CMS Price Transparency Data
Ultrasound, pelvis
Facility: Mercyone Centerville Medical Center
Billing Code: 76856 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 76856
- Insurance Median: $95
- Cash Discount Price: $259
- vs. Medicare Baseline: 0.89x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Mercyone Centerville Medical Center is $95. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $259. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.89x the Medicare baseline. Located in One St Joseph's Drive, Centerville, IA.
Cash / Self-Pay
$259
Average discount available for prompt cash payment at this facility.
Insurance Median
$95
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: $259 (242%)
Insurance Median: $95 (89%)
Cash: $259 (242% of Medicare)
Ins. Median: $95 (89% 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 | $21 - $274 | 20% |
| Wc Corvel | $29 - $93 | 27% |
| Aetna | $30 - $862 | 28% |
| Align Senior Care | $30 - $95 | 28% |
| Ally Align Care Adv | $30 - $95 | 28% |
| American Health Advantage Of Idaho | $30 - $95 | 28% |
| Aurora Special Needs | $30 - $95 | 28% |
| Blue Care Network Advantage | $30 - $95 | 28% |
| Blue Cross Blue Shield | $30 - $264 | 28% |
| Blue Shield - De (Highmark) Medciare Advantage | $30 - $95 | 28% |
| Care Dimensions | $30 - $95 | 28% |
| Care Improvement Plus | $30 - $95 | 28% |
| Care Resources Pace | $30 - $95 | 28% |
| Careplus Health Plans | $30 - $95 | 28% |
| Cca - Zing Health | $30 - $95 | 28% |
| Cca Senior Care Options | $30 - $95 | 28% |
| Central Valley Medical Services Corp Pace | $30 - $95 | 28% |
| Champion Health Plan Mcr Advantage | $30 - $95 | 28% |
| Champva | $30 - $94 | 28% |
| Cigna | $30 - $902 | 28% |
| Clear Spring Health | $30 - $95 | 28% |
| Clover Health | $30 - $95 | 28% |
| Commonwealth Care Alliance | $30 - $95 | 28% |
| Community Pace At Home | $30 - $95 | 28% |
| Eddy Senior Care-Pace | $30 - $95 | 28% |
| Eddy Seniorcare Pace | $30 - $95 | 28% |
| Elementcare | $30 - $95 | 28% |
| Evercare | $30 - $95 | 28% |
| Everence | $30 - $95 | 28% |
| Gateway Health Plan | $30 - $95 | 28% |
| Genesys Pace Of Genesee County | $30 - $95 | 28% |
| Georgia Health Advantage | $30 - $95 | 28% |
| Gold Advantage | $30 - $95 | 28% |
| Gpa Croell Redi Mix | $30 - $95 | 28% |
| Health America Advantra | $30 - $95 | 28% |
| Highmark Health Options Dual Plan | $30 - $95 | 28% |
| Hope Select Pace | $30 - $95 | 28% |
| Horizon Nj Total Care | $30 - $95 | 28% |
| Hudson Headwaters Pace | $30 - $95 | 28% |
| Humana | $30 - $156 | 28% |
| Huron Valley Pace | $30 - $95 | 28% |
| Innovative Integrated Health Community Plans | $30 - $95 | 28% |
| Johns Hopkins Advantage Md | $30 - $95 | 28% |
| Lasso Healthcare Msa | $30 - $95 | 28% |
| Life St Marys Pace | $30 - $95 | 28% |
