CMS Price Transparency Data
Office visit, established patient (30-39 min)
Facility: Saint Joseph Regional Medical Center - Plymouth
Billing Code: 99214 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 99214
- Insurance Median: $118
- Cash Discount Price: $241
- vs. Medicare Baseline: 0.87x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Saint Joseph Regional Medical Center - Plymouth is $118. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $241. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.87x the Medicare baseline. Located in 1915 Lake Ave, Plymouth, IN.
Cash / Self-Pay
$241
Average discount available for prompt cash payment at this facility.
Insurance Median
$118
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$135.6
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $135.6 (100%)
Cash / Self-Pay: $241 (178%)
Insurance Median: $118 (87%)
Cash: $241 (178% of Medicare)
Ins. Median: $118 (87% of Medicare)
Understanding this gauge: We use the federal Medicare rate of $135.6 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 | $66 - $118 | 49% |
| Aetna | $79 - $168 | 58% |
| Align Senior Care | $79 - $126 | 58% |
| Ally Align Care Adv | $79 - $126 | 58% |
| American Health Advantage Of Idaho | $79 - $126 | 58% |
| American Health Plan | $79 - $126 | 58% |
| Aurora Special Needs | $79 - $126 | 58% |
| Blue Care Network Advantage | $79 - $126 | 58% |
| Blue Cross Blue Shield | $79 - $142 | 58% |
| Blue Shield - De (Highmark) Medciare Advantage | $79 - $126 | 58% |
| Care Dimensions | $79 - $126 | 58% |
| Care Improvement Plus | $79 - $126 | 58% |
| Care Resources Pace | $79 - $126 | 58% |
| Careplus Health Plans | $79 - $126 | 58% |
| Cca - Zing Health | $79 - $126 | 58% |
| Cca Senior Care Options | $79 - $126 | 58% |
| Central Valley Medical Services Corp Pace | $79 - $126 | 58% |
| Champion Health Plan Mcr Advantage | $79 - $126 | 58% |
| Cigna | $79 - $189 | 58% |
| Clear Spring Health | $79 - $126 | 58% |
| Clover Health | $79 - $126 | 58% |
| Commonwealth Care Alliance | $79 - $126 | 58% |
| Community Pace At Home | $79 - $126 | 58% |
| Eddy Senior Care-Pace | $79 - $126 | 58% |
| Eddy Seniorcare Pace | $79 - $126 | 58% |
| Elementcare | $79 - $126 | 58% |
| Evercare | $79 - $126 | 58% |
| Everence | $79 - $126 | 58% |
| Gateway Health Plan | $79 - $126 | 58% |
| Genesys Pace Of Genesee County | $79 - $126 | 58% |
| Georgia Health Advantage | $79 - $126 | 58% |
| Gold Advantage | $79 - $126 | 58% |
| Gpa Croell Redi Mix | $79 - $126 | 58% |
| Health America Advantra | $79 - $126 | 58% |
| Highmark Health Options Dual Plan | $79 - $126 | 58% |
| Hope Select Pace | $79 - $126 | 58% |
| Horizon Nj Total Care | $79 - $126 | 58% |
| Hudson Headwaters Pace | $79 - $126 | 58% |
| Humana | $79 - $126 | 58% |
| Huron Valley Pace | $79 - $126 | 58% |
| Innovative Integrated Health Community Plans | $79 - $126 | 58% |
| Iowa Health Advantage | $79 - $126 | 58% |
| Johns Hopkins Advantage Md | $79 - $126 | 58% |
| Lasso Healthcare Msa | $79 - $126 | 58% |
| Life St Marys Pace | $79 - $126 | 58% |
| Lifecircles Pace | $79 - $126 | 58% |
