
| Fresno County Ccs | $56 | 52% |
| Ghc Scw Wi Badgercare | $56 | 52% |
| Harbor Health | $56 | 52% |
| Health Safety Net | $56 | 52% |
| Healthy Blue Ne | $56 | 52% |
| Hennepin Health | $56 | 52% |
| Id County Ada | $56 | 52% |
| Id County Canyon | $56 | 52% |
| Id County Cat Fund | $56 | 52% |
| Id County Other | $56 | 52% |
| Id County Payette | $56 | 52% |
| Idaho Dept Health And Wellfare | $56 | 52% |
| Idaho Womens Health Check | $56 | 52% |
| Indiana Breast Cervical Cancer | $56 | 52% |
| Inland Empire Health Plan | $56 | 52% |
| Intercommunity Health Ohp | $56 | 52% |
| Jai Medical System | $56 | 52% |
| Kern Family Health Plan | $56 | 52% |
| Keystone First | $56 | 52% |
| Keystone First Chip | $56 | 52% |
| La Care Health Plan | $56 | 52% |
| Lakeland Care Inc | $56 | 52% |
| Managed Health Services - Indiana | $56 | 52% |
| Maryland Breast & Cervical Program | $56 | 52% |
| Maryland Healthy Smiles - Scion Dental | $56 | 52% |
| Maryland Physicians Care | $56 | 52% |
| Massachusetts Behavioral Health Partnership | $56 | 52% |
| Mdwise | $56 | 52% |
| Medi-Cal | $56 | 52% |
| Medi-Cal Healthnet | $56 | 52% |
| Medstar Dc Healthy Family | $56 | 52% |
| Medstar Md Health Choice | $56 | 52% |
| Mo Home State Health Plan | $56 | 52% |
| Molina Centennial Care | $56 | 52% |
| Nascentia Health Options | $56 | 52% |
| New York Cancer Services Program | $56 | 52% |
| Nextlevel Health | $56 | 52% |
| Oregon Screenwise | $56 | 52% |
| Paramount Advantage | $56 | 52% |
| Parkland Community Health Plan | $56 | 52% |
| Partners Behavioral Lme | $56 | 52% |
| Peach State Healthplan | $56 | 52% |
| Philadelphia County Funding | $56 | 52% |
| Presbyterian Centennial Care | $56 | 52% |
| Prestige Health Choice | $56 | 52% |
| Priority Partners | $56 | 52% |
| Robert F Sing Program | $56 | 52% |
| Rx 340B Pass Along | $56 | 52% |
| Rx Assistance/Rx Manufacturer Assistance 0 Copay | $56 | 52% |
| Rx Medi-Cal | $56 | 52% |
| Rx Meridian Rx | $56 | 52% |
| Ryan White Florida Mssrp | $56 | 52% |
| Sandhills Center Lme | $56 | 52% |
| Screening For Life | $56 | 52% |
| St Joseph County Hlth Dpt | $56 | 52% |
| Sunshine State Health Plan | $56 | 52% |
| Superior Health | $56 | 52% |
| Tenncare | $56 | 52% |
| Texas Children'S Health Plan | $56 | 52% |
| Trillium Community Ohp | $56 | 52% |
| Tufts Health Public Plans | $56 | 52% |
| Vaya Health Lme | $56 | 52% |
| Washtenaw Health Plan | $56 | 52% |
| Wellsense Health Plan | $56 | 52% |
| Wi Womens Wellness | $56 | 52% |
| Iowa Total Care | $57 - $99 | 53% |
| Wellpoint | $58 | 54% |
| Amish Hospital Aid | $63 - $134 | 59% |
| Amps | $64 | 60% |
| Avera | $72 | 67% |
| Medical Associates | $79 - $528 | 74% |