| Lifecircles Pace | $30 - $95 | 28% |
| Longevity Health Plan | $30 - $95 | 28% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $30 - $95 | 28% |
| Martins Point Generations Advantage | $30 - $95 | 28% |
| Mass General Brigham Mcr Adv | $30 - $95 | 28% |
| Medicare (plans) | $30 - $277 | 28% |
| Medipak Advantage | $30 - $95 | 28% |
| Mercy Life | $30 - $95 | 28% |
| Mercyone Cedar Valley | $30 - $95 | 28% |
| Meridian Complete | $30 - $95 | 28% |
| Michigan Complete Health | $30 - $95 | 28% |
| Nascentia Health Plus | $30 - $95 | 28% |
| New Centry Health Careplus | $30 - $95 | 28% |
| Osu Prime Care Advantage | $30 - $95 | 28% |
| Pace Cny | $30 - $95 | 28% |
| Pace Iowa Immanuel Pathways | $30 - $95 | 28% |
| Pace Of Southwest Michigan | $30 - $95 | 28% |
| Pace Southeast | $30 - $95 | 28% |
| Pace-Trinity Health | $30 - $95 | 28% |
| Peak Pace Solutions | $30 - $95 | 28% |
| Perennial Advantage | $30 - $95 | 28% |
| Preferred Care Partners | $30 - $95 | 28% |
| Presbyterian Senior Plan | $30 - $95 | 28% |
| Provider Partners Health Plan Of Illinois | $30 - $95 | 28% |
| Provider Partners Health Plan Of Indiana | $30 - $95 | 28% |
| Pruitthealth Premier | $30 - $95 | 28% |
| Reliance Community Care Partners Care Resources Pace | $30 - $95 | 28% |
| Rx Allwin | $30 - $95 | 28% |
| Rx Grane Grnmedd | $30 - $95 | 28% |
| Rx Retiree Rx Care | $30 - $95 | 28% |
| Scan Health Plan Mcr Ipa Meritage Oon | $30 - $95 | 28% |
| Secure Horizons Ma Pffs | $30 - $95 | 28% |
| Serenity Pace | $30 - $95 | 28% |
| Siouxland Pace | $30 - $95 | 28% |
| Solis Health Plans | $30 - $95 | 28% |
| Sunnyview-Pace Finance Dept | $30 - $95 | 28% |
| Texan Plus | $30 - $95 | 28% |
| The Health Plan | $30 - $95 | 28% |
| Thome Pace | $30 - $95 | 28% |
| Todays Options | $30 - $95 | 28% |
| Tribute Health Plans | $30 - $95 | 28% |
| Tricare | $30 - $94 | 28% |
| Triwest Health Alliance | $30 - $94 | 28% |
| Um Health Advantage | $30 - $95 | 28% |
| Union Health Service | $30 - $95 | 28% |
| UnitedHealthcare | $30 - $920 | 28% |
| Us Family Health Plan | $30 - $94 | 28% |
| Veterans Eval Services | $30 - $94 | 28% |
| Welbe Health | $30 - $95 | 28% |
| Wellmed | $30 - $95 | 28% |
| Veterans Administration | $31 - $97 | 29% |
| American Health Plan | $32 - $100 | 30% |
| Iowa Health Advantage | $32 - $100 | 30% |
| Albany County Correctional Facility | $34 - $85 | 32% |
| Ambetter / Centene | $34 - $448 | 32% |
| Amish Mennonite | $34 - $85 | 32% |
| Ascension St. Vincent Public Safety Medical | $34 - $85 | 32% |
| Bcccp-Michigan | $34 - $85 | 32% |
| Bccp | $34 - $85 | 32% |
| Bmc Healthnet | $34 - $85 | 32% |
| Breast Grant-Connecticut | $34 - $85 | 32% |
| Broward County Dept Of Health | $34 - $85 | 32% |
| California Health And Wellness | $34 - $85 | 32% |
