CMS Price Transparency Data
Gallbladder removal (laparoscopic)
Facility: Mercyone Centerville Medical Center
Billing Code: 47562 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 47562
- Insurance Median: $275
- Cash Discount Price: $1,451
- vs. Medicare Baseline: 0.04x Medicare
The contracted insurance negotiated median rate for a Gallbladder removal (laparoscopic) at Mercyone Centerville Medical Center is $275. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,451. Compared to the federal Medicare reimbursement reference rate of $6,176.47, this hospital’s rate is 0.04x the Medicare baseline. Located in One St Joseph's Drive, Centerville, IA.
Cash / Self-Pay
$1,451
Average discount available for prompt cash payment at this facility.
Insurance Median
$275
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$6,176.47
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $6,176.47 (100%)
Cash / Self-Pay: $1,451 (23%)
Insurance Median: $275 (4%)
Cash: $1,451 (23% of Medicare)
Ins. Median: $275 (4% of Medicare)
Understanding this gauge: We use the federal Medicare rate of $6,176.47 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 |
|---|---|---|
| Avera | $69 - $429 | 1% |
| Humana | $72 - $449 | 1% |
| Medical Associates | $75 - $1,805 | 1% |
| Ambetter / Centene | $76 - $1,151 | 1% |
| Health Partners | $80 - $2,273 | 1% |
| Ucare | $80 - $503 | 1% |
| Lucent Health | $81 - $2,214 | 1% |
| Sanford Health Plan | $81 - $505 | 1% |
| Health Smart | $83 - $519 | 1% |
| Oscar | $84 - $525 | 1% |
| Usa Managed Care | $87 - $544 | 1% |
| Quiktrip | $88 - $547 | 1% |
| Centivo | $90 - $562 | 1% |
| Claimdoc | $94 - $1,377 | 2% |
| The Alliance | $94 - $589 | 2% |
| Global Excel | $101 - $634 | 2% |
| Bcn Domestic | $103 - $644 | 2% |
| Blue Benefit Administrators Of Massachusetts | $103 - $644 | 2% |
| Blue Care Network | $103 - $644 | 2% |
| Blue Cross Blue Shield | $103 - $757 | 2% |
| Blue Distinction Transplant | $103 - $644 | 2% |
| Blue Shield - Ca | $103 - $644 | 2% |
| Blue Shield - Id (Regence) | $103 - $644 | 2% |
| Blue Shield - Ny Highmark Northeastern | $103 - $644 | 2% |
| Blue Shield - Ny Highmark Western | $103 - $644 | 2% |
| Blue Shield - Pa (Highmark) | $103 - $644 | 2% |
| Blue Shield - Wa (Regence) | $103 - $644 | 2% |
| Health Choices | $103 - $1,805 | 2% |
| Kaiser Domestic | $103 - $644 | 2% |
| Pre-Employment | $103 - $644 | 2% |
| Wc Domestic | $103 - $644 | 2% |
| Velocity | $105 - $659 | 2% |
| Preferred One | $106 - $662 | 2% |
| Multiplan | $110 - $1,097 | 2% |
| Iowa Dept Of Public Health | $116 - $2,363 | 2% |
| Medicaid / KanCare | $116 - $1,182 | 2% |
| Nebraska Total Care | $116 - $1,182 | 2% |
| Geha | $120 - $2,068 | 2% |
| UnitedHealthcare | $120 - $2,363 | 2% |
| Newton Correctional Facility | $151 - $1,536 | 2% |
| Aetna | $170 - $2,363 | 3% |
| Meritain | $170 - $2,214 | 3% |
| Genex Wc | $174 - $1,772 | 3% |
| Allied Benefit Systems | $178 - $2,214 | 3% |
| Auxiant | $178 - $2,316 | 3% |
| Cigna | $178 - $2,316 | 3% |
| First Choice Health | $178 - $888 | 3% |
