CMS Price Transparency Data
New patient office visit (30-44 min)
Facility: Mercy Health Lakeshore Campus
Billing Code: 99203 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 99203
- Insurance Median: $113
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.96x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Mercy Health Lakeshore Campus is $113. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 0.96x the Medicare baseline. Located in 72 South State Street, Shelby, MI.
Cash / Self-Pay
Unavailable
Average discount available for prompt cash payment at this facility.
Insurance Median
$113
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$117.57
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $117.57 (100%)
Insurance Median: $113 (96%)
Ins. Median: $113 (96% of Medicare)
Understanding this gauge: We use the federal Medicare rate of $117.57 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 | $58 - $109 | 49% |
| Aetna | $75 - $166 | 64% |
| Albany County Correctional Facility | $75 - $103 | 64% |
| Ambetter / Centene | $75 - $103 | 64% |
| Amish Mennonite | $75 - $103 | 64% |
| Ascension St. Vincent Public Safety Medical | $75 - $103 | 64% |
| Bccp | $75 - $103 | 64% |
| Blue Cross Blue Shield | $75 - $117 | 64% |
| Bmc Healthnet | $75 - $103 | 64% |
| Breast Grant-Connecticut | $75 - $103 | 64% |
| Broward County Dept Of Health | $75 - $103 | 64% |
| California Health And Wellness | $75 - $103 | 64% |
| Can Community Health Inc | $75 - $103 | 64% |
| Cardinal Innovations Lme | $75 - $103 | 64% |
| Care Connections Of Northern Iowa | $75 - $103 | 64% |
| Care Oregon Ohp | $75 - $103 | 64% |
| Cencal Health Plan | $75 - $103 | 64% |
| Cenpatico | $75 - $103 | 64% |
| Chhuny | $75 - $103 | 64% |
| Childrens Comm Health Plan | $75 - $103 | 64% |
| Childrens Medical Services Title 19 | $75 - $103 | 64% |
| Cigna | $75 - $113 | 64% |
| City Of Philadelphia | $75 - $103 | 64% |
| Cmh Allegan County | $75 - $103 | 64% |
| Cmh Ausable Valley | $75 - $103 | 64% |
| Cmh Barry County | $75 - $103 | 64% |
| Cmh Bay-Arenac County | $75 - $103 | 64% |
| Cmh Berrien County | $75 - $103 | 64% |
| Cmh Cass County | $75 - $103 | 64% |
| Cmh Central Mi County | $75 - $103 | 64% |
| Cmh Clinton-Eaton-Ingham County | $75 - $103 | 64% |
| Cmh Detroit Wayne Integrated Health Network | $75 - $103 | 64% |
| Cmh Genesee County | $75 - $103 | 64% |
| Cmh Ionia County | $75 - $103 | 64% |
| Cmh Jackson County/Lifeways | $75 - $103 | 64% |
| Cmh Kalamazoo | $75 - $103 | 64% |
| Cmh Kent County | $75 - $103 | 64% |
| Cmh Lenawee County | $75 - $103 | 64% |
| Cmh Livingston County | $75 - $103 | 64% |
| Cmh Macomb | $75 - $103 | 64% |
| Cmh Misc | $75 - $103 | 64% |
| Cmh Monroe County | $75 - $103 | 64% |
| Cmh Montcalm County | $75 - $103 | 64% |
| Cmh Muskegon County | $75 - $103 | 64% |
| Cmh Newaygo County | $75 - $103 | 64% |
| Cmh North Country | $75 - $103 | 64% |
| Cmh Northern Lakes County | $75 - $103 | 64% |
| Cmh Oakland County | $75 - $103 | 64% |
| Cmh Ottawa County | $75 - $103 | 64% |
| Cmh Van Buren County | $75 - $103 | 64% |
| Cmh Washtenaw County | $75 - $103 | 64% |