| Longevity Health Plan | $79 - $126 | 58% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $79 - $126 | 58% |
| Martins Point Generations Advantage | $79 - $126 | 58% |
| Mass General Brigham Mcr Adv | $79 - $126 | 58% |
| Medicare (plans) | $79 - $131 | 58% |
| Medipak Advantage | $79 - $126 | 58% |
| Mercy Life | $79 - $126 | 58% |
| Mercyone Cedar Valley | $79 - $126 | 58% |
| Meridian Complete | $79 - $126 | 58% |
| Michigan Complete Health | $79 - $126 | 58% |
| Nascentia Health Plus | $79 - $126 | 58% |
| New Centry Health Careplus | $79 - $126 | 58% |
| Osu Prime Care Advantage | $79 - $126 | 58% |
| Pace Cny | $79 - $126 | 58% |
| Pace Iowa Immanuel Pathways | $79 - $126 | 58% |
| Pace Of Southwest Michigan | $79 - $126 | 58% |
| Pace Southeast | $79 - $126 | 58% |
| Pace-Trinity Health | $79 - $126 | 58% |
| Peak Pace Solutions | $79 - $126 | 58% |
| Perennial Advantage | $79 - $126 | 58% |
| Preferred Care Partners | $79 - $126 | 58% |
| Presbyterian Senior Plan | $79 - $126 | 58% |
| Provider Partners Health Plan Of Illinois | $79 - $126 | 58% |
| Pruitthealth Premier | $79 - $126 | 58% |
| Reliance Community Care Partners Care Resources Pace | $79 - $126 | 58% |
| Rx Allwin | $79 - $126 | 58% |
| Rx Grane Grnmedd | $79 - $126 | 58% |
| Rx Retiree Rx Care | $79 - $126 | 58% |
| Scan Health Plan Mcr Ipa Meritage Oon | $79 - $126 | 58% |
| Secure Horizons Ma Pffs | $79 - $126 | 58% |
| Serenity Pace | $79 - $126 | 58% |
| Siouxland Pace | $79 - $126 | 58% |
| Solis Health Plans | $79 - $126 | 58% |
| Sunnyview-Pace Finance Dept | $79 - $126 | 58% |
| Texan Plus | $79 - $126 | 58% |
| The Health Plan | $79 - $126 | 58% |
| Thome Pace | $79 - $126 | 58% |
| Todays Options | $79 - $126 | 58% |
| Tribute Health Plans | $79 - $126 | 58% |
| Um Health Advantage | $79 - $126 | 58% |
| Union Health Service | $79 - $126 | 58% |
| UnitedHealthcare | $79 - $158 | 58% |
| Welbe Health | $79 - $126 | 58% |
| Wellmed | $79 - $126 | 58% |
| Andrie Inc | $81 - $128 | 60% |
| East Greenbush Central School District | $81 - $128 | 60% |
| Genex Wc | $81 - $128 | 60% |
| Healthsmart Workers Comp | $81 - $128 | 60% |
| Jag Source | $81 - $128 | 60% |
| New York State Insurance Fund | $81 - $128 | 60% |
| Njm Insurance Group | $81 - $128 | 60% |
| Rx Heatlhcomp | $81 - $128 | 60% |
| Rx Restat | $81 - $128 | 60% |
| Rx Saif Opdp Wc | $81 - $128 | 60% |
| Rx Worker'S Comp | $81 - $128 | 60% |
| Veterans Administration | $81 - $128 | 60% |
| Wc Accident Fund | $81 - $128 | 60% |
| Wc Ace | $81 - $128 | 60% |
| Wc Acs Federal Employees | $81 - $128 | 60% |
| Wc Acuity | $81 - $128 | 60% |
| Wc Advantage | $81 - $128 | 60% |
| Wc Aegis | $81 - $128 | 60% |
| Wc Aig | $81 - $128 | 60% |
| Wc Aims | $81 - $128 | 60% |
| Wc Alaska National Ins | $81 - $128 | 60% |
| Wc Align Network | $81 - $128 | 60% |
| Wc Allied | $81 - $128 | 60% |
| Wc Am Trust N America | $81 - $128 | 60% |
| Wc American Claims Mgmt | $81 - $128 | 60% |
| Wc Amerisure | $81 - $128 | 60% |
| Wc Amtrust | $81 - $128 | 60% |
| Wc Asu Risk Mgt | $81 - $128 | 60% |
| Wc Benetech | $81 - $128 | 60% |
| Wc Berkley Admin | $81 - $128 | 60% |