| Group Administrators | $178 - $888 | 3% |
| Midlands | $178 - $2,316 | 3% |
| Midlands Choice | $178 - $2,316 | 3% |
| Wc Align Network | $186 - $1,890 | 3% |
| Wc Praxis Health Network | $197 - $2,009 | 3% |
| Wc Reny Company | $202 - $2,056 | 3% |
| Wc Velocity | $202 - $2,056 | 3% |
| Auto Velocity | $209 - $2,127 | 3% |
| Wc O'Hara Corp | $209 - $2,127 | 3% |
| Andrie Inc | $232 - $2,363 | 4% |
| East Greenbush Central School District | $232 - $2,363 | 4% |
| Healthsmart Workers Comp | $232 - $2,363 | 4% |
| Jag Source | $232 - $2,363 | 4% |
| New York State Insurance Fund | $232 - $2,363 | 4% |
| Njm Insurance Group | $232 - $2,363 | 4% |
| Rx Heatlhcomp | $232 - $2,363 | 4% |
| Rx Restat | $232 - $2,363 | 4% |
| Rx Saif Opdp Wc | $232 - $2,363 | 4% |
| Rx Worker'S Comp | $232 - $2,363 | 4% |
| Wc Accident Fund | $232 - $2,363 | 4% |
| Wc Ace | $232 - $2,363 | 4% |
| Wc Acs Federal Employees | $232 - $2,363 | 4% |
| Wc Acuity | $232 - $2,363 | 4% |
| Wc Advantage | $232 - $2,363 | 4% |
| Wc Aegis | $232 - $2,363 | 4% |
| Wc Aig | $232 - $2,363 | 4% |
| Wc Aims | $232 - $2,363 | 4% |
| Wc Alaska National Ins | $232 - $2,363 | 4% |
| Wc Allied | $232 - $2,363 | 4% |
| Wc Am Trust N America | $232 - $2,363 | 4% |
| Wc American Claims Mgmt | $232 - $2,363 | 4% |
| Wc Amerisure | $232 - $2,363 | 4% |
| Wc Amtrust | $232 - $2,363 | 4% |
| Wc Asu Risk Mgt | $232 - $2,363 | 4% |
| Wc Benetech | $232 - $2,363 | 4% |
| Wc Berkley Admin | $232 - $2,363 | 4% |
| Wc Broadspire | $232 - $2,363 | 4% |
| Wc Broward County | $232 - $2,363 | 4% |
| Wc Bunch & Associates | $232 - $2,363 | 4% |
| Wc California State Comp Ins | $232 - $2,363 | 4% |
| Wc California State Ins Fund | $232 - $2,363 | 4% |
| Wc Capitol Area Health Consortium | $232 - $2,363 | 4% |
| Wc Ccmsi | $232 - $2,363 | 4% |
| Wc Chartis | $232 - $2,363 | 4% |
| Wc Chubb | $232 - $2,363 | 4% |
| Wc Cirma | $232 - $2,363 | 4% |
| Wc City Of Albany | $232 - $2,363 | 4% |
| Wc City Of Sioux City | $232 - $2,363 | 4% |
| Wc Claims Mgmt Inc | $232 - $2,363 | 4% |
| Wc Cna | $232 - $2,363 | 4% |
| Wc Comp One Admin C/O Manageability | $232 - $2,363 | 4% |
| Wc Compone Admin | $232 - $2,363 | 4% |
| Wc Ct Healthcare Trust | $232 - $2,363 | 4% |
| Wc Donegal Insurance Group | $232 - $2,363 | 4% |
| Wc Emc Insurance Company | $232 - $2,363 | 4% |
| Wc Employee Mutual | $232 - $2,363 | 4% |
| Wc Enablecomp | $232 - $2,363 | 4% |
| Wc Encore Health Network | $232 - $2,363 | 4% |
| Wc Erie | $232 - $2,363 | 4% |
| Wc Esis | $232 - $2,363 | 4% |
| Wc Evolutions | $232 - $2,363 | 4% |
| Wc Fcci | $232 - $2,363 | 4% |
| Wc Fed Ex | $232 - $2,363 | 4% |
| Wc Federal Black Lung | $232 - $2,363 | 4% |
| Wc Federated | $232 - $2,363 | 4% |
| Wc Finley Occupational Health | $232 - $2,363 | 4% |
| Wc First Agency/Occunet | $232 - $2,363 | 4% |
| Wc Ford Motor | $232 - $2,363 | 4% |
| Wc Fresno Unified Emp | $232 - $2,363 | 4% |
| Wc Gallagher Bassett | $232 - $2,363 | 4% |
| Wc General Motors | $232 - $2,363 | 4% |
| Wc Generic | $232 - $2,363 | 4% |
| Wc Genex Care For Ohio | $232 - $2,363 | 4% |