| Cmh Wayne County/Carelink | $75 - $103 | 64% |
| Cmh Wayne Cty/Com Liv Svcs | $75 - $103 | 64% |
| Cmh West Mi County | $75 - $103 | 64% |
| Community Benefit Health | $75 - $103 | 64% |
| Community Care Behavorial Health | $75 - $103 | 64% |
| Community Care Partners | $75 - $103 | 64% |
| Community Health Choice | $75 - $103 | 64% |
| Connections Csp | $75 - $103 | 64% |
| County Coroner | $75 - $103 | 64% |
| County Funding Generic | $75 - $103 | 64% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund | $75 - $103 | 64% |
| Dean Wi Badgercare | $75 - $103 | 64% |
| Delaware County Department Of Health | $75 - $103 | 64% |
| Delaware First Health | $75 - $103 | 64% |
| Delta Dental Nj | $75 - $103 | 64% |
| Dph Tb Program | $75 - $103 | 64% |
| Dscc | $75 - $103 | 64% |
| Eastpointe Lme | $75 - $103 | 64% |
| Family Health Network | $75 - $103 | 64% |
| Freedom First Healthcare | $75 - $103 | 64% |
| Fresno County Ccs | $75 - $103 | 64% |
| Ghc Scw Wi Badgercare | $75 - $103 | 64% |
| Harbor Health | $75 - $103 | 64% |
| Health Safety Net | $75 - $103 | 64% |
| Healthy Blue Ne | $75 - $103 | 64% |
| Hennepin Health | $75 - $103 | 64% |
| Humana | $75 - $113 | 64% |
| Id County Ada | $75 - $103 | 64% |
| Id County Canyon | $75 - $103 | 64% |
| Id County Cat Fund | $75 - $103 | 64% |
| Id County Other | $75 - $103 | 64% |
| Id County Payette | $75 - $103 | 64% |
| Idaho Dept Health And Wellfare | $75 - $103 | 64% |
| Idaho Womens Health Check | $75 - $103 | 64% |
| Indiana Breast Cervical Cancer | $75 - $103 | 64% |
| Inland Empire Health Plan | $75 - $103 | 64% |
| Intercommunity Health Ohp | $75 - $103 | 64% |
| Iowa Total Care | $75 - $103 | 64% |
| Jai Medical System | $75 - $103 | 64% |
| Kern Family Health Plan | $75 - $103 | 64% |
| Keystone First | $75 - $103 | 64% |
| Keystone First Chip | $75 - $103 | 64% |
| La Care Health Plan | $75 - $103 | 64% |
| Lakeland Care Inc | $75 - $103 | 64% |
| Managed Health Services - Indiana | $75 - $103 | 64% |
| Maryland Breast & Cervical Program | $75 - $103 | 64% |
| Maryland Healthy Smiles - Scion Dental | $75 - $103 | 64% |
| Maryland Physicians Care | $75 - $103 | 64% |
| Massachusetts Behavioral Health Partnership | $75 - $103 | 64% |
| Mdwise | $75 - $103 | 64% |
| Medi-Cal | $75 - $103 | 64% |
| Medi-Cal Healthnet | $75 - $103 | 64% |
| Medstar Dc Healthy Family | $75 - $103 | 64% |
| Medstar Md Health Choice | $75 - $103 | 64% |
| Mo Home State Health Plan | $75 - $103 | 64% |
| Molina Centennial Care | $75 - $103 | 64% |
| Nascentia Health Options | $75 - $103 | 64% |
| Nebraska Total Care | $75 - $103 | 64% |
| New York Cancer Services Program | $75 - $103 | 64% |
| Nextlevel Health | $75 - $103 | 64% |
| Oregon Screenwise | $75 - $103 | 64% |
| Pace Of Southwest Michigan | $75 - $103 | 64% |
| Paramount Advantage | $75 - $103 | 64% |
| Parkland Community Health Plan | $75 - $103 | 64% |
| Partners Behavioral Lme | $75 - $103 | 64% |
| Peach State Healthplan | $75 - $103 | 64% |
| Philadelphia County Funding | $75 - $103 | 64% |
| Presbyterian Centennial Care | $75 - $103 | 64% |
