CMS Price Transparency Data
Inguinal hernia repair
Facility: Mercyone Des Moines Medical Center
Billing Code: 49505 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 49505
- Insurance Median: $193
- Cash Discount Price: $1,157
- vs. Medicare Baseline: 0.05x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Mercyone Des Moines Medical Center is $193. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,157. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.05x the Medicare baseline. Located in 1111 6Th Ave, Des Moines, IA.
Cash / Self-Pay
$1,157
Average discount available for prompt cash payment at this facility.
Insurance Median
$193
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$3,657.95
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $3,657.95 (100%)
Cash / Self-Pay: $1,157 (32%)
Insurance Median: $193 (5%)
Cash: $1,157 (32% of Medicare)
Ins. Median: $193 (5% of Medicare)
Understanding this gauge: We use the federal Medicare rate of $3,657.95 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
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Input your details and click calculate to compare out-of-pocket costs.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Wc Corvel | $51 - $322 | 1% |
| Aetna | $53 - $3,389 | 1% |
| Align Senior Care | $53 - $332 | 1% |
| Ally Align Care Adv | $53 - $332 | 1% |
| American Health Advantage Of Idaho | $53 - $332 | 1% |
| Aurora Special Needs | $53 - $332 | 1% |
| Blue Care Network Advantage | $53 - $332 | 1% |
| Blue Cross Blue Shield | $53 - $3,658 | 1% |
| Blue Shield - De (Highmark) Medciare Advantage | $53 - $332 | 1% |
| Care Dimensions | $53 - $332 | 1% |
| Care Improvement Plus | $53 - $332 | 1% |
| Care Resources Pace | $53 - $332 | 1% |
| Careplus Health Plans | $53 - $332 | 1% |
| Cca - Zing Health | $53 - $332 | 1% |
| Cca Senior Care Options | $53 - $332 | 1% |
| Central Valley Medical Services Corp Pace | $53 - $332 | 1% |
| Champion Health Plan Mcr Advantage | $53 - $332 | 1% |
| Cigna | $53 - $1,058 | 1% |
| Clear Spring Health | $53 - $332 | 1% |
| Clover Health | $53 - $332 | 1% |
| Commonwealth Care Alliance | $53 - $332 | 1% |
| Community Pace At Home | $53 - $332 | 1% |
| Eddy Senior Care-Pace | $53 - $332 | 1% |
| Eddy Seniorcare Pace | $53 - $332 | 1% |
| Elementcare | $53 - $332 | 1% |
| Evercare | $53 - $332 | 1% |
| Everence | $53 - $332 | 1% |
| Gateway Health Plan | $53 - $332 | 1% |
| Genesys Pace Of Genesee County | $53 - $332 | 1% |
| Georgia Health Advantage | $53 - $332 | 1% |
| Gold Advantage | $53 - $332 | 1% |
| Gpa Croell Redi Mix | $53 - $332 | 1% |
| Health America Advantra | $53 - $332 | 1% |
| Highmark Health Options Dual Plan | $53 - $332 | 1% |
| Hope Select Pace | $53 - $332 | 1% |
| Horizon Nj Total Care | $53 - $332 | 1% |