| Wc Great West Casualty | $232 - $2,363 | 4% |
| Wc Guarantee Insurance | $232 - $2,363 | 4% |
| Wc Guard Insurance Company | $232 - $2,363 | 4% |
| Wc Hab | $232 - $2,363 | 4% |
| Wc Hartford | $232 - $2,363 | 4% |
| Wc Hastings | $232 - $2,363 | 4% |
| Wc Health Management | $232 - $2,363 | 4% |
| Wc Heritage Summit | $232 - $2,363 | 4% |
| Wc Hireright | $232 - $2,363 | 4% |
| Wc Horizon | $232 - $2,363 | 4% |
| Wc Icw Group | $232 - $2,363 | 4% |
| Wc Idaho State Ins Fund | $232 - $2,363 | 4% |
| Wc Intercare Insurance | $232 - $2,363 | 4% |
| Wc Intermountain | $232 - $2,363 | 4% |
| Wc Johns Eastern | $232 - $2,363 | 4% |
| Wc Kemberton | $232 - $2,363 | 4% |
| Wc Key Ins & Benefit Solutions | $232 - $2,363 | 4% |
| Wc Liberty Mutual | $232 - $2,363 | 4% |
| Wc Mac Risk Management | $232 - $2,363 | 4% |
| Wc Massachusetts | $232 - $2,363 | 4% |
| Wc Mdia | $232 - $2,363 | 4% |
| Wc Meadowbrook Claim | $232 - $2,363 | 4% |
| Wc Medical Administrators | $232 - $2,363 | 4% |
| Wc Meijers | $232 - $2,363 | 4% |
| Wc Memic | $232 - $2,363 | 4% |
| Wc Mercy Workcare | $232 - $2,363 | 4% |
| Wc Michigan | $232 - $2,363 | 4% |
| Wc Michigan Millers Mutual | $232 - $2,363 | 4% |
| Wc Mitchell Frankenmuth | $232 - $2,363 | 4% |
| Wc Mra | $232 - $2,363 | 4% |
| Wc Nationwide | $232 - $2,363 | 4% |
| Wc Nca Comp | $232 - $2,363 | 4% |
| Wc New York | $232 - $2,363 | 4% |
| Wc New York Special Funds | $232 - $2,363 | 4% |
| Wc North American Rishces | $232 - $2,363 | 4% |
| Wc Northeast Health | $232 - $2,363 | 4% |
| Wc Notre Dame | $232 - $2,363 | 4% |
| Wc Novanet | $232 - $2,363 | 4% |
| Wc Occ Health Allen | $232 - $2,363 | 4% |
| Wc Ohio Bureau | $232 - $2,363 | 4% |
| Wc One Call Medical | $232 - $2,363 | 4% |
| Wc Paradigm | $232 - $2,363 | 4% |
| Wc Peerless | $232 - $2,363 | 4% |
| Wc Pma | $232 - $2,363 | 4% |
| Wc Price Chopper | $232 - $2,363 | 4% |
| Wc Procura Management | $232 - $2,363 | 4% |
| Wc Qualcare | $232 - $2,363 | 4% |
| Wc Quiktrip | $232 - $2,363 | 4% |
| Wc Rev Claims | $232 - $2,363 | 4% |
| Wc Risico | $232 - $2,363 | 4% |
| Wc Rural Mutual | $232 - $2,363 | 4% |
| Wc Saif Oregon | $232 - $2,363 | 4% |
| Wc Secura | $232 - $2,363 | 4% |
| Wc Sedgwick | $232 - $2,363 | 4% |
| Wc Sentry | $232 - $2,363 | 4% |
| Wc Sheakley Unicomp | $232 - $2,363 | 4% |
| Wc Smile Lodge | $232 - $2,363 | 4% |
| Wc Society | $232 - $2,363 | 4% |
| Wc Srs | $232 - $2,363 | 4% |
| Wc Taconic (Mro) | $232 - $2,363 | 4% |
| Wc Taconic Farms | $232 - $2,363 | 4% |
| Wc Travelers | $232 - $2,363 | 4% |
| Wc Triad Group | $232 - $2,363 | 4% |
| Wc Tristar | $232 - $2,363 | 4% |
| Wc Troy Ny | $232 - $2,363 | 4% |
| Wc Tyson | $232 - $2,363 | 4% |
| Wc Unified Health Services | $232 - $2,363 | 4% |
| Wc United Heartland | $232 - $2,363 | 4% |
| Wc Us Dept Of Labor | $232 - $2,363 | 4% |
| Wc Walmart | $232 - $2,363 | 4% |
| Wc West Bend | $232 - $2,363 | 4% |
| Wc West Bend Mutual/Argent | $232 - $2,363 | 4% |
| Wc Winnebago Industries | $232 - $2,363 | 4% |
| Wc Yankee Trails | $232 - $2,363 | 4% |
| Wc York Risk | $232 - $2,363 | 4% |