| Sanford Health Plan | $79 | 74% |
| Oscar | $84 - $143 | 79% |
| Lucent Health | $85 - $912 | 80% |
| Ucare | $85 | 80% |
| Centivo | $89 - $146 | 83% |
| Quiktrip | $92 | 86% |
| Usa Managed Care | $92 - $2,233 | 86% |
| Health Partners | $96 - $1,668 | 90% |
| Bcn Domestic | $98 | 92% |
| Blue Benefit Administrators Of Massachusetts | $98 - $107 | 92% |
| Blue Care Network | $98 - $107 | 92% |
| Blue Distinction Transplant | $98 - $107 | 92% |
| Blue Shield - Ca | $98 - $107 | 92% |
| Blue Shield - Id (Regence) | $98 - $107 | 92% |
| Blue Shield - Ny Highmark Northeastern | $98 - $107 | 92% |
| Blue Shield - Ny Highmark Western | $98 - $107 | 92% |
| Blue Shield - Pa (Highmark) | $98 - $107 | 92% |
| Blue Shield - Wa (Regence) | $98 - $107 | 92% |
| Health Choices | $98 - $528 | 92% |
| Kaiser Domestic | $98 | 92% |
| Pre-Employment | $98 | 92% |
| Wc Domestic | $98 | 92% |
| Claimdoc | $99 - $203 | 93% |
| The Alliance | $99 | 93% |
| Meritain | $100 - $912 | 94% |
| Preferred One | $103 | 96% |
| Global Excel | $107 | 100% |
| Geha | $109 - $240 | 102% |
| Velocity | $111 | 104% |
| Newton Correctional Facility | $115 - $120 | 108% |
| Genex Wc | $133 - $138 | 125% |
| Allied Benefit Systems | $139 - $912 | 130% |
| Auxiant | $139 - $1,708 | 130% |
| First Choice Health | $139 | 130% |
| Group Administrators | $139 | 130% |
| Midlands | $139 - $1,708 | 130% |
| Midlands Choice | $139 - $1,708 | 130% |
| Wc Align Network | $142 - $147 | 133% |
| Wc Praxis Health Network | $150 - $156 | 140% |
| Wc Reny Company | $154 - $160 | 144% |
| Wc Velocity | $154 - $160 | 144% |
| Auto Velocity | $159 - $166 | 149% |
| Health Smart | $159 - $166 | 149% |
| Wc O'Hara Corp | $159 - $166 | 149% |
| Andrie Inc | $177 - $184 | 166% |
| East Greenbush Central School District | $177 - $184 | 166% |
| Healthsmart Workers Comp | $177 - $184 | 166% |
| Iowa Dept Of Public Health | $177 - $2,627 | 166% |
| Jag Source | $177 - $184 | 166% |
| Multiplan | $177 | 166% |
| Nebraska Total Care | $177 - $184 | 166% |
| New York State Insurance Fund | $177 - $184 | 166% |
| Njm Insurance Group | $177 - $184 | 166% |
| Rx Heatlhcomp | $177 - $184 | 166% |
| Rx Restat | $177 - $184 | 166% |
| Rx Saif Opdp Wc | $177 - $184 | 166% |
| Rx Worker'S Comp | $177 - $184 | 166% |
| Wc Accident Fund | $177 - $184 | 166% |
| Wc Ace | $177 - $184 | 166% |
| Wc Acs Federal Employees | $177 - $184 | 166% |
| Wc Acuity | $177 - $184 | 166% |
| Wc Advantage | $177 - $184 | 166% |
| Wc Aegis | $177 - $184 | 166% |
| Wc Aig | $177 - $184 | 166% |
| Wc Aims | $177 - $184 | 166% |
| Wc Alaska National Ins | $177 - $184 | 166% |
| Wc Allied | $177 - $184 | 166% |
| Wc Am Trust N America | $177 - $184 | 166% |