| Can Community Health Inc | $34 - $85 | 32% |
| Cardinal Innovations Lme | $34 - $85 | 32% |
| Care Connections Of Northern Iowa | $34 - $85 | 32% |
| Care Oregon Ohp | $34 - $85 | 32% |
| Cencal Health Plan | $34 - $85 | 32% |
| Cenpatico | $34 - $85 | 32% |
| Chhuny | $34 - $85 | 32% |
| Childrens Comm Health Plan | $34 - $85 | 32% |
| Childrens Medical Services Title 19 | $34 - $85 | 32% |
| City Of Philadelphia | $34 - $85 | 32% |
| Cmh Allegan County | $34 - $85 | 32% |
| Cmh Ausable Valley | $34 - $85 | 32% |
| Cmh Barry County | $34 - $85 | 32% |
| Cmh Bay-Arenac County | $34 - $85 | 32% |
| Cmh Berrien County | $34 - $85 | 32% |
| Cmh Cass County | $34 - $85 | 32% |
| Cmh Central Mi County | $34 - $85 | 32% |
| Cmh Clinton-Eaton-Ingham County | $34 - $85 | 32% |
| Cmh Detroit Wayne Integrated Health Network | $34 - $85 | 32% |
| Cmh Genesee County | $34 - $85 | 32% |
| Cmh Ionia County | $34 - $85 | 32% |
| Cmh Jackson County/Lifeways | $34 - $85 | 32% |
| Cmh Kalamazoo | $34 - $85 | 32% |
| Cmh Kent County | $34 - $85 | 32% |
| Cmh Lenawee County | $34 - $85 | 32% |
| Cmh Livingston County | $34 - $85 | 32% |
| Cmh Macomb | $34 - $85 | 32% |
| Cmh Misc | $34 - $85 | 32% |
| Cmh Monroe County | $34 - $85 | 32% |
| Cmh Montcalm County | $34 - $85 | 32% |
| Cmh Muskegon County | $34 - $85 | 32% |
| Cmh Newaygo County | $34 - $85 | 32% |
| Cmh North Country | $34 - $85 | 32% |
| Cmh Northern Lakes County | $34 - $85 | 32% |
| Cmh Oakland County | $34 - $85 | 32% |
| Cmh Ottawa County | $34 - $85 | 32% |
| Cmh Van Buren County | $34 - $85 | 32% |
| Cmh Washtenaw County | $34 - $85 | 32% |
| Cmh Wayne County/Carelink | $34 - $85 | 32% |
| Cmh Wayne Cty/Com Liv Svcs | $34 - $85 | 32% |
| Cmh West Mi County | $34 - $85 | 32% |
| Community Benefit Health | $34 - $85 | 32% |
| Community Care Behavorial Health | $34 - $85 | 32% |
| Community Care Partners | $34 - $85 | 32% |
| Community Health Choice | $34 - $85 | 32% |
| Connections Csp | $34 - $85 | 32% |
| County Coroner | $34 - $85 | 32% |
| County Funding Generic | $34 - $85 | 32% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund | $34 - $85 | 32% |
| Dean Wi Badgercare | $34 - $85 | 32% |
| Delaware County Department Of Health | $34 - $85 | 32% |
| Delaware First Health | $34 - $85 | 32% |
| Delta Dental Nj | $34 - $85 | 32% |
| Dph Tb Program | $34 - $85 | 32% |
| Dscc | $34 - $85 | 32% |
| Eastpointe Lme | $34 - $85 | 32% |
| Family Health Network | $34 - $85 | 32% |
| Freedom First Healthcare | $34 - $85 | 32% |
| Fresno County Ccs | $34 - $85 | 32% |
| Ghc Scw Wi Badgercare | $34 - $85 | 32% |
| Harbor Health | $34 - $85 | 32% |
| Health Safety Net | $34 - $85 | 32% |
| Healthy Blue Ne | $34 - $85 | 32% |
| Hennepin Health | $34 - $85 | 32% |