| Wc Zenith | $232 - $2,363 | 4% |
| Wc Zurich | $232 - $2,363 | 4% |
| Wc Corvel | $266 | 4% |
| Align Senior Care | $275 | 4% |
| Ally Align Care Adv | $275 | 4% |
| American Health Advantage Of Idaho | $275 | 4% |
| Aurora Special Needs | $275 | 4% |
| Blue Care Network Advantage | $275 | 4% |
| Blue Shield - De (Highmark) Medciare Advantage | $275 | 4% |
| Care Dimensions | $275 | 4% |
| Care Improvement Plus | $275 | 4% |
| Care Resources Pace | $275 | 4% |
| Careplus Health Plans | $275 | 4% |
| Cca - Zing Health | $275 | 4% |
| Cca Senior Care Options | $275 | 4% |
| Central Valley Medical Services Corp Pace | $275 | 4% |
| Champion Health Plan Mcr Advantage | $275 | 4% |
| Clear Spring Health | $275 | 4% |
| Clover Health | $275 | 4% |
| Commonwealth Care Alliance | $275 | 4% |
| Community Pace At Home | $275 | 4% |
| Eddy Senior Care-Pace | $275 | 4% |
| Eddy Seniorcare Pace | $275 | 4% |
| Elementcare | $275 | 4% |
| Evercare | $275 | 4% |
| Everence | $275 | 4% |
| Gateway Health Plan | $275 | 4% |
| Genesys Pace Of Genesee County | $275 | 4% |
| Georgia Health Advantage | $275 | 4% |
| Gold Advantage | $275 | 4% |
| Gpa Croell Redi Mix | $275 | 4% |
| Health America Advantra | $275 | 4% |
| Highmark Health Options Dual Plan | $275 | 4% |
| Hope Select Pace | $275 | 4% |
| Horizon Nj Total Care | $275 | 4% |
| Hudson Headwaters Pace | $275 | 4% |
| Huron Valley Pace | $275 | 4% |
| Innovative Integrated Health Community Plans | $275 | 4% |
| Johns Hopkins Advantage Md | $275 | 4% |
| Lasso Healthcare Msa | $275 | 4% |
| Life St Marys Pace | $275 | 4% |
| Lifecircles Pace | $275 | 4% |
| Longevity Health Plan | $275 | 4% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $275 | 4% |
| Martins Point Generations Advantage | $275 | 4% |
| Mass General Brigham Mcr Adv | $275 | 4% |
| Medicare (plans) | $275 - $712 | 4% |
| Medipak Advantage | $275 | 4% |
| Mercy Life | $275 | 4% |
| Mercyone Cedar Valley | $275 | 4% |
| Meridian Complete | $275 | 4% |
| Michigan Complete Health | $275 | 4% |
| Nascentia Health Plus | $275 | 4% |
| New Centry Health Careplus | $275 | 4% |
| Osu Prime Care Advantage | $275 | 4% |
| Pace Cny | $275 | 4% |
| Pace Iowa Immanuel Pathways | $275 | 4% |
| Pace Of Southwest Michigan | $275 - $317 | 4% |
| Pace Southeast | $275 | 4% |
| Pace-Trinity Health | $275 | 4% |
| Peak Pace Solutions | $275 | 4% |
| Perennial Advantage | $275 | 4% |
| Preferred Care Partners | $275 | 4% |
| Presbyterian Senior Plan | $275 | 4% |
| Provider Partners Health Plan Of Illinois | $275 | 4% |
| Provider Partners Health Plan Of Indiana | $275 | 4% |
| Pruitthealth Premier | $275 | 4% |
| Reliance Community Care Partners Care Resources Pace | $275 | 4% |
| Rx Allwin | $275 | 4% |
| Rx Grane Grnmedd | $275 | 4% |
| Rx Retiree Rx Care | $275 | 4% |
| Scan Health Plan Mcr Ipa Meritage Oon | $275 | 4% |
| Secure Horizons Ma Pffs | $275 | 4% |
| Serenity Pace | $275 | 4% |
| Siouxland Pace | $275 | 4% |
| Solis Health Plans | $275 | 4% |
| Sunnyview-Pace Finance Dept | $275 | 4% |
| Texan Plus | $275 | 4% |
