CMS Price Transparency Data
Psychiatric evaluation (first visit)
Facility: Mercy Health Lakeshore Campus
Billing Code: 90791 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 90791
- Insurance Median: $197
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.09x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Mercy Health Lakeshore Campus is $197. 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 $181.34, this hospital’s rate is 1.09x 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
$197
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$181.34
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $181.34 (100%)
Insurance Median: $197 (109%)
Ins. Median: $197 (109% of Medicare)
Understanding this gauge: We use the federal Medicare rate of $181.34 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 |
|---|---|---|
| Champva | $121 - $161 | 67% |
| Tricare | $121 - $161 | 67% |
| Triwest Health Alliance | $121 - $161 | 67% |
| Us Family Health Plan | $121 - $161 | 67% |
| Veterans Eval Services | $121 - $161 | 67% |
| Medicaid / KanCare | $122 - $364 | 67% |
| Aetna | $125 - $288 | 69% |
| Medicare (plans) | $125 - $174 | 69% |
| Align Senior Care | $127 - $170 | 70% |
| Veterans Administration | $127 - $170 | 70% |
| Asr Health Benefits | $137 - $182 | 76% |
| Cca - Zing Health | $137 - $183 | 76% |
| Access Health | $142 - $190 | 78% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $143 - $191 | 79% |
| Us Health And Life | $154 - $198 | 85% |
| Hap | $157 - $195 | 87% |
| Health Partners | $157 | 87% |
| Tufts Health Plan | $157 | 87% |
| Geha | $159 | 88% |
| UnitedHealthcare | $159 - $175 | 88% |
| Albany County Correctional Facility | $170 | 94% |
| Ambetter / Centene | $170 | 94% |
| Amish Mennonite | $170 | 94% |
| Ascension St. Vincent Public Safety Medical | $170 | 94% |
| Bccp | $170 | 94% |
| Blue Cross Blue Shield | $170 - $217 | 94% |
| Bmc Healthnet | $170 | 94% |
| Breast Grant-Connecticut | $170 | 94% |
| Broward County Dept Of Health | $170 | 94% |
| California Health And Wellness | $170 | 94% |
| Can Community Health Inc | $170 | 94% |
| Cardinal Innovations Lme | $170 | 94% |
| Care Connections Of Northern Iowa | $170 | 94% |
| Care Oregon Ohp | $170 | 94% |
| Cencal Health Plan | $170 | 94% |
| Cenpatico | $170 | 94% |
| Chhuny | $170 | 94% |
| Childrens Comm Health Plan | $170 | 94% |
| Childrens Medical Services Title 19 | $170 | 94% |
| Cigna | $170 - $206 | 94% |
| City Of Philadelphia | $170 | 94% |
| Cmh Allegan County | $170 | 94% |
| Cmh Ausable Valley | $170 | 94% |
| Cmh Barry County | $170 | 94% |
| Cmh Bay-Arenac County | $170 | 94% |
| Cmh Berrien County | $170 | 94% |
| Cmh Cass County | $170 | 94% |
| Cmh Central Mi County | $170 | 94% |
| Cmh Clinton-Eaton-Ingham County | $170 | 94% |
| Cmh Detroit Wayne Integrated Health Network | $170 | 94% |
| Cmh Genesee County | $170 | 94% |
| Cmh Ionia County | $170 | 94% |
| Cmh Jackson County/Lifeways | $170 | 94% |
| Cmh Kalamazoo | $170 | 94% |
| Cmh Kent County | $170 | 94% |
| Cmh Lenawee County | $170 | 94% |