| Hudson Headwaters Pace | $53 - $332 | 1% |
| Humana | $53 - $542 | 1% |
| Huron Valley Pace | $53 - $332 | 1% |
| Innovative Integrated Health Community Plans | $53 - $332 | 1% |
| Johns Hopkins Advantage Md | $53 - $332 | 1% |
| Lasso Healthcare Msa | $53 - $332 | 1% |
| Life St Marys Pace | $53 - $332 | 1% |
| Lifecircles Pace | $53 - $332 | 1% |
| Longevity Health Plan | $53 - $332 | 1% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $53 - $332 | 1% |
| Martins Point Generations Advantage | $53 - $332 | 1% |
| Mass General Brigham Mcr Adv | $53 - $332 | 1% |
| Medicare (plans) | $53 - $3,527 | 1% |
| Medipak Advantage | $53 - $332 | 1% |
| Mercy Life | $53 - $332 | 1% |
| Mercyone Cedar Valley | $53 - $332 | 1% |
| Meridian Complete | $53 - $332 | 1% |
| Michigan Complete Health | $53 - $332 | 1% |
| Nascentia Health Plus | $53 - $332 | 1% |
| New Centry Health Careplus | $53 - $332 | 1% |
| Osu Prime Care Advantage | $53 - $332 | 1% |
| Pace Cny | $53 - $332 | 1% |
| Pace Iowa Immanuel Pathways | $53 - $332 | 1% |
| Pace Of Southwest Michigan | $53 - $332 | 1% |
| Pace Southeast | $53 - $332 | 1% |
| Pace-Trinity Health | $53 - $332 | 1% |
| Peak Pace Solutions | $53 - $332 | 1% |
| Perennial Advantage | $53 - $332 | 1% |
| Preferred Care Partners | $53 - $332 | 1% |
| Presbyterian Senior Plan | $53 - $332 | 1% |
| Provider Partners Health Plan Of Illinois | $53 - $332 | 1% |
| Provider Partners Health Plan Of Indiana | $53 - $332 | 1% |
| Pruitthealth Premier | $53 - $332 | 1% |
| Reliance Community Care Partners Care Resources Pace | $53 - $332 | 1% |
| Rx Allwin | $53 - $332 | 1% |
| Rx Grane Grnmedd | $53 - $332 | 1% |
| Rx Retiree Rx Care | $53 - $332 | 1% |
| Scan Health Plan Mcr Ipa Meritage Oon | $53 - $332 | 1% |
| Secure Horizons Ma Pffs | $53 - $332 | 1% |
| Serenity Pace | $53 - $332 | 1% |
| Siouxland Pace | $53 - $332 | 1% |
| Solis Health Plans | $53 - $332 | 1% |
| Sunnyview-Pace Finance Dept | $53 - $332 | 1% |
| Texan Plus | $53 - $332 | 1% |
| The Health Plan | $53 - $332 | 1% |
| Thome Pace | $53 - $332 | 1% |
| Todays Options | $53 - $332 | 1% |
| Tribute Health Plans | $53 - $332 | 1% |
| Um Health Advantage | $53 - $332 | 1% |
| Union Health Service | $53 - $332 | 1% |
| UnitedHealthcare | $53 - $3,457 | 1% |
| Welbe Health | $53 - $332 | 1% |
| Wellmed | $53 - $332 | 1% |
| Veterans Administration | $54 - $338 | 1% |
| Avera | $55 - $520 | 2% |
| American Health Plan | $56 - $348 | 2% |
| Champva | $56 - $348 | 2% |
| Iowa Health Advantage | $56 - $348 | 2% |
| Tricare | $56 - $348 | 2% |
| Triwest Health Alliance | $56 - $348 | 2% |
| Us Family Health Plan | $56 - $348 | 2% |
| Veterans Eval Services | $56 - $348 | 2% |
| Medicaid / KanCare | $60 - $3,426 | 2% |
| Medical Associates | $60 - $565 | 2% |
| Ambetter / Centene | $61 - $5,810 | 2% |