| Wc Broadspire | $81 - $128 | 60% |
| Wc Broward County | $81 - $128 | 60% |
| Wc Bunch & Associates | $81 - $128 | 60% |
| Wc California State Comp Ins | $81 - $128 | 60% |
| Wc California State Ins Fund | $81 - $128 | 60% |
| Wc Capitol Area Health Consortium | $81 - $128 | 60% |
| Wc Ccmsi | $81 - $128 | 60% |
| Wc Chartis | $81 - $128 | 60% |
| Wc Chubb | $81 - $128 | 60% |
| Wc Cirma | $81 - $128 | 60% |
| Wc City Of Albany | $81 - $128 | 60% |
| Wc City Of Sioux City | $81 - $128 | 60% |
| Wc Claims Mgmt Inc | $81 - $128 | 60% |
| Wc Cna | $81 - $128 | 60% |
| Wc Comp One Admin C/O Manageability | $81 - $128 | 60% |
| Wc Compone Admin | $81 - $128 | 60% |
| Wc Corvel | $81 - $128 | 60% |
| Wc Ct Healthcare Trust | $81 - $128 | 60% |
| Wc Donegal Insurance Group | $81 - $128 | 60% |
| Wc Emc Insurance Company | $81 - $128 | 60% |
| Wc Employee Mutual | $81 - $128 | 60% |
| Wc Enablecomp | $81 - $128 | 60% |
| Wc Erie | $81 - $128 | 60% |
| Wc Esis | $81 - $128 | 60% |
| Wc Evolutions | $81 - $128 | 60% |
| Wc Fcci | $81 - $128 | 60% |
| Wc Fed Ex | $81 - $128 | 60% |
| Wc Federal Black Lung | $81 - $128 | 60% |
| Wc Federated | $81 - $128 | 60% |
| Wc Finley Occupational Health | $81 - $128 | 60% |
| Wc First Agency/Occunet | $81 - $128 | 60% |
| Wc Ford Motor | $81 - $128 | 60% |
| Wc Fresno Unified Emp | $81 - $128 | 60% |
| Wc Gallagher Bassett | $81 - $128 | 60% |
| Wc General Motors | $81 - $128 | 60% |
| Wc Generic | $81 - $128 | 60% |
| Wc Genex Care For Ohio | $81 - $128 | 60% |
| Wc Great West Casualty | $81 - $128 | 60% |
| Wc Guarantee Insurance | $81 - $128 | 60% |
| Wc Guard Insurance Company | $81 - $128 | 60% |
| Wc Hab | $81 - $128 | 60% |
| Wc Hartford | $81 - $128 | 60% |
| Wc Hastings | $81 - $128 | 60% |
| Wc Health Management | $81 - $128 | 60% |
| Wc Heritage Summit | $81 - $128 | 60% |
| Wc Hireright | $81 - $128 | 60% |
| Wc Horizon | $81 - $128 | 60% |
| Wc Icw Group | $81 - $128 | 60% |
| Wc Idaho State Ins Fund | $81 - $128 | 60% |
| Wc Intercare Insurance | $81 - $128 | 60% |
| Wc Intermountain | $81 - $128 | 60% |
| Wc Johns Eastern | $81 - $128 | 60% |
| Wc Kemberton | $81 - $128 | 60% |
| Wc Key Ins & Benefit Solutions | $81 - $128 | 60% |
| Wc Liberty Mutual | $81 - $128 | 60% |
| Wc Mac Risk Management | $81 - $128 | 60% |
| Wc Massachusetts | $81 - $128 | 60% |
| Wc Mdia | $81 - $128 | 60% |
| Wc Meadowbrook Claim | $81 - $128 | 60% |
| Wc Medical Administrators | $81 - $128 | 60% |
| Wc Meijers | $81 - $128 | 60% |
| Wc Memic | $81 - $128 | 60% |
| Wc Mercy Workcare | $81 - $128 | 60% |
| Wc Michigan | $81 - $128 | 60% |
| Wc Michigan Millers Mutual | $81 - $128 | 60% |
| Wc Mitchell Frankenmuth | $81 - $128 | 60% |
| Wc Mra | $81 - $128 | 60% |
| Wc Nationwide | $81 - $128 | 60% |
| Wc Nca Comp | $81 - $128 | 60% |
| Wc New York | $81 - $128 | 60% |
| Wc New York Special Funds | $81 - $128 | 60% |
| Wc North American Rishces | $81 - $128 | 60% |
| Wc Northeast Health | $81 - $128 | 60% |
| Wc Notre Dame | $81 - $128 | 60% |
| Wc Novanet | $81 - $128 | 60% |
| Wc O'Hara Corp | $81 - $128 | 60% |
| Wc Occ Health Allen | $81 - $128 | 60% |
| Wc Ohio Bureau | $81 - $128 | 60% |