| The Health Plan | $275 | 4% |
| Thome Pace | $275 | 4% |
| Todays Options | $275 | 4% |
| Tribute Health Plans | $275 | 4% |
| Um Health Advantage | $275 | 4% |
| Union Health Service | $275 | 4% |
| Welbe Health | $275 | 4% |
| Wellmed | $275 | 4% |
| Veterans Administration | $280 | 5% |
| American Health Plan | $289 | 5% |
| Iowa Health Advantage | $289 | 5% |
| Champva | $292 | 5% |
| Tricare | $292 | 5% |
| Triwest Health Alliance | $292 | 5% |
| Us Family Health Plan | $292 | 5% |
| Veterans Eval Services | $292 | 5% |
| Albany County Correctional Facility | $317 | 5% |
| Amish Mennonite | $317 | 5% |
| Ascension St. Vincent Public Safety Medical | $317 | 5% |
| Bcccp-Michigan | $317 | 5% |
| Bccp | $317 | 5% |
| Bmc Healthnet | $317 | 5% |
| Breast Grant-Connecticut | $317 | 5% |
| Broward County Dept Of Health | $317 | 5% |
| California Health And Wellness | $317 | 5% |
| Can Community Health Inc | $317 | 5% |
| Cardinal Innovations Lme | $317 | 5% |
| Care Connections Of Northern Iowa | $317 | 5% |
| Care Oregon Ohp | $317 | 5% |
| Cencal Health Plan | $317 | 5% |
| Cenpatico | $317 | 5% |
| Chhuny | $317 | 5% |
| Childrens Comm Health Plan | $317 | 5% |
| Childrens Medical Services Title 19 | $317 | 5% |
| City Of Philadelphia | $317 | 5% |
| Cmh Allegan County | $317 | 5% |
| Cmh Ausable Valley | $317 | 5% |
| Cmh Barry County | $317 | 5% |
| Cmh Bay-Arenac County | $317 | 5% |
| Cmh Berrien County | $317 | 5% |
| Cmh Cass County | $317 | 5% |
| Cmh Central Mi County | $317 | 5% |
| Cmh Clinton-Eaton-Ingham County | $317 | 5% |
| Cmh Detroit Wayne Integrated Health Network | $317 | 5% |
| Cmh Genesee County | $317 | 5% |
| Cmh Ionia County | $317 | 5% |
| Cmh Jackson County/Lifeways | $317 | 5% |
| Cmh Kalamazoo | $317 | 5% |
| Cmh Kent County | $317 | 5% |
| Cmh Lenawee County | $317 | 5% |
| Cmh Livingston County | $317 | 5% |
| Cmh Macomb | $317 | 5% |
| Cmh Misc | $317 | 5% |
| Cmh Monroe County | $317 | 5% |
| Cmh Montcalm County | $317 | 5% |
| Cmh Muskegon County | $317 | 5% |
| Cmh Newaygo County | $317 | 5% |
| Cmh North Country | $317 | 5% |
| Cmh Northern Lakes County | $317 | 5% |
| Cmh Oakland County | $317 | 5% |
| Cmh Ottawa County | $317 | 5% |
| Cmh Van Buren County | $317 | 5% |
| Cmh Washtenaw County | $317 | 5% |
| Cmh Wayne County/Carelink | $317 | 5% |
| Cmh Wayne Cty/Com Liv Svcs | $317 | 5% |
| Cmh West Mi County | $317 | 5% |
| Community Benefit Health | $317 | 5% |
| Community Care Behavorial Health | $317 | 5% |
| Community Care Partners | $317 | 5% |
| Community Health Choice | $317 | 5% |
| Connections Csp | $317 | 5% |
| County Coroner | $317 | 5% |
| County Funding Generic | $317 | 5% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund | $317 | 5% |
| Dean Wi Badgercare | $317 | 5% |
| Delaware County Department Of Health | $317 | 5% |
| Delaware First Health | $317 | 5% |
| Delta Dental Nj | $317 | 5% |
| Dph Tb Program | $317 | 5% |
| Dscc | $317 | 5% |
| Eastpointe Lme | $317 | 5% |
| Family Health Network | $317 | 5% |
| Freedom First Healthcare | $317 | 5% |
| Fresno County Ccs | $317 | 5% |