| Id County Ada | $34 - $85 | 32% |
| Id County Canyon | $34 - $85 | 32% |
| Id County Cat Fund | $34 - $85 | 32% |
| Id County Other | $34 - $85 | 32% |
| Id County Payette | $34 - $85 | 32% |
| Idaho Dept Health And Wellfare | $34 - $85 | 32% |
| Idaho Womens Health Check | $34 - $85 | 32% |
| Indiana Breast Cervical Cancer | $34 - $85 | 32% |
| Inland Empire Health Plan | $34 - $85 | 32% |
| Intercommunity Health Ohp | $34 - $85 | 32% |
| Iowa Total Care | $34 - $253 | 32% |
| Jai Medical System | $34 - $85 | 32% |
| Kern Family Health Plan | $34 - $85 | 32% |
| Keystone First | $34 - $85 | 32% |
| Keystone First Chip | $34 - $85 | 32% |
| La Care Health Plan | $34 - $85 | 32% |
| Lakeland Care Inc | $34 - $85 | 32% |
| Managed Health Services - Indiana | $34 - $85 | 32% |
| Maryland Breast & Cervical Program | $34 - $85 | 32% |
| Maryland Healthy Smiles - Scion Dental | $34 - $85 | 32% |
| Maryland Physicians Care | $34 - $85 | 32% |
| Massachusetts Behavioral Health Partnership | $34 - $85 | 32% |
| Mdwise | $34 - $85 | 32% |
| Medi-Cal | $34 - $85 | 32% |
| Medi-Cal Healthnet | $34 - $85 | 32% |
| Medstar Dc Healthy Family | $34 - $85 | 32% |
| Medstar Md Health Choice | $34 - $85 | 32% |
| Mo Home State Health Plan | $34 - $85 | 32% |
| Molina Centennial Care | $34 - $85 | 32% |
| Nascentia Health Options | $34 - $85 | 32% |
| New York Cancer Services Program | $34 - $85 | 32% |
| Nextlevel Health | $34 - $85 | 32% |
| Oregon Screenwise | $34 - $85 | 32% |
| Paramount Advantage | $34 - $85 | 32% |
| Parkland Community Health Plan | $34 - $85 | 32% |
| Partners Behavioral Lme | $34 - $85 | 32% |
| Peach State Healthplan | $34 - $85 | 32% |
| Philadelphia County Funding | $34 - $85 | 32% |
| Presbyterian Centennial Care | $34 - $85 | 32% |
| Prestige Health Choice | $34 - $85 | 32% |
| Priority Partners | $34 - $85 | 32% |
| Robert F Sing Program | $34 - $85 | 32% |
| Rx 340B Pass Along | $34 - $85 | 32% |
| Rx Assistance/Rx Manufacturer Assistance 0 Copay | $34 - $85 | 32% |
| Rx Medi-Cal | $34 - $85 | 32% |
| Rx Meridian Rx | $34 - $85 | 32% |
| Ryan White Florida Mssrp | $34 - $85 | 32% |
| Sandhills Center Lme | $34 - $85 | 32% |
| Screening For Life | $34 - $85 | 32% |
| St Joseph County Hlth Dpt | $34 - $85 | 32% |
| Stephenson Cty Health | $34 - $109 | 32% |
| Sunshine State Health Plan | $34 - $85 | 32% |
| Superior Health | $34 - $85 | 32% |
| Tenncare | $34 - $85 | 32% |
| Texas Children'S Health Plan | $34 - $85 | 32% |
| Trillium Community Ohp | $34 - $85 | 32% |
| Tufts Health Public Plans | $34 - $85 | 32% |
| Vaya Health Lme | $34 - $85 | 32% |
| Washtenaw Health Plan | $34 - $85 | 32% |
| Wellsense Health Plan | $34 - $85 | 32% |
| Wi Womens Wellness | $34 - $85 | 32% |
| Wellpoint | $35 - $88 | 33% |