| Wc One Call Medical | $81 - $128 | 60% |
| Wc Paradigm | $81 - $128 | 60% |
| Wc Peerless | $81 - $128 | 60% |
| Wc Pma | $81 - $128 | 60% |
| Wc Praxis Health Network | $81 - $128 | 60% |
| Wc Price Chopper | $81 - $128 | 60% |
| Wc Procura Management | $81 - $128 | 60% |
| Wc Qualcare | $81 - $128 | 60% |
| Wc Quiktrip | $81 - $128 | 60% |
| Wc Reny Company | $81 - $128 | 60% |
| Wc Rev Claims | $81 - $128 | 60% |
| Wc Risico | $81 - $128 | 60% |
| Wc Rural Mutual | $81 - $128 | 60% |
| Wc Saif Oregon | $81 - $128 | 60% |
| Wc Secura | $81 - $128 | 60% |
| Wc Sedgwick | $81 - $128 | 60% |
| Wc Sentry | $81 - $128 | 60% |
| Wc Sheakley Unicomp | $81 - $128 | 60% |
| Wc Smile Lodge | $81 - $128 | 60% |
| Wc Society | $81 - $128 | 60% |
| Wc Srs | $81 - $128 | 60% |
| Wc Taconic (Mro) | $81 - $128 | 60% |
| Wc Taconic Farms | $81 - $128 | 60% |
| Wc Travelers | $81 - $128 | 60% |
| Wc Triad Group | $81 - $128 | 60% |
| Wc Tristar | $81 - $128 | 60% |
| Wc Troy Ny | $81 - $128 | 60% |
| Wc Tyson | $81 - $128 | 60% |
| Wc Unified Health Services | $81 - $128 | 60% |
| Wc United Heartland | $81 - $128 | 60% |
| Wc Us Dept Of Labor | $81 - $128 | 60% |
| Wc Velocity | $81 - $128 | 60% |
| Wc Walmart | $81 - $128 | 60% |
| Wc West Bend | $81 - $128 | 60% |
| Wc West Bend Mutual/Argent | $81 - $128 | 60% |
| Wc Winnebago Industries | $81 - $128 | 60% |
| Wc Yankee Trails | $81 - $128 | 60% |
| Wc York Risk | $81 - $128 | 60% |
| Wc Zenith | $81 - $128 | 60% |
| Wc Zurich | $81 - $128 | 60% |
| Albany County Correctional Facility | $89 - $118 | 66% |
| Ambetter / Centene | $89 - $118 | 66% |
| Amish Mennonite | $89 - $118 | 66% |
| Ascension St. Vincent Public Safety Medical | $89 - $118 | 66% |
| Bcccp-Michigan | $89 - $118 | 66% |
| Bccp | $89 - $118 | 66% |
| Bmc Healthnet | $89 - $118 | 66% |
| Breast Grant-Connecticut | $89 - $118 | 66% |
| Broward County Dept Of Health | $89 - $118 | 66% |
| California Health And Wellness | $89 - $118 | 66% |
| Cardinal Innovations Lme | $89 - $118 | 66% |
| Care Connections Of Northern Iowa | $89 - $118 | 66% |
| Care Oregon Ohp | $89 - $118 | 66% |
| Cencal Health Plan | $89 - $118 | 66% |
| Cenpatico | $89 - $118 | 66% |
| Champva | $89 - $118 | 66% |
| Chhuny | $89 - $118 | 66% |
| Childrens Comm Health Plan | $89 - $118 | 66% |
| Childrens Medical Services Title 19 | $89 - $118 | 66% |
| City Of Philadelphia | $89 - $118 | 66% |
| Cmh Allegan County | $89 - $118 | 66% |
| Cmh Ausable Valley | $89 - $118 | 66% |
| Cmh Barry County | $89 - $118 | 66% |
| Cmh Bay-Arenac County | $89 - $118 | 66% |
| Cmh Berrien County | $89 - $118 | 66% |
| Cmh Cass County | $89 - $118 | 66% |
| Cmh Central Mi County | $89 - $118 | 66% |
| Cmh Clinton-Eaton-Ingham County | $89 - $118 | 66% |
| Cmh Detroit Wayne Integrated Health Network | $89 - $118 | 66% |
| Cmh Genesee County | $89 - $118 | 66% |
| Cmh Ionia County | $89 - $118 | 66% |
| Cmh Jackson County/Lifeways | $89 - $118 | 66% |
| Cmh Kalamazoo | $89 - $118 | 66% |
| Cmh Kent County | $89 - $118 | 66% |
| Cmh Lenawee County | $89 - $118 | 66% |
| Cmh Livingston County | $89 - $118 | 66% |