| Ghc Scw Wi Badgercare | $317 | 5% |
| Harbor Health | $317 | 5% |
| Health Safety Net | $317 | 5% |
| Healthy Blue Ne | $317 | 5% |
| Hennepin Health | $317 | 5% |
| Id County Ada | $317 | 5% |
| Id County Canyon | $317 | 5% |
| Id County Cat Fund | $317 | 5% |
| Id County Other | $317 | 5% |
| Id County Payette | $317 | 5% |
| Idaho Dept Health And Wellfare | $317 | 5% |
| Idaho Womens Health Check | $317 | 5% |
| Indiana Breast Cervical Cancer | $317 | 5% |
| Inland Empire Health Plan | $317 | 5% |
| Intercommunity Health Ohp | $317 | 5% |
| Jai Medical System | $317 | 5% |
| Kern Family Health Plan | $317 | 5% |
| Keystone First | $317 | 5% |
| Keystone First Chip | $317 | 5% |
| La Care Health Plan | $317 | 5% |
| Lakeland Care Inc | $317 | 5% |
| Managed Health Services - Indiana | $317 | 5% |
| Maryland Breast & Cervical Program | $317 | 5% |
| Maryland Healthy Smiles - Scion Dental | $317 | 5% |
| Maryland Physicians Care | $317 | 5% |
| Massachusetts Behavioral Health Partnership | $317 | 5% |
| Mdwise | $317 | 5% |
| Medi-Cal | $317 | 5% |
| Medi-Cal Healthnet | $317 | 5% |
| Medstar Dc Healthy Family | $317 | 5% |
| Medstar Md Health Choice | $317 | 5% |
| Mo Home State Health Plan | $317 | 5% |
| Molina Centennial Care | $317 | 5% |
| Nascentia Health Options | $317 | 5% |
| New York Cancer Services Program | $317 | 5% |
| Nextlevel Health | $317 | 5% |
| Oregon Screenwise | $317 | 5% |
| Paramount Advantage | $317 | 5% |
| Parkland Community Health Plan | $317 | 5% |
| Partners Behavioral Lme | $317 | 5% |
| Peach State Healthplan | $317 | 5% |
| Philadelphia County Funding | $317 | 5% |
| Presbyterian Centennial Care | $317 | 5% |
| Prestige Health Choice | $317 | 5% |
| Priority Partners | $317 | 5% |
| Robert F Sing Program | $317 | 5% |
| Rx 340B Pass Along | $317 | 5% |
| Rx Assistance/Rx Manufacturer Assistance 0 Copay | $317 | 5% |
| Rx Medi-Cal | $317 | 5% |
| Rx Meridian Rx | $317 | 5% |
| Ryan White Florida Mssrp | $317 | 5% |
| Sandhills Center Lme | $317 | 5% |
| Screening For Life | $317 | 5% |
| St Joseph County Hlth Dpt | $317 | 5% |
| Sunshine State Health Plan | $317 | 5% |
| Superior Health | $317 | 5% |
| Tenncare | $317 | 5% |
| Texas Children'S Health Plan | $317 | 5% |
| Trillium Community Ohp | $317 | 5% |
| Tufts Health Public Plans | $317 | 5% |
| Vaya Health Lme | $317 | 5% |
| Washtenaw Health Plan | $317 | 5% |
| Wellsense Health Plan | $317 | 5% |
| Wi Womens Wellness | $317 | 5% |
| Iowa Total Care | $323 - $651 | 5% |
| Wellpoint | $327 | 5% |
| Amish Hospital Aid | $373 - $911 | 6% |
| Stephenson Cty Health | $375 | 6% |
| Amps | $379 | 6% |
| Nova | $1,377 | 22% |
| 1199 National Benefit Fund | $2,214 | 36% |
| Asr Health Benefits | $2,214 | 36% |
| Christian Brother Services | $2,214 | 36% |
| Coventry | $2,214 | 36% |
| First Health | $2,214 | 36% |
| Luminare Health | $2,214 | 36% |
| Medical Mutual | $2,214 | 36% |
| Trustmark Small Business Benefits | $2,214 | 36% |
| Webtpa | $2,214 | 36% |
| Medica | $2,316 | 37% |
| Crime Victim Assistance | $2,363 | 38% |