| Cmh Livingston County | $170 | 94% |
| Cmh Macomb | $170 | 94% |
| Cmh Misc | $170 | 94% |
| Cmh Monroe County | $170 | 94% |
| Cmh Montcalm County | $170 | 94% |
| Cmh Muskegon County | $170 | 94% |
| Cmh Newaygo County | $170 | 94% |
| Cmh North Country | $170 | 94% |
| Cmh Northern Lakes County | $170 | 94% |
| Cmh Oakland County | $170 | 94% |
| Cmh Ottawa County | $170 | 94% |
| Cmh Van Buren County | $170 | 94% |
| Cmh Washtenaw County | $170 | 94% |
| Cmh Wayne County/Carelink | $170 | 94% |
| Cmh Wayne Cty/Com Liv Svcs | $170 | 94% |
| Cmh West Mi County | $170 | 94% |
| Community Benefit Health | $170 | 94% |
| Community Care Behavorial Health | $170 | 94% |
| Community Care Partners | $170 | 94% |
| Community Health Choice | $170 | 94% |
| Connections Csp | $170 | 94% |
| County Coroner | $170 | 94% |
| County Funding Generic | $170 | 94% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund | $170 | 94% |
| Dean Wi Badgercare | $170 | 94% |
| Delaware County Department Of Health | $170 | 94% |
| Delaware First Health | $170 | 94% |
| Delta Dental Nj | $170 | 94% |
| Dph Tb Program | $170 | 94% |
| Dscc | $170 | 94% |
| Eastpointe Lme | $170 | 94% |
| Family Health Network | $170 | 94% |
| Freedom First Healthcare | $170 | 94% |
| Fresno County Ccs | $170 | 94% |
| Ghc Scw Wi Badgercare | $170 | 94% |
| Harbor Health | $170 | 94% |
| Health Safety Net | $170 | 94% |
| Healthy Blue Ne | $170 | 94% |
| Hennepin Health | $170 | 94% |
| Humana | $170 - $211 | 94% |
| Id County Ada | $170 | 94% |
| Id County Canyon | $170 | 94% |
| Id County Cat Fund | $170 | 94% |
| Id County Other | $170 | 94% |
| Id County Payette | $170 | 94% |
| Idaho Dept Health And Wellfare | $170 | 94% |
| Idaho Womens Health Check | $170 | 94% |
| Indiana Breast Cervical Cancer | $170 | 94% |
| Inland Empire Health Plan | $170 | 94% |
| Intercommunity Health Ohp | $170 | 94% |
| Iowa Total Care | $170 | 94% |
| Jai Medical System | $170 | 94% |
| Kern Family Health Plan | $170 | 94% |
| Keystone First | $170 | 94% |
| Keystone First Chip | $170 | 94% |
| La Care Health Plan | $170 | 94% |
| Lakeland Care Inc | $170 | 94% |
| Managed Health Services - Indiana | $170 | 94% |
| Maryland Breast & Cervical Program | $170 | 94% |
| Maryland Healthy Smiles - Scion Dental | $170 | 94% |
| Maryland Physicians Care | $170 | 94% |
| Massachusetts Behavioral Health Partnership | $170 | 94% |
| Mdwise | $170 | 94% |
| Medi-Cal | $170 | 94% |
| Medi-Cal Healthnet | $170 | 94% |
| Medstar Dc Healthy Family | $170 | 94% |
| Medstar Md Health Choice | $170 | 94% |
| Mo Home State Health Plan | $170 | 94% |
| Molina Centennial Care | $170 | 94% |
| Nascentia Health Options | $170 | 94% |
| Nebraska Total Care | $170 | 94% |
| New York Cancer Services Program | $170 | 94% |
| Nextlevel Health | $170 | 94% |
| Oregon Screenwise | $170 | 94% |
| Pace Of Southwest Michigan | $170 | 94% |
| Paramount Advantage | $170 | 94% |
| Parkland Community Health Plan | $170 | 94% |
| Partners Behavioral Lme | $170 | 94% |
| Peach State Healthplan | $170 | 94% |