| Prestige Health Choice | $75 - $103 | 64% |
| Priority Partners | $75 - $103 | 64% |
| Robert F Sing Program | $75 - $103 | 64% |
| Rx 340B Pass Along | $75 - $103 | 64% |
| Rx Assistance/Rx Manufacturer Assistance 0 Copay | $75 - $103 | 64% |
| Rx Medi-Cal | $75 - $103 | 64% |
| Rx Meridian Rx | $75 - $103 | 64% |
| Ryan White Florida Mssrp | $75 - $103 | 64% |
| Sandhills Center Lme | $75 - $103 | 64% |
| Screening For Life | $75 - $103 | 64% |
| St Joseph County Hlth Dpt | $75 - $103 | 64% |
| Stephenson Cty Health | $75 - $103 | 64% |
| Sunshine State Health Plan | $75 - $103 | 64% |
| Superior Health | $75 - $103 | 64% |
| Tenncare | $75 - $103 | 64% |
| Texas Children'S Health Plan | $75 - $103 | 64% |
| Trillium Community Ohp | $75 - $103 | 64% |
| Tufts Health Public Plans | $75 - $103 | 64% |
| Vaya Health Lme | $75 - $103 | 64% |
| Washtenaw Health Plan | $75 - $103 | 64% |
| Wellsense Health Plan | $75 - $103 | 64% |
| Wi Womens Wellness | $75 - $103 | 64% |
| UnitedHealthcare | $77 - $115 | 65% |
| Champva | $88 - $103 | 75% |
| Tricare | $88 - $103 | 75% |
| Triwest Health Alliance | $88 - $103 | 75% |
| Us Family Health Plan | $88 - $103 | 75% |
| Veterans Eval Services | $88 - $103 | 75% |
| Geha | $94 - $111 | 80% |
| Medicare (plans) | $94 - $116 | 80% |
| Align Senior Care | $96 - $113 | 82% |
| American Postal Workers Secondary | $96 - $113 | 82% |
| Veterans Administration | $96 - $113 | 82% |
| Blue Care Network | $97 - $114 | 83% |
| Blue Benefit Administrators Of Massachusetts | $100 - $117 | 85% |
| Blue Distinction Transplant | $100 - $117 | 85% |
| Blue Shield - Ca | $100 - $117 | 85% |
| Blue Shield - Id (Regence) | $100 - $117 | 85% |
| Blue Shield - Ny Highmark Northeastern | $100 - $117 | 85% |
| Blue Shield - Ny Highmark Western | $100 - $117 | 85% |
| Blue Shield - Pa (Highmark) | $100 - $117 | 85% |
| Blue Shield - Wa (Regence) | $100 - $117 | 85% |
| Priority Health | $102 - $119 | 87% |
| Cca - Zing Health | $104 - $122 | 88% |
| Access Health | $108 - $127 | 92% |
| Bcccp-Michigan | $108 | 92% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $108 - $128 | 92% |
| Acclaim | $113 | 96% |
| Administrative Concepts | $113 | 96% |
| Allegeant | $113 | 96% |
| Allied Benefit Systems | $113 | 96% |
| Ameriben | $113 | 96% |
| American Family | $113 | 96% |
| American Healthcare Alliance | $113 | 96% |
| American National | $113 | 96% |
| American Republic | $113 | 96% |
| Amerihealth | $113 | 96% |
| Aultcare | $113 | 96% |
| Automated Benefit Services | $113 | 96% |
| Auxiant | $113 | 96% |
| Benefit Administrative Systems,Llc | $113 | 96% |
| Boon Chapman | $113 | 96% |
| Cam Administrative Services | $113 | 96% |
| Christian Brother Services | $113 | 96% |
| Christian Brothers Holy Cross | $113 | 96% |
| Claimchoice Adminstrators | $113 | 96% |
| Comprehensive Benefits | $113 | 96% |
| Consociate | $113 | 96% |
| Continental Life Insurance | $113 | 96% |
| Coventry | $113 | 96% |
| Custom Benefit Administrators | $113 | 96% |
| Cypress Benefit Administrators | $113 | 96% |
| Employee Benefit Concepts | $113 | 96% |