| Wc American Claims Mgmt | $177 - $184 | 166% |
| Wc Amerisure | $177 - $184 | 166% |
| Wc Amtrust | $177 - $184 | 166% |
| Wc Asu Risk Mgt | $177 - $184 | 166% |
| Wc Benetech | $177 - $184 | 166% |
| Wc Berkley Admin | $177 - $184 | 166% |
| Wc Broadspire | $177 - $184 | 166% |
| Wc Broward County | $177 - $184 | 166% |
| Wc Bunch & Associates | $177 - $184 | 166% |
| Wc California State Comp Ins | $177 - $184 | 166% |
| Wc California State Ins Fund | $177 - $184 | 166% |
| Wc Capitol Area Health Consortium | $177 - $184 | 166% |
| Wc Ccmsi | $177 - $184 | 166% |
| Wc Chartis | $177 - $184 | 166% |
| Wc Chubb | $177 - $184 | 166% |
| Wc Cirma | $177 - $184 | 166% |
| Wc City Of Albany | $177 - $184 | 166% |
| Wc City Of Sioux City | $177 - $184 | 166% |
| Wc Claims Mgmt Inc | $177 - $184 | 166% |
| Wc Cna | $177 - $184 | 166% |
| Wc Comp One Admin C/O Manageability | $177 - $184 | 166% |
| Wc Compone Admin | $177 - $184 | 166% |
| Wc Ct Healthcare Trust | $177 - $184 | 166% |
| Wc Donegal Insurance Group | $177 - $184 | 166% |
| Wc Emc Insurance Company | $177 - $184 | 166% |
| Wc Employee Mutual | $177 - $184 | 166% |
| Wc Enablecomp | $177 - $184 | 166% |
| Wc Encore Health Network | $177 - $184 | 166% |
| Wc Erie | $177 - $184 | 166% |
| Wc Esis | $177 - $184 | 166% |
| Wc Evolutions | $177 - $184 | 166% |
| Wc Fcci | $177 - $184 | 166% |
| Wc Fed Ex | $177 - $184 | 166% |
| Wc Federal Black Lung | $177 - $184 | 166% |
| Wc Federated | $177 - $184 | 166% |
| Wc Finley Occupational Health | $177 - $184 | 166% |
| Wc First Agency/Occunet | $177 - $184 | 166% |
| Wc Ford Motor | $177 - $184 | 166% |
| Wc Fresno Unified Emp | $177 - $184 | 166% |
| Wc Gallagher Bassett | $177 - $184 | 166% |
| Wc General Motors | $177 - $184 | 166% |
| Wc Generic | $177 - $184 | 166% |
| Wc Genex Care For Ohio | $177 - $184 | 166% |
| Wc Great West Casualty | $177 - $184 | 166% |
| Wc Guarantee Insurance | $177 - $184 | 166% |
| Wc Guard Insurance Company | $177 - $184 | 166% |
| Wc Hab | $177 - $184 | 166% |
| Wc Hartford | $177 - $184 | 166% |
| Wc Hastings | $177 - $184 | 166% |
| Wc Health Management | $177 - $184 | 166% |
| Wc Heritage Summit | $177 - $184 | 166% |
| Wc Hireright | $177 - $184 | 166% |
| Wc Horizon | $177 - $184 | 166% |
| Wc Icw Group | $177 - $184 | 166% |
| Wc Idaho State Ins Fund | $177 - $184 | 166% |
| Wc Intercare Insurance | $177 - $184 | 166% |
| Wc Intermountain | $177 - $184 | 166% |
| Wc Johns Eastern | $177 - $184 | 166% |
| Wc Kemberton | $177 - $184 | 166% |
| Wc Key Ins & Benefit Solutions | $177 - $184 | 166% |
| Wc Liberty Mutual | $177 - $184 | 166% |
| Wc Mac Risk Management | $177 - $184 | 166% |
| Wc Massachusetts | $177 - $184 | 166% |