| Philadelphia County Funding | $170 | 94% |
| Presbyterian Centennial Care | $170 | 94% |
| Prestige Health Choice | $170 | 94% |
| Priority Partners | $170 | 94% |
| Robert F Sing Program | $170 | 94% |
| Rx 340B Pass Along | $170 | 94% |
| Rx Assistance/Rx Manufacturer Assistance 0 Copay | $170 | 94% |
| Rx Medi-Cal | $170 | 94% |
| Rx Meridian Rx | $170 | 94% |
| Ryan White Florida Mssrp | $170 | 94% |
| Sandhills Center Lme | $170 | 94% |
| Screening For Life | $170 | 94% |
| St Joseph County Hlth Dpt | $170 | 94% |
| Stephenson Cty Health | $170 | 94% |
| Sunshine State Health Plan | $170 | 94% |
| Superior Health | $170 | 94% |
| Tenncare | $170 | 94% |
| Texas Children'S Health Plan | $170 | 94% |
| Trillium Community Ohp | $170 | 94% |
| Tufts Health Public Plans | $170 | 94% |
| Vaya Health Lme | $170 | 94% |
| Washtenaw Health Plan | $170 | 94% |
| Wellsense Health Plan | $170 | 94% |
| Wi Womens Wellness | $170 | 94% |
| 1199 National Benefit Fund | $172 - $229 | 95% |
| Allied National Global Care | $172 - $229 | 95% |
| Asrm - Reliance Standard Life Insurance | $172 - $229 | 95% |
| Christian Care Ministry | $172 - $229 | 95% |
| Dean Health | $172 - $229 | 95% |
| Fallon Health | $172 - $229 | 95% |
| Family Life Insurance Company | $172 - $229 | 95% |
| International Benefit Administrators | $172 - $229 | 95% |
| Lifetime Benefit Solutions | $172 - $229 | 95% |
| Manhattan Life | $172 - $229 | 95% |
| Molina Marketplace | $172 - $229 | 95% |
| Multiplan | $172 - $229 | 95% |
| Mvp | $172 - $229 | 95% |
| Oscar | $172 - $229 | 95% |
| Pai | $172 - $229 | 95% |
| Pan-American Life | $172 - $229 | 95% |
| Phcs | $172 - $229 | 95% |
| Trinity Health Share | $172 - $229 | 95% |
| Wellpath | $172 - $229 | 95% |
| American Postal Workers Secondary | $175 - $206 | 97% |
| Blue Care Network | $181 - $213 | 100% |
| Blue Benefit Administrators Of Massachusetts | $184 - $217 | 101% |
| Blue Distinction Transplant | $184 - $217 | 101% |
| Blue Shield - Ca | $184 - $217 | 101% |
| Blue Shield - Id (Regence) | $184 - $217 | 101% |
| Blue Shield - Ny Highmark Northeastern | $184 - $217 | 101% |
| Blue Shield - Ny Highmark Western | $184 - $217 | 101% |
| Blue Shield - Pa (Highmark) | $184 - $217 | 101% |
| Blue Shield - Wa (Regence) | $184 - $217 | 101% |
| Partners Direct Health - Brio | $184 - $246 | 101% |
| Priority Health | $186 - $219 | 103% |
| Varipro | $195 | 108% |
| Acclaim | $197 - $211 | 109% |
| Administrative Concepts | $197 - $211 | 109% |
| Allegeant | $197 - $211 | 109% |
| Allied Benefit Systems | $197 - $211 | 109% |
| Ameriben | $197 - $211 | 109% |
| American Family | $197 - $211 | 109% |
| American Healthcare Alliance | $197 - $211 | 109% |
| American National | $197 - $211 | 109% |
| American Republic | $197 - $211 | 109% |
| Amerihealth | $197 - $211 | 109% |
| Aultcare | $197 - $211 | 109% |
| Automated Benefit Services | $197 - $211 | 109% |
| Auxiant | $197 - $211 | 109% |
| Benefit Administrative Systems,Llc | $197 - $211 | 109% |
| Boon Chapman | $197 - $211 | 109% |
| Cam Administrative Services | $197 - $211 | 109% |