| Health Partners | $65 - $953 | 2% |
| Lucent Health | $65 - $609 | 2% |
| Sanford Health Plan | $65 - $609 | 2% |
| Ucare | $65 - $610 | 2% |
| Oscar | $68 - $4,914 | 2% |
| Quiktrip | $70 - $660 | 2% |
| Usa Managed Care | $70 - $657 | 2% |
| Amish Hospital Aid | $72 - $4,599 | 2% |
| Centivo | $72 - $4,990 | 2% |
| Stephenson Cty Health | $72 - $449 | 2% |
| Amps | $73 - $457 | 2% |
| Claimdoc | $75 - $6,951 | 2% |
| The Alliance | $76 - $711 | 2% |
| Bcn Domestic | $82 - $767 | 2% |
| Blue Benefit Administrators Of Massachusetts | $82 - $3,658 | 2% |
| Blue Care Network | $82 - $3,658 | 2% |
| Blue Distinction Transplant | $82 - $3,658 | 2% |
| Blue Shield - Ca | $82 - $3,658 | 2% |
| Blue Shield - Id (Regence) | $82 - $3,658 | 2% |
| Blue Shield - Ny Highmark Northeastern | $82 - $3,658 | 2% |
| Blue Shield - Ny Highmark Western | $82 - $3,658 | 2% |
| Blue Shield - Pa (Highmark) | $82 - $3,658 | 2% |
| Blue Shield - Wa (Regence) | $82 - $3,658 | 2% |
| Global Excel | $82 - $765 | 2% |
| Health Choices | $82 - $1,058 | 2% |
| Kaiser Domestic | $82 - $767 | 2% |
| Pre-Employment | $82 - $767 | 2% |
| Wc Domestic | $82 - $767 | 2% |
| Preferred One | $84 - $787 | 2% |
| Velocity | $85 - $795 | 2% |
| Multiplan | $87 - $872 | 2% |
| Iowa Dept Of Public Health | $93 - $1,157 | 3% |
| Nebraska Total Care | $93 - $1,157 | 3% |
| Geha | $95 - $890 | 3% |
| Newton Correctional Facility | $120 - $1,504 | 3% |
| Meritain | $135 - $1,270 | 4% |
| Genex Wc | $139 - $1,736 | 4% |
| Allied Benefit Systems | $141 - $1,058 | 4% |
| Auxiant | $141 - $1,058 | 4% |
| First Choice Health | $141 - $1,058 | 4% |
| Group Administrators | $141 - $1,058 | 4% |
| Midlands | $141 - $1,058 | 4% |
| Midlands Choice | $141 - $1,058 | 4% |
| Wc Align Network | $148 - $1,851 | 4% |
| Wc Praxis Health Network | $157 - $1,967 | 4% |
| Wc Reny Company | $161 - $2,013 | 4% |
| Wc Velocity | $161 - $2,013 | 4% |
| Auto Velocity | $167 - $2,083 | 5% |
| Health Smart | $167 - $2,083 | 5% |
| Wc O'Hara Corp | $167 - $2,083 | 5% |
| Andrie Inc | $185 - $2,314 | 5% |
| East Greenbush Central School District | $185 - $2,314 | 5% |
| Healthsmart Workers Comp | $185 - $2,314 | 5% |
| Jag Source | $185 - $2,314 | 5% |
| New York State Insurance Fund | $185 - $2,314 | 5% |
| Njm Insurance Group | $185 - $2,314 | 5% |
| Rx Heatlhcomp | $185 - $2,314 | 5% |
| Rx Restat | $185 - $2,314 | 5% |
| Rx Saif Opdp Wc | $185 - $2,314 | 5% |
| Rx Worker'S Comp | $185 - $2,314 | 5% |
| Wc Accident Fund | $185 - $2,314 | 5% |
| Wc Ace | $185 - $2,314 | 5% |
| Wc Acs Federal Employees | $185 - $2,314 | 5% |
| Wc Acuity | $185 - $2,314 | 5% |
| Wc Advantage | $185 - $2,314 | 5% |
| Wc Aegis | $185 - $2,314 | 5% |
| Wc Aig | $185 - $2,314 | 5% |
| Wc Aims | $185 - $2,314 | 5% |