| Cmh Macomb | $89 - $118 | 66% |
| Cmh Misc | $89 - $118 | 66% |
| Cmh Monroe County | $89 - $118 | 66% |
| Cmh Montcalm County | $89 - $118 | 66% |
| Cmh Muskegon County | $89 - $118 | 66% |
| Cmh Newaygo County | $89 - $118 | 66% |
| Cmh North Country | $89 - $118 | 66% |
| Cmh Northern Lakes County | $89 - $118 | 66% |
| Cmh Oakland County | $89 - $118 | 66% |
| Cmh Ottawa County | $89 - $118 | 66% |
| Cmh Van Buren County | $89 - $118 | 66% |
| Cmh Washtenaw County | $89 - $118 | 66% |
| Cmh Wayne County/Carelink | $89 - $118 | 66% |
| Cmh Wayne Cty/Com Liv Svcs | $89 - $118 | 66% |
| Cmh West Mi County | $89 - $118 | 66% |
| Community Benefit Health | $89 - $118 | 66% |
| Community Care Behavorial Health | $89 - $118 | 66% |
| Community Care Partners | $89 - $118 | 66% |
| Community Health Choice | $89 - $118 | 66% |
| Connections Csp | $89 - $118 | 66% |
| County Coroner | $89 - $118 | 66% |
| County Funding Generic | $89 - $118 | 66% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund | $89 - $118 | 66% |
| Dean Wi Badgercare | $89 - $118 | 66% |
| Delaware County Department Of Health | $89 - $118 | 66% |
| Delaware First Health | $89 - $118 | 66% |
| Delta Dental Nj | $89 - $118 | 66% |
| Dph Tb Program | $89 - $118 | 66% |
| Dscc | $89 - $118 | 66% |
| Eastpointe Lme | $89 - $118 | 66% |
| Family Health Network | $89 - $118 | 66% |
| Freedom First Healthcare | $89 - $118 | 66% |
| Fresno County Ccs | $89 - $118 | 66% |
| Ghc Scw Wi Badgercare | $89 - $118 | 66% |
| Harbor Health | $89 - $118 | 66% |
| Health Safety Net | $89 - $118 | 66% |
| Healthy Blue Ne | $89 - $118 | 66% |
| Hennepin Health | $89 - $118 | 66% |
| Id County Ada | $89 - $118 | 66% |
| Id County Canyon | $89 - $118 | 66% |
| Id County Cat Fund | $89 - $118 | 66% |
| Id County Other | $89 - $118 | 66% |
| Id County Payette | $89 - $118 | 66% |
| Idaho Dept Health And Wellfare | $89 - $118 | 66% |
| Idaho Womens Health Check | $89 - $118 | 66% |
| Indiana Breast Cervical Cancer | $89 - $118 | 66% |
| Inland Empire Health Plan | $89 - $118 | 66% |
| Intercommunity Health Ohp | $89 - $118 | 66% |
| Iowa Total Care | $89 - $118 | 66% |
| Jai Medical System | $89 - $118 | 66% |
| Kern Family Health Plan | $89 - $118 | 66% |
| Keystone First | $89 - $118 | 66% |
| Keystone First Chip | $89 - $118 | 66% |
| La Care Health Plan | $89 - $118 | 66% |
| Lakeland Care Inc | $89 - $118 | 66% |
| Managed Health Services - Indiana | $89 - $118 | 66% |
| Maryland Breast & Cervical Program | $89 - $118 | 66% |
| Maryland Healthy Smiles - Scion Dental | $89 - $118 | 66% |
| Maryland Physicians Care | $89 - $118 | 66% |
| Massachusetts Behavioral Health Partnership | $89 - $118 | 66% |
| Mdwise | $89 - $118 | 66% |
| Medi-Cal | $89 - $118 | 66% |
| Medi-Cal Healthnet | $89 - $118 | 66% |
| Medstar Dc Healthy Family | $89 - $118 | 66% |
| Medstar Md Health Choice | $89 - $118 | 66% |
| Mo Home State Health Plan | $89 - $118 | 66% |
| Molina Centennial Care | $89 - $118 | 66% |
| Nascentia Health Options | $89 - $118 | 66% |
| Nebraska Total Care | $89 - $118 | 66% |
| New York Cancer Services Program | $89 - $118 | 66% |