| Christian Brother Services | $197 - $211 | 109% |
| Christian Brothers Holy Cross | $197 - $211 | 109% |
| Claimchoice Adminstrators | $197 - $211 | 109% |
| Claimdoc | $197 - $263 | 109% |
| Comprehensive Benefits | $197 - $211 | 109% |
| Consociate | $197 - $211 | 109% |
| Continental Life Insurance | $197 - $211 | 109% |
| Coventry | $197 - $211 | 109% |
| Custom Benefit Administrators | $197 - $211 | 109% |
| Cypress Benefit Administrators | $197 - $211 | 109% |
| Employee Benefit Concepts | $197 - $211 | 109% |
| Employee Benefit Management | $197 - $211 | 109% |
| Enterprise Group Planning | $197 - $211 | 109% |
| First Health | $197 - $211 | 109% |
| Forest County Potawatomi | $197 - $211 | 109% |
| Freedom Life Insurance Company | $197 - $211 | 109% |
| Group Administrators | $197 - $211 | 109% |
| Group Marketing Services | $197 - $211 | 109% |
| Group Pension Administrators | $197 - $211 | 109% |
| Guardian | $197 - $211 | 109% |
| Health America | $197 - $211 | 109% |
| Health Choices | $197 - $211 | 109% |
| Health Smart | $197 - $211 | 109% |
| Healthcare Management Admin | $197 - $211 | 109% |
| Healthez | $197 - $211 | 109% |
| Healthgram | $197 - $211 | 109% |
| Healthscope | $197 - $211 | 109% |
| Insight | $197 - $211 | 109% |
| Intercare | $197 - $211 | 109% |
| Jfp Benefit Management | $197 - $211 | 109% |
| Jp Farley Corporation | $197 - $211 | 109% |
| Kent County Jail | $197 - $263 | 109% |
| Key Benefit Administrator | $197 - $211 | 109% |
| Liberty Union Life Assurance Co | $197 - $211 | 109% |
| Lucent Health | $197 - $211 | 109% |
| Luminare Health | $197 - $211 | 109% |
| Luminare Health (Detroit) | $197 - $211 | 109% |
| Magnacare | $197 - $211 | 109% |
| Medben | $197 - $211 | 109% |
| Medcost | $197 - $211 | 109% |
| Medical Mutual | $197 - $211 | 109% |
| Muskegon County Jail | $197 - $263 | 109% |
| Mutual Health Services | $197 - $211 | 109% |
| Mutual Of Omaha | $197 - $211 | 109% |
| Ncas | $197 - $211 | 109% |
| Nippon Life Ins | $197 - $211 | 109% |
| Nomi Health | $197 - $263 | 109% |
| Nova | $197 - $211 | 109% |
| Painters Union Insurance Fund | $197 - $211 | 109% |
| Physicians Mutual | $197 - $211 | 109% |
| Plumbers Local 98 Insurance Fund | $197 - $211 | 109% |
| Prairie States | $197 - $211 | 109% |
| Preferred One | $197 - $211 | 109% |
| Primary Physician Care | $197 - $211 | 109% |
| Professional Benefit Administrators | $197 - $211 | 109% |
| Secureone Preferred United Plans | $197 - $211 | 109% |
| Siho Insurance Services | $197 - $211 | 109% |
| Sisco Benefits | $197 - $211 | 109% |
| The Health Plan | $197 - $211 | 109% |
| The Loomis Company | $197 - $211 | 109% |
| Trustmark Small Business Benefits | $197 - $211 | 109% |
| Unicare | $197 - $211 | 109% |
| Unified Group Services | $197 - $211 | 109% |
| Valenz | $197 - $211 | 109% |
| Webtpa | $197 - $211 | 109% |
| Western & Southern Financial Group | $197 - $211 | 109% |
| Wps | $197 - $211 | 109% |
| Wc Accident Fund | $205 - $241 | 113% |
| Wc Advantage | $205 - $241 | 113% |
| Wc Aig | $205 - $241 | 113% |