| Amish Hospital Aid | $41 - $355 | 38% |
| Amps | $42 - $132 | 39% |
| Avera | $47 - $156 | 44% |
| Medical Associates | $52 - $703 | 49% |
| Sanford Health Plan | $52 - $169 | 49% |
| Oscar | $55 - $174 | 51% |
| Ucare | $55 - $186 | 51% |
| Lucent Health | $56 - $862 | 52% |
| Health Partners | $57 - $885 | 53% |
| Health Smart | $57 - $180 | 53% |
| Bcn Domestic | $58 - $186 | 54% |
| Blue Benefit Administrators Of Massachusetts | $58 - $186 | 54% |
| Blue Care Network | $58 - $186 | 54% |
| Blue Distinction Transplant | $58 - $186 | 54% |
| Blue Shield - Ca | $58 - $186 | 54% |
| Blue Shield - Id (Regence) | $58 - $186 | 54% |
| Blue Shield - Ny Highmark Northeastern | $58 - $186 | 54% |
| Blue Shield - Ny Highmark Western | $58 - $186 | 54% |
| Blue Shield - Pa (Highmark) | $58 - $186 | 54% |
| Blue Shield - Wa (Regence) | $58 - $186 | 54% |
| Centivo | $58 - $184 | 54% |
| Health Choices | $58 - $703 | 54% |
| Kaiser Domestic | $58 - $186 | 54% |
| Meritain | $58 - $862 | 54% |
| Pre-Employment | $58 - $186 | 54% |
| Wc Domestic | $58 - $186 | 54% |
| Quiktrip | $60 - $190 | 56% |
| Usa Managed Care | $60 - $189 | 56% |
| Claimdoc | $64 - $536 | 60% |
| Geha | $65 - $662 | 61% |
| The Alliance | $65 - $205 | 61% |
| Preferred One | $66 - $218 | 62% |
| Global Excel | $70 - $220 | 66% |
| Nebraska Total Care | $72 - $274 | 67% |
| Velocity | $73 - $229 | 68% |
| Newton Correctional Facility | $74 - $195 | 69% |
| Allied Benefit Systems | $83 - $862 | 78% |
| Auxiant | $83 - $902 | 78% |
| First Choice Health | $83 - $269 | 78% |
| Group Administrators | $83 - $269 | 78% |
| Midlands | $83 - $902 | 78% |
| Midlands Choice | $83 - $902 | 78% |
| Genex Wc | $86 - $225 | 81% |
| Wc Align Network | $91 - $240 | 85% |
| Wc Praxis Health Network | $97 - $255 | 91% |
| Wc Reny Company | $99 - $261 | 93% |
| Wc Velocity | $99 - $261 | 93% |
| Auto Velocity | $103 - $270 | 96% |
| Wc O'Hara Corp | $103 - $270 | 96% |
| Multiplan | $113 - $300 | 106% |
| Andrie Inc | $114 - $300 | 107% |
| East Greenbush Central School District | $114 - $300 | 107% |
| Healthsmart Workers Comp | $114 - $300 | 107% |
| Iowa Dept Of Public Health | $114 - $920 | 107% |
| Jag Source | $114 - $300 | 107% |
| New York State Insurance Fund | $114 - $300 | 107% |
| Njm Insurance Group | $114 - $300 | 107% |
| Rx Heatlhcomp | $114 - $300 | 107% |
| Rx Restat | $114 - $300 | 107% |
| Rx Saif Opdp Wc | $114 - $300 | 107% |
| Rx Worker'S Comp | $114 - $300 | 107% |
| Wc Accident Fund | $114 - $300 | 107% |
| Wc Ace | $114 - $300 | 107% |
| Wc Acs Federal Employees | $114 - $300 | 107% |
| Wc Acuity | $114 - $300 | 107% |
| Wc Advantage | $114 - $300 | 107% |
| Wc Aegis | $114 - $300 | 107% |
| Wc Aig | $114 - $300 | 107% |
| Wc Aims | $114 - $300 | 107% |