| Employee Benefit Management | $113 | 96% |
| Enterprise Group Planning | $113 | 96% |
| First Health | $113 | 96% |
| Forest County Potawatomi | $113 | 96% |
| Freedom Life Insurance Company | $113 | 96% |
| Group Administrators | $113 | 96% |
| Group Marketing Services | $113 | 96% |
| Group Pension Administrators | $113 | 96% |
| Guardian | $113 | 96% |
| Health America | $113 | 96% |
| Health Choices | $113 | 96% |
| Health Smart | $113 | 96% |
| Healthcare Management Admin | $113 | 96% |
| Healthez | $113 | 96% |
| Healthgram | $113 | 96% |
| Healthscope | $113 | 96% |
| Insight | $113 | 96% |
| Intercare | $113 | 96% |
| Jfp Benefit Management | $113 | 96% |
| Jp Farley Corporation | $113 | 96% |
| Key Benefit Administrator | $113 | 96% |
| Liberty Union Life Assurance Co | $113 | 96% |
| Lucent Health | $113 | 96% |
| Luminare Health | $113 | 96% |
| Luminare Health (Detroit) | $113 | 96% |
| Magnacare | $113 | 96% |
| Medben | $113 | 96% |
| Medcost | $113 | 96% |
| Medical Mutual | $113 | 96% |
| Mutual Health Services | $113 | 96% |
| Mutual Of Omaha | $113 | 96% |
| Ncas | $113 | 96% |
| Nippon Life Ins | $113 | 96% |
| Nova | $113 | 96% |
| Painters Union Insurance Fund | $113 | 96% |
| Physicians Mutual | $113 | 96% |
| Plumbers Local 98 Insurance Fund | $113 | 96% |
| Prairie States | $113 | 96% |
| Preferred One | $113 | 96% |
| Primary Physician Care | $113 | 96% |
| Professional Benefit Administrators | $113 | 96% |
| Secureone Preferred United Plans | $113 | 96% |
| Siho Insurance Services | $113 | 96% |
| Sisco Benefits | $113 | 96% |
| The Health Plan | $113 | 96% |
| The Loomis Company | $113 | 96% |
| Trustmark Small Business Benefits | $113 | 96% |
| Unicare | $113 | 96% |
| Unified Group Services | $113 | 96% |
| Valenz | $113 | 96% |
| Webtpa | $113 | 96% |
| Western & Southern Financial Group | $113 | 96% |
| Wps | $113 | 96% |
| Asr Health Benefits | $114 - $134 | 97% |
| Us Health And Life | $114 - $145 | 97% |
| Hap | $117 - $140 | 100% |
| Health Partners | $117 | 100% |
| Tufts Health Plan | $117 | 100% |
| Meritain | $122 - $144 | 104% |
| 1199 National Benefit Fund | $130 - $153 | 111% |
| Allied National Global Care | $130 - $153 | 111% |
| Asrm - Reliance Standard Life Insurance | $130 - $153 | 111% |
| Christian Care Ministry | $130 - $153 | 111% |
| Dean Health | $130 - $153 | 111% |
| Fallon Health | $130 - $153 | 111% |
| Family Life Insurance Company | $130 - $153 | 111% |
| International Benefit Administrators | $130 - $153 | 111% |
| Lifetime Benefit Solutions | $130 - $153 | 111% |
| Manhattan Life | $130 - $153 | 111% |
| Molina Marketplace | $130 - $153 | 111% |
| Multiplan | $130 - $153 | 111% |
| Mvp | $130 - $153 | 111% |
| Oscar | $130 - $153 | 111% |
| Pai | $130 - $153 | 111% |
| Pan-American Life | $130 - $153 | 111% |
| Phcs | $130 - $153 | 111% |
| Trinity Health Share | $130 - $153 | 111% |
| Wellpath | $130 - $153 | 111% |
| Wc Accident Fund | $134 - $158 | 114% |
| Wc Advantage | $134 - $158 | 114% |
| Wc Aig | $134 - $158 | 114% |
| Wc Allied | $134 - $158 | 114% |
| Wc Amerisure | $134 - $158 | 114% |
| Wc Amtrust | $134 - $158 | 114% |