| Wc Allied | $205 - $241 | 113% |
| Wc Amerisure | $205 - $241 | 113% |
| Wc Amtrust | $205 - $241 | 113% |
| Wc Asu Risk Mgt | $205 - $241 | 113% |
| Wc Berkley Admin | $205 - $241 | 113% |
| Wc Broadspire | $205 - $241 | 113% |
| Wc Bunch & Associates | $205 - $241 | 113% |
| Wc Ccmsi | $205 - $241 | 113% |
| Wc Emc Insurance Company | $205 - $241 | 113% |
| Wc Esis | $205 - $241 | 113% |
| Wc Fcci | $205 - $241 | 113% |
| Wc Federated | $205 - $241 | 113% |
| Wc Gallagher Bassett | $205 - $241 | 113% |
| Wc Genex Care For Ohio | $205 - $241 | 113% |
| Wc Guard Insurance Company | $205 - $241 | 113% |
| Wc Hartford | $205 - $241 | 113% |
| Wc Liberty Mutual | $205 - $241 | 113% |
| Wc Meijers | $205 - $241 | 113% |
| Wc Michigan | $205 - $241 | 113% |
| Wc Mitchell Frankenmuth | $205 - $241 | 113% |
| Wc Pma | $205 - $241 | 113% |
| Wc Sedgwick | $205 - $241 | 113% |
| Wc Sentry | $205 - $241 | 113% |
| Wc Travelers | $205 - $241 | 113% |
| Wc Tristar | $205 - $241 | 113% |
| Wc Walmart | $205 - $241 | 113% |
| Wc Zurich | $205 - $241 | 113% |
| Andrie Inc | $215 - $253 | 119% |
| East Greenbush Central School District | $215 - $253 | 119% |
| Genex Wc | $215 - $253 | 119% |
| Healthsmart Workers Comp | $215 - $253 | 119% |
| Jag Source | $215 - $253 | 119% |
| New York State Insurance Fund | $215 - $253 | 119% |
| Njm Insurance Group | $215 - $253 | 119% |
| Rx Heatlhcomp | $215 - $253 | 119% |
| Rx Restat | $215 - $253 | 119% |
| Rx Saif Opdp Wc | $215 - $253 | 119% |
| Rx Worker'S Comp | $215 - $253 | 119% |
| Wc Ace | $215 - $253 | 119% |
| Wc Acs Federal Employees | $215 - $253 | 119% |
| Wc Acuity | $215 - $253 | 119% |
| Wc Aegis | $215 - $253 | 119% |
| Wc Aims | $215 - $253 | 119% |
| Wc Alaska National Ins | $215 - $253 | 119% |
| Wc Align Network | $215 - $253 | 119% |
| Wc Am Trust N America | $215 - $253 | 119% |
| Wc American Claims Mgmt | $215 - $253 | 119% |
| Wc Benetech | $215 - $253 | 119% |
| Wc Broward County | $215 - $253 | 119% |
| Wc California State Comp Ins | $215 - $253 | 119% |
| Wc California State Ins Fund | $215 - $253 | 119% |
| Wc Capitol Area Health Consortium | $215 - $253 | 119% |
| Wc Chartis | $215 - $253 | 119% |
| Wc Chubb | $215 - $253 | 119% |
| Wc Cirma | $215 - $253 | 119% |
| Wc City Of Albany | $215 - $253 | 119% |
| Wc City Of Sioux City | $215 - $253 | 119% |
| Wc Claims Mgmt Inc | $215 - $253 | 119% |
| Wc Cna | $215 - $253 | 119% |
| Wc Comp One Admin C/O Manageability | $215 - $253 | 119% |
| Wc Compone Admin | $215 - $253 | 119% |
| Wc Corvel | $215 - $253 | 119% |
| Wc Ct Healthcare Trust | $215 - $253 | 119% |
| Wc Donegal Insurance Group | $215 - $253 | 119% |
| Wc Employee Mutual | $215 - $253 | 119% |
| Wc Enablecomp | $215 - $253 | 119% |
| Wc Encore Health Network | $215 - $253 | 119% |
| Wc Erie | $215 - $253 | 119% |
| Wc Evolutions | $215 - $253 | 119% |
| Wc Fed Ex | $215 - $253 | 119% |
| Wc Federal Black Lung | $215 - $253 | 119% |
| Wc Finley Occupational Health | $215 - $253 | 119% |
| Wc First Agency/Occunet | $215 - $253 | 119% |