| Wc Alaska National Ins | $185 - $2,314 | 5% |
| Wc Allied | $185 - $2,314 | 5% |
| Wc Am Trust N America | $185 - $2,314 | 5% |
| Wc American Claims Mgmt | $185 - $2,314 | 5% |
| Wc Amerisure | $185 - $2,314 | 5% |
| Wc Amtrust | $185 - $2,314 | 5% |
| Wc Asu Risk Mgt | $185 - $2,314 | 5% |
| Wc Benetech | $185 - $2,314 | 5% |
| Wc Berkley Admin | $185 - $2,314 | 5% |
| Wc Broadspire | $185 - $2,314 | 5% |
| Wc Broward County | $185 - $2,314 | 5% |
| Wc Bunch & Associates | $185 - $2,314 | 5% |
| Wc California State Comp Ins | $185 - $2,314 | 5% |
| Wc California State Ins Fund | $185 - $2,314 | 5% |
| Wc Capitol Area Health Consortium | $185 - $2,314 | 5% |
| Wc Ccmsi | $185 - $2,314 | 5% |
| Wc Chartis | $185 - $2,314 | 5% |
| Wc Chubb | $185 - $2,314 | 5% |
| Wc Cirma | $185 - $2,314 | 5% |
| Wc City Of Albany | $185 - $2,314 | 5% |
| Wc City Of Sioux City | $185 - $2,314 | 5% |
| Wc Claims Mgmt Inc | $185 - $2,314 | 5% |
| Wc Cna | $185 - $2,314 | 5% |
| Wc Comp One Admin C/O Manageability | $185 - $2,314 | 5% |
| Wc Compone Admin | $185 - $2,314 | 5% |
| Wc Ct Healthcare Trust | $185 - $2,314 | 5% |
| Wc Donegal Insurance Group | $185 - $2,314 | 5% |
| Wc Emc Insurance Company | $185 - $2,314 | 5% |
| Wc Employee Mutual | $185 - $2,314 | 5% |
| Wc Enablecomp | $185 - $2,314 | 5% |
| Wc Encore Health Network | $185 - $2,314 | 5% |
| Wc Erie | $185 - $2,314 | 5% |
| Wc Esis | $185 - $2,314 | 5% |
| Wc Evolutions | $185 - $2,314 | 5% |
| Wc Fcci | $185 - $2,314 | 5% |
| Wc Fed Ex | $185 - $2,314 | 5% |
| Wc Federal Black Lung | $185 - $2,314 | 5% |
| Wc Federated | $185 - $2,314 | 5% |
| Wc Finley Occupational Health | $185 - $2,314 | 5% |
| Wc First Agency/Occunet | $185 - $2,314 | 5% |
| Wc Ford Motor | $185 - $2,314 | 5% |
| Wc Fresno Unified Emp | $185 - $2,314 | 5% |
| Wc Gallagher Bassett | $185 - $2,314 | 5% |
| Wc General Motors | $185 - $2,314 | 5% |
| Wc Generic | $185 - $2,314 | 5% |
| Wc Genex Care For Ohio | $185 - $2,314 | 5% |
| Wc Great West Casualty | $185 - $2,314 | 5% |
| Wc Guarantee Insurance | $185 - $2,314 | 5% |
| Wc Guard Insurance Company | $185 - $2,314 | 5% |
| Wc Hab | $185 - $2,314 | 5% |
| Wc Hartford | $185 - $2,314 | 5% |
| Wc Hastings | $185 - $2,314 | 5% |
| Wc Health Management | $185 - $2,314 | 5% |
| Wc Heritage Summit | $185 - $2,314 | 5% |
| Wc Hireright | $185 - $2,314 | 5% |
| Wc Horizon | $185 - $2,314 | 5% |
| Wc Icw Group | $185 - $2,314 | 5% |
| Wc Idaho State Ins Fund | $185 - $2,314 | 5% |
| Wc Intercare Insurance | $185 - $2,314 | 5% |
| Wc Intermountain | $185 - $2,314 | 5% |
| Wc Johns Eastern | $185 - $2,314 | 5% |
| Wc Kemberton | $185 - $2,314 | 5% |
| Wc Key Ins & Benefit Solutions | $185 - $2,314 | 5% |
| Wc Liberty Mutual | $185 - $2,314 | 5% |
| Wc Mac Risk Management | $185 - $2,314 | 5% |