| Wc Asu Risk Mgt | $134 - $158 | 114% |
| Wc Berkley Admin | $134 - $158 | 114% |
| Wc Broadspire | $134 - $158 | 114% |
| Wc Bunch & Associates | $134 - $158 | 114% |
| Wc Ccmsi | $134 - $158 | 114% |
| Wc Emc Insurance Company | $134 - $158 | 114% |
| Wc Esis | $134 - $158 | 114% |
| Wc Fcci | $134 - $158 | 114% |
| Wc Federated | $134 - $158 | 114% |
| Wc Gallagher Bassett | $134 - $158 | 114% |
| Wc Genex Care For Ohio | $134 - $158 | 114% |
| Wc Guard Insurance Company | $134 - $158 | 114% |
| Wc Hartford | $134 - $158 | 114% |
| Wc Liberty Mutual | $134 - $158 | 114% |
| Wc Meijers | $134 - $158 | 114% |
| Wc Michigan | $134 - $158 | 114% |
| Wc Mitchell Frankenmuth | $134 - $158 | 114% |
| Wc Pma | $134 - $158 | 114% |
| Wc Sedgwick | $134 - $158 | 114% |
| Wc Sentry | $134 - $158 | 114% |
| Wc Travelers | $134 - $158 | 114% |
| Wc Tristar | $134 - $158 | 114% |
| Wc Walmart | $134 - $158 | 114% |
| Wc Zurich | $134 - $158 | 114% |
| Partners Direct Health - Brio | $139 - $164 | 118% |
| Varipro | $140 | 119% |
| Andrie Inc | $141 - $166 | 120% |
| East Greenbush Central School District | $141 - $166 | 120% |
| Genex Wc | $141 - $166 | 120% |
| Healthsmart Workers Comp | $141 - $166 | 120% |
| Jag Source | $141 - $166 | 120% |
| New York State Insurance Fund | $141 - $166 | 120% |
| Njm Insurance Group | $141 - $166 | 120% |
| Rx Heatlhcomp | $141 - $166 | 120% |
| Rx Restat | $141 - $166 | 120% |
| Rx Saif Opdp Wc | $141 - $166 | 120% |
| Rx Worker'S Comp | $141 - $166 | 120% |
| Wc Ace | $141 - $166 | 120% |
| Wc Acs Federal Employees | $141 - $166 | 120% |
| Wc Acuity | $141 - $166 | 120% |
| Wc Aegis | $141 - $166 | 120% |
| Wc Aims | $141 - $166 | 120% |
| Wc Alaska National Ins | $141 - $166 | 120% |
| Wc Align Network | $141 - $166 | 120% |
| Wc Am Trust N America | $141 - $166 | 120% |
| Wc American Claims Mgmt | $141 - $166 | 120% |
| Wc Benetech | $141 - $166 | 120% |
| Wc Broward County | $141 - $166 | 120% |
| Wc California State Comp Ins | $141 - $166 | 120% |
| Wc California State Ins Fund | $141 - $166 | 120% |
| Wc Capitol Area Health Consortium | $141 - $166 | 120% |
| Wc Chartis | $141 - $166 | 120% |
| Wc Chubb | $141 - $166 | 120% |
| Wc Cirma | $141 - $166 | 120% |
| Wc City Of Albany | $141 - $166 | 120% |
| Wc City Of Sioux City | $141 - $166 | 120% |
| Wc Claims Mgmt Inc | $141 - $166 | 120% |
| Wc Cna | $141 - $166 | 120% |
| Wc Comp One Admin C/O Manageability | $141 - $166 | 120% |
| Wc Compone Admin | $141 - $166 | 120% |
| Wc Corvel | $141 - $166 | 120% |
| Wc Ct Healthcare Trust | $141 - $166 | 120% |
| Wc Donegal Insurance Group | $141 - $166 | 120% |
| Wc Employee Mutual | $141 - $166 | 120% |
| Wc Enablecomp | $141 - $166 | 120% |
| Wc Encore Health Network | $141 - $166 | 120% |
| Wc Erie | $141 - $166 | 120% |
| Wc Evolutions | $141 - $166 | 120% |
| Wc Fed Ex | $141 - $166 | 120% |
| Wc Federal Black Lung | $141 - $166 | 120% |
| Wc Finley Occupational Health | $141 - $166 | 120% |
| Wc First Agency/Occunet | $141 - $166 | 120% |
| Wc Ford Motor | $141 - $166 | 120% |
| Wc Fresno Unified Emp | $141 - $166 | 120% |