| Nextlevel Health | $89 - $118 | 66% |
| Oregon Screenwise | $89 - $118 | 66% |
| Paramount Advantage | $89 - $118 | 66% |
| Parkland Community Health Plan | $89 - $118 | 66% |
| Partners Behavioral Lme | $89 - $118 | 66% |
| Peach State Healthplan | $89 - $118 | 66% |
| Philadelphia County Funding | $89 - $118 | 66% |
| Presbyterian Centennial Care | $89 - $118 | 66% |
| Prestige Health Choice | $89 - $118 | 66% |
| Priority Partners | $89 - $118 | 66% |
| Provider Partners Health Plan Of Indiana | $89 - $141 | 66% |
| Robert F Sing Program | $89 - $118 | 66% |
| Rx 340B Pass Along | $89 - $118 | 66% |
| Rx Assistance/Rx Manufacturer Assistance 0 Copay | $89 - $118 | 66% |
| Rx Medi-Cal | $89 - $118 | 66% |
| Rx Meridian Rx | $89 - $118 | 66% |
| Ryan White Florida Mssrp | $89 - $118 | 66% |
| Sandhills Center Lme | $89 - $118 | 66% |
| Screening For Life | $89 - $118 | 66% |
| St Joseph County Hlth Dpt | $89 - $118 | 66% |
| Stephenson Cty Health | $89 - $118 | 66% |
| Sunshine State Health Plan | $89 - $118 | 66% |
| Superior Health | $89 - $118 | 66% |
| Tenncare | $89 - $118 | 66% |
| Texas Children'S Health Plan | $89 - $118 | 66% |
| Tricare | $89 - $118 | 66% |
| Trillium Community Ohp | $89 - $118 | 66% |
| Triwest Health Alliance | $89 - $118 | 66% |
| Tufts Health Public Plans | $89 - $118 | 66% |
| Us Family Health Plan | $89 - $118 | 66% |
| Vaya Health Lme | $89 - $118 | 66% |
| Veterans Eval Services | $89 - $118 | 66% |
| Washtenaw Health Plan | $89 - $118 | 66% |
| Wellsense Health Plan | $89 - $118 | 66% |
| Wi Womens Wellness | $89 - $118 | 66% |
| Caresource | $105 - $167 | 77% |
| Christian Brother Services | $106 - $168 | 78% |
| Meritain | $106 - $168 | 78% |
| Preferred One | $106 - $168 | 78% |
| Geha | $117 - $158 | 86% |
| Ameriben | $121 - $164 | 89% |
| Bcn Domestic | $123 - $142 | 91% |
| Blue Benefit Administrators Of Massachusetts | $123 - $142 | 91% |
| Blue Care Network | $123 - $142 | 91% |
| Blue Distinction Transplant | $123 - $142 | 91% |
| Blue Shield - Ca | $123 - $142 | 91% |
| Blue Shield - Id (Regence) | $123 - $142 | 91% |
| Blue Shield - Ny Highmark Northeastern | $123 - $142 | 91% |
| Blue Shield - Ny Highmark Western | $123 - $142 | 91% |
| Blue Shield - Pa (Highmark) | $123 - $142 | 91% |
| Blue Shield - Wa (Regence) | $123 - $142 | 91% |
| Health Choices | $123 - $142 | 91% |
| Kaiser Domestic | $123 - $142 | 91% |
| Pre-Employment | $123 - $142 | 91% |
| Wc Domestic | $123 - $142 | 91% |
| Community Health Alliance | $125 - $138 | 92% |
| Allied Benefit Systems | $134 - $178 | 99% |
| Auxiant | $134 - $189 | 99% |
| Benefit Administrative Systems,Llc | $134 - $178 | 99% |
| Custom Design Benefits | $134 - $178 | 99% |
| Encore Health | $134 - $189 | 99% |
| Key Benefit Administrator | $134 - $178 | 99% |
| Luminare Health (Detroit) | $134 - $178 | 99% |
| Physicians Health Plan Northern Indiana Health Insurance | $134 - $178 | 99% |
| Sagamore Health Network | $143 - $189 | 105% |
| Signature Care | $143 - $189 | 105% |
| Wc Encore Health Network | $175 | 129% |
| Phcs | $186 - $247 | 137% |
| Plain Church Group | $207 - $274 | 153% |