| Wc Mdia | $177 - $184 | 166% |
| Wc Meadowbrook Claim | $177 - $184 | 166% |
| Wc Medical Administrators | $177 - $184 | 166% |
| Wc Meijers | $177 - $184 | 166% |
| Wc Memic | $177 - $184 | 166% |
| Wc Mercy Workcare | $177 - $184 | 166% |
| Wc Michigan | $177 - $184 | 166% |
| Wc Michigan Millers Mutual | $177 - $184 | 166% |
| Wc Mitchell Frankenmuth | $177 - $184 | 166% |
| Wc Mra | $177 - $184 | 166% |
| Wc Nationwide | $177 - $184 | 166% |
| Wc Nca Comp | $177 - $184 | 166% |
| Wc New York | $177 - $184 | 166% |
| Wc New York Special Funds | $177 - $184 | 166% |
| Wc North American Rishces | $177 - $184 | 166% |
| Wc Northeast Health | $177 - $184 | 166% |
| Wc Notre Dame | $177 - $184 | 166% |
| Wc Novanet | $177 - $184 | 166% |
| Wc Occ Health Allen | $177 - $184 | 166% |
| Wc Ohio Bureau | $177 - $184 | 166% |
| Wc One Call Medical | $177 - $184 | 166% |
| Wc Paradigm | $177 - $184 | 166% |
| Wc Peerless | $177 - $184 | 166% |
| Wc Pma | $177 - $184 | 166% |
| Wc Price Chopper | $177 - $184 | 166% |
| Wc Procura Management | $177 - $184 | 166% |
| Wc Qualcare | $177 - $184 | 166% |
| Wc Quiktrip | $177 - $184 | 166% |
| Wc Rev Claims | $177 - $184 | 166% |
| Wc Risico | $177 - $184 | 166% |
| Wc Rural Mutual | $177 - $184 | 166% |
| Wc Saif Oregon | $177 - $184 | 166% |
| Wc Secura | $177 - $184 | 166% |
| Wc Sedgwick | $177 - $184 | 166% |
| Wc Sentry | $177 - $184 | 166% |
| Wc Sheakley Unicomp | $177 - $184 | 166% |
| Wc Smile Lodge | $177 - $184 | 166% |
| Wc Society | $177 - $184 | 166% |
| Wc Srs | $177 - $184 | 166% |
| Wc Taconic (Mro) | $177 - $184 | 166% |
| Wc Taconic Farms | $177 - $184 | 166% |
| Wc Travelers | $177 - $184 | 166% |
| Wc Triad Group | $177 - $184 | 166% |
| Wc Tristar | $177 - $184 | 166% |
| Wc Troy Ny | $177 - $184 | 166% |
| Wc Tyson | $177 - $184 | 166% |
| Wc Unified Health Services | $177 - $184 | 166% |
| Wc United Heartland | $177 - $184 | 166% |
| Wc Us Dept Of Labor | $177 - $184 | 166% |
| Wc Walmart | $177 - $184 | 166% |
| Wc West Bend | $177 - $184 | 166% |
| Wc West Bend Mutual/Argent | $177 - $184 | 166% |
| Wc Winnebago Industries | $177 - $184 | 166% |
| Wc Yankee Trails | $177 - $184 | 166% |
| Wc York Risk | $177 - $184 | 166% |
| Wc Zenith | $177 - $184 | 166% |
| Wc Zurich | $177 - $184 | 166% |
| Nova | $203 | 190% |
| 1199 National Benefit Fund | $912 | 854% |
| Asr Health Benefits | $912 | 854% |
| Christian Brother Services | $912 | 854% |
| Coventry | $912 | 854% |
| First Health | $912 | 854% |
| Luminare Health | $912 | 854% |
| Medical Mutual | $912 | 854% |
| Trustmark Small Business Benefits | $912 | 854% |
| Webtpa | $912 | 854% |
| Medica | $1,708 | 1599% |
| Crime Victim Assistance | $2,627 | 2460% |