| Wc Ford Motor | $215 - $253 | 119% |
| Wc Fresno Unified Emp | $215 - $253 | 119% |
| Wc General Motors | $215 - $253 | 119% |
| Wc Generic | $215 - $253 | 119% |
| Wc Great West Casualty | $215 - $253 | 119% |
| Wc Guarantee Insurance | $215 - $253 | 119% |
| Wc Hab | $215 - $253 | 119% |
| Wc Hastings | $215 - $253 | 119% |
| Wc Health Management | $215 - $253 | 119% |
| Wc Heritage Summit | $215 - $253 | 119% |
| Wc Hireright | $215 - $253 | 119% |
| Wc Horizon | $215 - $253 | 119% |
| Wc Icw Group | $215 - $253 | 119% |
| Wc Idaho State Ins Fund | $215 - $253 | 119% |
| Wc Intercare Insurance | $215 - $253 | 119% |
| Wc Intermountain | $215 - $253 | 119% |
| Wc Johns Eastern | $215 - $253 | 119% |
| Wc Kemberton | $215 - $253 | 119% |
| Wc Key Ins & Benefit Solutions | $215 - $253 | 119% |
| Wc Mac Risk Management | $215 - $253 | 119% |
| Wc Massachusetts | $215 - $253 | 119% |
| Wc Mdia | $215 - $253 | 119% |
| Wc Meadowbrook Claim | $215 - $253 | 119% |
| Wc Medical Administrators | $215 - $253 | 119% |
| Wc Memic | $215 - $253 | 119% |
| Wc Mercy Workcare | $215 - $253 | 119% |
| Wc Michigan Millers Mutual | $215 - $253 | 119% |
| Wc Mra | $215 - $253 | 119% |
| Wc Nationwide | $215 - $253 | 119% |
| Wc Nca Comp | $215 - $253 | 119% |
| Wc New York | $215 - $253 | 119% |
| Wc New York Special Funds | $215 - $253 | 119% |
| Wc North American Rishces | $215 - $253 | 119% |
| Wc Northeast Health | $215 - $253 | 119% |
| Wc Notre Dame | $215 - $253 | 119% |
| Wc Novanet | $215 - $253 | 119% |
| Wc O'Hara Corp | $215 - $253 | 119% |
| Wc Occ Health Allen | $215 - $253 | 119% |
| Wc Ohio Bureau | $215 - $253 | 119% |
| Wc One Call Medical | $215 - $253 | 119% |
| Wc Paradigm | $215 - $253 | 119% |
| Wc Peerless | $215 - $253 | 119% |
| Wc Praxis Health Network | $215 - $253 | 119% |
| Wc Price Chopper | $215 - $253 | 119% |
| Wc Procura Management | $215 - $253 | 119% |
| Wc Qualcare | $215 - $253 | 119% |
| Wc Quiktrip | $215 - $253 | 119% |
| Wc Reny Company | $215 - $253 | 119% |
| Wc Rev Claims | $215 - $253 | 119% |
| Wc Risico | $215 - $253 | 119% |
| Wc Rural Mutual | $215 - $253 | 119% |
| Wc Saif Oregon | $215 - $253 | 119% |
| Wc Secura | $215 - $253 | 119% |
| Wc Sheakley Unicomp | $215 - $253 | 119% |
| Wc Smile Lodge | $215 - $253 | 119% |
| Wc Society | $215 - $253 | 119% |
| Wc Srs | $215 - $253 | 119% |
| Wc Taconic (Mro) | $215 - $253 | 119% |
| Wc Taconic Farms | $215 - $253 | 119% |
| Wc Triad Group | $215 - $253 | 119% |
| Wc Troy Ny | $215 - $253 | 119% |
| Wc Tyson | $215 - $253 | 119% |
| Wc Unified Health Services | $215 - $253 | 119% |
| Wc United Heartland | $215 - $253 | 119% |
| Wc Us Dept Of Labor | $215 - $253 | 119% |
| Wc Velocity | $215 - $253 | 119% |
| Wc West Bend | $215 - $253 | 119% |
| Wc West Bend Mutual/Argent | $215 - $253 | 119% |
| Wc Winnebago Industries | $215 - $253 | 119% |
| Wc Yankee Trails | $215 - $253 | 119% |
| Wc York Risk | $215 - $253 | 119% |
| Wc Zenith | $215 - $253 | 119% |
| Meritain | $288 | 159% |
| U Of M Health Plan | $300 | 165% |
| Bcccp-Michigan | $340 - $364 | 187% |