| Wc Massachusetts | $185 - $2,314 | 5% |
| Wc Mdia | $185 - $2,314 | 5% |
| Wc Meadowbrook Claim | $185 - $2,314 | 5% |
| Wc Medical Administrators | $185 - $2,314 | 5% |
| Wc Meijers | $185 - $2,314 | 5% |
| Wc Memic | $185 - $2,314 | 5% |
| Wc Mercy Workcare | $185 - $2,314 | 5% |
| Wc Michigan | $185 - $2,314 | 5% |
| Wc Michigan Millers Mutual | $185 - $2,314 | 5% |
| Wc Mitchell Frankenmuth | $185 - $2,314 | 5% |
| Wc Mra | $185 - $2,314 | 5% |
| Wc Nationwide | $185 - $2,314 | 5% |
| Wc Nca Comp | $185 - $2,314 | 5% |
| Wc New York | $185 - $2,314 | 5% |
| Wc New York Special Funds | $185 - $2,314 | 5% |
| Wc North American Rishces | $185 - $2,314 | 5% |
| Wc Northeast Health | $185 - $2,314 | 5% |
| Wc Notre Dame | $185 - $2,314 | 5% |
| Wc Novanet | $185 - $2,314 | 5% |
| Wc Occ Health Allen | $185 - $2,314 | 5% |
| Wc Ohio Bureau | $185 - $2,314 | 5% |
| Wc One Call Medical | $185 - $2,314 | 5% |
| Wc Paradigm | $185 - $2,314 | 5% |
| Wc Peerless | $185 - $2,314 | 5% |
| Wc Pma | $185 - $2,314 | 5% |
| Wc Price Chopper | $185 - $2,314 | 5% |
| Wc Procura Management | $185 - $2,314 | 5% |
| Wc Qualcare | $185 - $2,314 | 5% |
| Wc Quiktrip | $185 - $2,314 | 5% |
| Wc Rev Claims | $185 - $2,314 | 5% |
| Wc Risico | $185 - $2,314 | 5% |
| Wc Rural Mutual | $185 - $2,314 | 5% |
| Wc Saif Oregon | $185 - $2,314 | 5% |
| Wc Secura | $185 - $2,314 | 5% |
| Wc Sedgwick | $185 - $2,314 | 5% |
| Wc Sentry | $185 - $2,314 | 5% |
| Wc Sheakley Unicomp | $185 - $2,314 | 5% |
| Wc Smile Lodge | $185 - $2,314 | 5% |
| Wc Society | $185 - $2,314 | 5% |
| Wc Srs | $185 - $2,314 | 5% |
| Wc Taconic (Mro) | $185 - $2,314 | 5% |
| Wc Taconic Farms | $185 - $2,314 | 5% |
| Wc Travelers | $185 - $2,314 | 5% |
| Wc Triad Group | $185 - $2,314 | 5% |
| Wc Tristar | $185 - $2,314 | 5% |
| Wc Troy Ny | $185 - $2,314 | 5% |
| Wc Tyson | $185 - $2,314 | 5% |
| Wc Unified Health Services | $185 - $2,314 | 5% |
| Wc United Heartland | $185 - $2,314 | 5% |
| Wc Us Dept Of Labor | $185 - $2,314 | 5% |
| Wc Walmart | $185 - $2,314 | 5% |
| Wc West Bend | $185 - $2,314 | 5% |
| Wc West Bend Mutual/Argent | $185 - $2,314 | 5% |
| Wc Winnebago Industries | $185 - $2,314 | 5% |
| Wc Yankee Trails | $185 - $2,314 | 5% |
| Wc York Risk | $185 - $2,314 | 5% |
| Wc Zenith | $185 - $2,314 | 5% |
| Wc Zurich | $185 - $2,314 | 5% |
| Albany County Correctional Facility | $193 - $289 | 5% |
| Amish Mennonite | $193 - $289 | 5% |
| Ascension St. Vincent Public Safety Medical | $193 - $289 | 5% |
| Bcccp-Michigan | $193 - $289 | 5% |
| Bccp | $193 - $289 | 5% |
| Bmc Healthnet | $193 - $289 | 5% |
| Breast Grant-Connecticut | $193 - $289 | 5% |
| Broward County Dept Of Health | $193 - $289 | 5% |
| California Health And Wellness | $193 - $289 | 5% |
| Can Community Health Inc | $193 - $289 | 5% |