| Wc General Motors | $141 - $166 | 120% |
| Wc Generic | $141 - $166 | 120% |
| Wc Great West Casualty | $141 - $166 | 120% |
| Wc Guarantee Insurance | $141 - $166 | 120% |
| Wc Hab | $141 - $166 | 120% |
| Wc Hastings | $141 - $166 | 120% |
| Wc Health Management | $141 - $166 | 120% |
| Wc Heritage Summit | $141 - $166 | 120% |
| Wc Hireright | $141 - $166 | 120% |
| Wc Horizon | $141 - $166 | 120% |
| Wc Icw Group | $141 - $166 | 120% |
| Wc Idaho State Ins Fund | $141 - $166 | 120% |
| Wc Intercare Insurance | $141 - $166 | 120% |
| Wc Intermountain | $141 - $166 | 120% |
| Wc Johns Eastern | $141 - $166 | 120% |
| Wc Kemberton | $141 - $166 | 120% |
| Wc Key Ins & Benefit Solutions | $141 - $166 | 120% |
| Wc Mac Risk Management | $141 - $166 | 120% |
| Wc Massachusetts | $141 - $166 | 120% |
| Wc Mdia | $141 - $166 | 120% |
| Wc Meadowbrook Claim | $141 - $166 | 120% |
| Wc Medical Administrators | $141 - $166 | 120% |
| Wc Memic | $141 - $166 | 120% |
| Wc Mercy Workcare | $141 - $166 | 120% |
| Wc Michigan Millers Mutual | $141 - $166 | 120% |
| Wc Mra | $141 - $166 | 120% |
| Wc Nationwide | $141 - $166 | 120% |
| Wc Nca Comp | $141 - $166 | 120% |
| Wc New York | $141 - $166 | 120% |
| Wc New York Special Funds | $141 - $166 | 120% |
| Wc North American Rishces | $141 - $166 | 120% |
| Wc Northeast Health | $141 - $166 | 120% |
| Wc Notre Dame | $141 - $166 | 120% |
| Wc Novanet | $141 - $166 | 120% |
| Wc O'Hara Corp | $141 - $166 | 120% |
| Wc Occ Health Allen | $141 - $166 | 120% |
| Wc Ohio Bureau | $141 - $166 | 120% |
| Wc One Call Medical | $141 - $166 | 120% |
| Wc Paradigm | $141 - $166 | 120% |
| Wc Peerless | $141 - $166 | 120% |
| Wc Praxis Health Network | $141 - $166 | 120% |
| Wc Price Chopper | $141 - $166 | 120% |
| Wc Procura Management | $141 - $166 | 120% |
| Wc Qualcare | $141 - $166 | 120% |
| Wc Quiktrip | $141 - $166 | 120% |
| Wc Reny Company | $141 - $166 | 120% |
| Wc Rev Claims | $141 - $166 | 120% |
| Wc Risico | $141 - $166 | 120% |
| Wc Rural Mutual | $141 - $166 | 120% |
| Wc Saif Oregon | $141 - $166 | 120% |
| Wc Secura | $141 - $166 | 120% |
| Wc Sheakley Unicomp | $141 - $166 | 120% |
| Wc Smile Lodge | $141 - $166 | 120% |
| Wc Society | $141 - $166 | 120% |
| Wc Srs | $141 - $166 | 120% |
| Wc Taconic (Mro) | $141 - $166 | 120% |
| Wc Taconic Farms | $141 - $166 | 120% |
| Wc Triad Group | $141 - $166 | 120% |
| Wc Troy Ny | $141 - $166 | 120% |
| Wc Tyson | $141 - $166 | 120% |
| Wc Unified Health Services | $141 - $166 | 120% |
| Wc United Heartland | $141 - $166 | 120% |
| Wc Us Dept Of Labor | $141 - $166 | 120% |
| Wc Velocity | $141 - $166 | 120% |
| Wc West Bend | $141 - $166 | 120% |
| Wc West Bend Mutual/Argent | $141 - $166 | 120% |
| Wc Winnebago Industries | $141 - $166 | 120% |
| Wc Yankee Trails | $141 - $166 | 120% |
| Wc York Risk | $141 - $166 | 120% |
| Wc Zenith | $141 - $166 | 120% |
| U Of M Health Plan | $145 - $171 | 123% |
| Claimdoc | $149 - $175 | 127% |
| Kent County Jail | $149 - $175 | 127% |
| Muskegon County Jail | $149 - $175 | 127% |
| Nomi Health | $149 - $175 | 127% |