| Wc Alaska National Ins | $114 - $300 | 107% |
| Wc Allied | $114 - $300 | 107% |
| Wc Am Trust N America | $114 - $300 | 107% |
| Wc American Claims Mgmt | $114 - $300 | 107% |
| Wc Amerisure | $114 - $300 | 107% |
| Wc Amtrust | $114 - $300 | 107% |
| Wc Asu Risk Mgt | $114 - $300 | 107% |
| Wc Benetech | $114 - $300 | 107% |
| Wc Berkley Admin | $114 - $300 | 107% |
| Wc Broadspire | $114 - $300 | 107% |
| Wc Broward County | $114 - $300 | 107% |
| Wc Bunch & Associates | $114 - $300 | 107% |
| Wc California State Comp Ins | $114 - $300 | 107% |
| Wc California State Ins Fund | $114 - $300 | 107% |
| Wc Capitol Area Health Consortium | $114 - $300 | 107% |
| Wc Ccmsi | $114 - $300 | 107% |
| Wc Chartis | $114 - $300 | 107% |
| Wc Chubb | $114 - $300 | 107% |
| Wc Cirma | $114 - $300 | 107% |
| Wc City Of Albany | $114 - $300 | 107% |
| Wc City Of Sioux City | $114 - $300 | 107% |
| Wc Claims Mgmt Inc | $114 - $300 | 107% |
| Wc Cna | $114 - $300 | 107% |
| Wc Comp One Admin C/O Manageability | $114 - $300 | 107% |
| Wc Compone Admin | $114 - $300 | 107% |
| Wc Ct Healthcare Trust | $114 - $300 | 107% |
| Wc Donegal Insurance Group | $114 - $300 | 107% |
| Wc Emc Insurance Company | $114 - $300 | 107% |
| Wc Employee Mutual | $114 - $300 | 107% |
| Wc Enablecomp | $114 - $300 | 107% |
| Wc Encore Health Network | $114 - $300 | 107% |
| Wc Erie | $114 - $300 | 107% |
| Wc Esis | $114 - $300 | 107% |
| Wc Evolutions | $114 - $300 | 107% |
| Wc Fcci | $114 - $300 | 107% |
| Wc Fed Ex | $114 - $300 | 107% |
| Wc Federal Black Lung | $114 - $300 | 107% |
| Wc Federated | $114 - $300 | 107% |
| Wc Finley Occupational Health | $114 - $300 | 107% |
| Wc First Agency/Occunet | $114 - $300 | 107% |
| Wc Ford Motor | $114 - $300 | 107% |
| Wc Fresno Unified Emp | $114 - $300 | 107% |
| Wc Gallagher Bassett | $114 - $300 | 107% |
| Wc General Motors | $114 - $300 | 107% |
| Wc Generic | $114 - $300 | 107% |
| Wc Genex Care For Ohio | $114 - $300 | 107% |
| Wc Great West Casualty | $114 - $300 | 107% |
| Wc Guarantee Insurance | $114 - $300 | 107% |
| Wc Guard Insurance Company | $114 - $300 | 107% |
| Wc Hab | $114 - $300 | 107% |
| Wc Hartford | $114 - $300 | 107% |
| Wc Hastings | $114 - $300 | 107% |
| Wc Health Management | $114 - $300 | 107% |
| Wc Heritage Summit | $114 - $300 | 107% |
| Wc Hireright | $114 - $300 | 107% |
| Wc Horizon | $114 - $300 | 107% |
| Wc Icw Group | $114 - $300 | 107% |
| Wc Idaho State Ins Fund | $114 - $300 | 107% |
| Wc Intercare Insurance | $114 - $300 | 107% |
| Wc Intermountain | $114 - $300 | 107% |
| Wc Johns Eastern | $114 - $300 | 107% |
| Wc Kemberton | $114 - $300 | 107% |
| Wc Key Ins & Benefit Solutions | $114 - $300 | 107% |
| Wc Liberty Mutual | $114 - $300 | 107% |
| Wc Mac Risk Management | $114 - $300 | 107% |