| Cardinal Innovations Lme | $193 - $289 | 5% |
| Care Connections Of Northern Iowa | $193 - $289 | 5% |
| Care Oregon Ohp | $193 - $289 | 5% |
| Cencal Health Plan | $193 - $289 | 5% |
| Cenpatico | $193 - $289 | 5% |
| Chhuny | $193 - $289 | 5% |
| Childrens Comm Health Plan | $193 - $289 | 5% |
| Childrens Medical Services Title 19 | $193 - $289 | 5% |
| City Of Philadelphia | $193 - $289 | 5% |
| Cmh Allegan County | $193 - $289 | 5% |
| Cmh Ausable Valley | $193 - $289 | 5% |
| Cmh Barry County | $193 - $289 | 5% |
| Cmh Bay-Arenac County | $193 - $289 | 5% |
| Cmh Berrien County | $193 - $289 | 5% |
| Cmh Cass County | $193 - $289 | 5% |
| Cmh Central Mi County | $193 - $289 | 5% |
| Cmh Clinton-Eaton-Ingham County | $193 - $289 | 5% |
| Cmh Detroit Wayne Integrated Health Network | $193 - $289 | 5% |
| Cmh Genesee County | $193 - $289 | 5% |
| Cmh Ionia County | $193 - $289 | 5% |
| Cmh Jackson County/Lifeways | $193 - $289 | 5% |
| Cmh Kalamazoo | $193 - $289 | 5% |
| Cmh Kent County | $193 - $289 | 5% |
| Cmh Lenawee County | $193 - $289 | 5% |
| Cmh Livingston County | $193 - $289 | 5% |
| Cmh Macomb | $193 - $289 | 5% |
| Cmh Misc | $193 - $289 | 5% |
| Cmh Monroe County | $193 - $289 | 5% |
| Cmh Montcalm County | $193 - $289 | 5% |
| Cmh Muskegon County | $193 - $289 | 5% |
| Cmh Newaygo County | $193 - $289 | 5% |
| Cmh North Country | $193 - $289 | 5% |
| Cmh Northern Lakes County | $193 - $289 | 5% |
| Cmh Oakland County | $193 - $289 | 5% |
| Cmh Ottawa County | $193 - $289 | 5% |
| Cmh Van Buren County | $193 - $289 | 5% |
| Cmh Washtenaw County | $193 - $289 | 5% |
| Cmh Wayne County/Carelink | $193 - $289 | 5% |
| Cmh Wayne Cty/Com Liv Svcs | $193 - $289 | 5% |
| Cmh West Mi County | $193 - $289 | 5% |
| Community Benefit Health | $193 - $289 | 5% |
| Community Care Behavorial Health | $193 - $289 | 5% |
| Community Care Partners | $193 - $289 | 5% |
| Community Health Choice | $193 - $289 | 5% |
| Connections Csp | $193 - $289 | 5% |
| County Coroner | $193 - $289 | 5% |
| County Funding Generic | $193 - $289 | 5% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund | $193 - $289 | 5% |
| Dean Wi Badgercare | $193 - $289 | 5% |
| Delaware County Department Of Health | $193 - $289 | 5% |
| Delaware First Health | $193 - $289 | 5% |
| Delta Dental Nj | $193 - $289 | 5% |
| Dph Tb Program | $193 - $289 | 5% |
| Dscc | $193 - $289 | 5% |
| Eastpointe Lme | $193 - $289 | 5% |
| Family Health Network | $193 - $289 | 5% |
| Freedom First Healthcare | $193 - $289 | 5% |
| Fresno County Ccs | $193 - $289 | 5% |
| Ghc Scw Wi Badgercare | $193 - $289 | 5% |
| Harbor Health | $193 - $289 | 5% |
| Health Safety Net | $193 - $289 | 5% |
| Healthy Blue Ne | $193 - $289 | 5% |
| Hennepin Health | $193 - $289 | 5% |