| Wc Massachusetts | $114 - $300 | 107% |
| Wc Mdia | $114 - $300 | 107% |
| Wc Meadowbrook Claim | $114 - $300 | 107% |
| Wc Medical Administrators | $114 - $300 | 107% |
| Wc Meijers | $114 - $300 | 107% |
| Wc Memic | $114 - $300 | 107% |
| Wc Mercy Workcare | $114 - $300 | 107% |
| Wc Michigan | $114 - $300 | 107% |
| Wc Michigan Millers Mutual | $114 - $300 | 107% |
| Wc Mitchell Frankenmuth | $114 - $300 | 107% |
| Wc Mra | $114 - $300 | 107% |
| Wc Nationwide | $114 - $300 | 107% |
| Wc Nca Comp | $114 - $300 | 107% |
| Wc New York | $114 - $300 | 107% |
| Wc New York Special Funds | $114 - $300 | 107% |
| Wc North American Rishces | $114 - $300 | 107% |
| Wc Northeast Health | $114 - $300 | 107% |
| Wc Notre Dame | $114 - $300 | 107% |
| Wc Novanet | $114 - $300 | 107% |
| Wc Occ Health Allen | $114 - $300 | 107% |
| Wc Ohio Bureau | $114 - $300 | 107% |
| Wc One Call Medical | $114 - $300 | 107% |
| Wc Paradigm | $114 - $300 | 107% |
| Wc Peerless | $114 - $300 | 107% |
| Wc Pma | $114 - $300 | 107% |
| Wc Price Chopper | $114 - $300 | 107% |
| Wc Procura Management | $114 - $300 | 107% |
| Wc Qualcare | $114 - $300 | 107% |
| Wc Quiktrip | $114 - $300 | 107% |
| Wc Rev Claims | $114 - $300 | 107% |
| Wc Risico | $114 - $300 | 107% |
| Wc Rural Mutual | $114 - $300 | 107% |
| Wc Saif Oregon | $114 - $300 | 107% |
| Wc Secura | $114 - $300 | 107% |
| Wc Sedgwick | $114 - $300 | 107% |
| Wc Sentry | $114 - $300 | 107% |
| Wc Sheakley Unicomp | $114 - $300 | 107% |
| Wc Smile Lodge | $114 - $300 | 107% |
| Wc Society | $114 - $300 | 107% |
| Wc Srs | $114 - $300 | 107% |
| Wc Taconic (Mro) | $114 - $300 | 107% |
| Wc Taconic Farms | $114 - $300 | 107% |
| Wc Travelers | $114 - $300 | 107% |
| Wc Triad Group | $114 - $300 | 107% |
| Wc Tristar | $114 - $300 | 107% |
| Wc Troy Ny | $114 - $300 | 107% |
| Wc Tyson | $114 - $300 | 107% |
| Wc Unified Health Services | $114 - $300 | 107% |
| Wc United Heartland | $114 - $300 | 107% |
| Wc Us Dept Of Labor | $114 - $300 | 107% |
| Wc Walmart | $114 - $300 | 107% |
| Wc West Bend | $114 - $300 | 107% |
| Wc West Bend Mutual/Argent | $114 - $300 | 107% |
| Wc Winnebago Industries | $114 - $300 | 107% |
| Wc Yankee Trails | $114 - $300 | 107% |
| Wc York Risk | $114 - $300 | 107% |
| Wc Zenith | $114 - $300 | 107% |
| Wc Zurich | $114 - $300 | 107% |
| Nova | $536 | 502% |
| 1199 National Benefit Fund | $862 | 807% |
| Asr Health Benefits | $862 | 807% |
| Christian Brother Services | $862 | 807% |
| Coventry | $862 | 807% |
| First Health | $862 | 807% |
| Luminare Health | $862 | 807% |
| Medical Mutual | $862 | 807% |
| Trustmark Small Business Benefits | $862 | 807% |
| Webtpa | $862 | 807% |
| Medica | $902 | 844% |
| Crime Victim Assistance | $920 | 861% |