| Id County Ada | $193 - $289 | 5% |
| Id County Canyon | $193 - $289 | 5% |
| Id County Cat Fund | $193 - $289 | 5% |
| Id County Other | $193 - $289 | 5% |
| Id County Payette | $193 - $289 | 5% |
| Idaho Dept Health And Wellfare | $193 - $289 | 5% |
| Idaho Womens Health Check | $193 - $289 | 5% |
| Indiana Breast Cervical Cancer | $193 - $289 | 5% |
| Inland Empire Health Plan | $193 - $289 | 5% |
| Intercommunity Health Ohp | $193 - $289 | 5% |
| Jai Medical System | $193 - $289 | 5% |
| Kern Family Health Plan | $193 - $289 | 5% |
| Keystone First | $193 - $289 | 5% |
| Keystone First Chip | $193 - $289 | 5% |
| La Care Health Plan | $193 - $289 | 5% |
| Lakeland Care Inc | $193 - $289 | 5% |
| Managed Health Services - Indiana | $193 - $289 | 5% |
| Maryland Breast & Cervical Program | $193 - $289 | 5% |
| Maryland Healthy Smiles - Scion Dental | $193 - $289 | 5% |
| Maryland Physicians Care | $193 - $289 | 5% |
| Massachusetts Behavioral Health Partnership | $193 - $289 | 5% |
| Mdwise | $193 - $289 | 5% |
| Medi-Cal | $193 - $289 | 5% |
| Medi-Cal Healthnet | $193 - $289 | 5% |
| Medstar Dc Healthy Family | $193 - $289 | 5% |
| Medstar Md Health Choice | $193 - $289 | 5% |
| Mo Home State Health Plan | $193 - $289 | 5% |
| Molina Centennial Care | $193 - $289 | 5% |
| Nascentia Health Options | $193 - $289 | 5% |
| New York Cancer Services Program | $193 - $289 | 5% |
| Nextlevel Health | $193 - $289 | 5% |
| Oregon Screenwise | $193 - $289 | 5% |
| Paramount Advantage | $193 - $289 | 5% |
| Parkland Community Health Plan | $193 - $289 | 5% |
| Partners Behavioral Lme | $193 - $289 | 5% |
| Peach State Healthplan | $193 - $289 | 5% |
| Philadelphia County Funding | $193 - $289 | 5% |
| Presbyterian Centennial Care | $193 - $289 | 5% |
| Prestige Health Choice | $193 - $289 | 5% |
| Priority Partners | $193 - $289 | 5% |
| Robert F Sing Program | $193 - $289 | 5% |
| Rx 340B Pass Along | $193 - $289 | 5% |
| Rx Assistance/Rx Manufacturer Assistance 0 Copay | $193 - $289 | 5% |
| Rx Medi-Cal | $193 - $289 | 5% |
| Rx Meridian Rx | $193 - $289 | 5% |
| Ryan White Florida Mssrp | $193 - $289 | 5% |
| Sandhills Center Lme | $193 - $289 | 5% |
| Screening For Life | $193 - $289 | 5% |
| St Joseph County Hlth Dpt | $193 - $289 | 5% |
| Sunshine State Health Plan | $193 - $289 | 5% |
| Superior Health | $193 - $289 | 5% |
| Tenncare | $193 - $289 | 5% |
| Texas Children'S Health Plan | $193 - $289 | 5% |
| Trillium Community Ohp | $193 - $289 | 5% |
| Tufts Health Public Plans | $193 - $289 | 5% |
| Vaya Health Lme | $193 - $289 | 5% |
| Washtenaw Health Plan | $193 - $289 | 5% |
| Wellsense Health Plan | $193 - $289 | 5% |
| Wi Womens Wellness | $193 - $289 | 5% |
| Iowa Total Care | $197 - $3,379 | 5% |
| Wellpoint | $199 - $298 | 5% |
| Nova | $6,951 | 190% |