CMS Price Transparency Data
X-ray, chest (single view)
Facility: Mercy Health Lakeshore Campus
Billing Code: 71045 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 71045
- Insurance Median: $25
- Cash Discount Price: $2,085
- vs. Medicare Baseline: 0.28x Medicare
The contracted insurance negotiated median rate for a X-ray, chest (single view) at Mercy Health Lakeshore Campus is $25. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,085. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.28x the Medicare baseline. Located in 72 South State Street, Shelby, MI.
Cash / Self-Pay
$2,085
Average discount available for prompt cash payment at this facility.
Insurance Median
$25
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$88.91
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $88.91 (100%)
Cash / Self-Pay: $2,085 (2345%)
Insurance Median: $25 (28%)
Cash: $2,085 (2345% of Medicare)
Ins. Median: $25 (28% of Medicare)
Understanding this gauge: We use the federal Medicare rate of $88.91 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 |
|---|---|---|
| Hap | $9 - $185 | 10% |
| Health Partners | $9 - $16 | 10% |
| Tufts Health Plan | $9 - $16 | 10% |
| Aetna | $11 - $160 | 12% |
| Albany County Correctional Facility | $11 - $16 | 12% |
| Ambetter / Centene | $11 - $16 | 12% |
| Amish Mennonite | $11 - $16 | 12% |
| Ascension St. Vincent Public Safety Medical | $11 - $16 | 12% |
| Bccp | $11 - $16 | 12% |
| Blue Cross Blue Shield | $11 - $172 | 12% |
| Bmc Healthnet | $11 - $16 | 12% |
| Breast Grant-Connecticut | $11 - $16 | 12% |
| Broward County Dept Of Health | $11 - $16 | 12% |
| California Health And Wellness | $11 - $16 | 12% |
| Can Community Health Inc | $11 - $16 | 12% |
| Cardinal Innovations Lme | $11 - $16 | 12% |
| Care Connections Of Northern Iowa | $11 - $16 | 12% |
| Care Oregon Ohp | $11 - $16 | 12% |
| Cencal Health Plan | $11 - $16 | 12% |
| Cenpatico | $11 - $16 | 12% |
| Chhuny | $11 - $16 | 12% |
| Childrens Comm Health Plan | $11 - $16 | 12% |
| Childrens Medical Services Title 19 | $11 - $16 | 12% |
| Cigna | $11 - $174 | 12% |
| City Of Philadelphia | $11 - $16 | 12% |
| Cmh Allegan County | $11 - $16 | 12% |
| Cmh Ausable Valley | $11 - $16 | 12% |
| Cmh Barry County | $11 - $16 | 12% |
| Cmh Bay-Arenac County | $11 - $16 | 12% |
| Cmh Berrien County | $11 - $16 | 12% |
| Cmh Cass County | $11 - $16 | 12% |
| Cmh Central Mi County | $11 - $16 | 12% |
| Cmh Clinton-Eaton-Ingham County | $11 - $16 | 12% |
| Cmh Detroit Wayne Integrated Health Network | $11 - $16 | 12% |
| Cmh Genesee County | $11 - $16 | 12% |
| Cmh Ionia County | $11 - $16 | 12% |
| Cmh Jackson County/Lifeways | $11 - $16 | 12% |
| Cmh Kalamazoo | $11 - $16 | 12% |
| Cmh Kent County | $11 - $16 | 12% |
| Cmh Lenawee County | $11 - $16 | 12% |
| Cmh Livingston County | $11 - $16 | 12% |
| Cmh Macomb | $11 - $16 | 12% |
| Cmh Misc | $11 - $16 | 12% |
| Cmh Monroe County | $11 - $16 | 12% |
| Cmh Montcalm County | $11 - $16 | 12% |
| Cmh Muskegon County | $11 - $16 | 12% |
| Cmh Newaygo County | $11 - $16 | 12% |
| Cmh North Country | $11 - $16 | 12% |
| Cmh Northern Lakes County | $11 - $16 | 12% |
| Cmh Oakland County | $11 - $16 | 12% |
| Cmh Ottawa County | $11 - $16 | 12% |
| Cmh Van Buren County | $11 - $16 | 12% |
| Cmh Washtenaw County | $11 - $16 | 12% |
| Cmh Wayne County/Carelink | $11 - $16 | 12% |
| Cmh Wayne Cty/Com Liv Svcs | $11 - $16 | 12% |
| Cmh West Mi County | $11 - $16 | 12% |
| Community Benefit Health | $11 - $16 | 12% |
| Community Care Behavorial Health | $11 - $16 | 12% |
| Community Care Partners | $11 - $16 | 12% |
| Community Health Choice | $11 - $16 | 12% |
| Connections Csp | $11 - $16 | 12% |
| County Coroner | $11 - $16 | 12% |
| County Funding Generic | $11 - $16 | 12% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund | $11 - $16 | 12% |
| Dean Wi Badgercare | $11 - $16 | 12% |
| Delaware County Department Of Health | $11 - $16 | 12% |
| Delaware First Health | $11 - $16 | 12% |
| Delta Dental Nj | $11 - $16 | 12% |
| Dph Tb Program | $11 - $16 | 12% |
| Dscc | $11 - $16 | 12% |
| Eastpointe Lme | $11 - $16 | 12% |
| Family Health Network | $11 - $16 | 12% |
| Freedom First Healthcare | $11 - $16 | 12% |
| Fresno County Ccs | $11 - $16 | 12% |
| Geha | $11 - $181 | 12% |
| Ghc Scw Wi Badgercare | $11 - $16 | 12% |
| Harbor Health | $11 - $16 | 12% |
| Health Safety Net | $11 - $16 | 12% |
| Healthy Blue Ne | $11 - $16 | 12% |
| Hennepin Health | $11 - $16 | 12% |
| Humana | $11 - $180 | 12% |
| Id County Ada | $11 - $16 | 12% |
| Id County Canyon | $11 - $16 | 12% |
| Id County Cat Fund | $11 - $16 | 12% |
| Id County Other | $11 - $16 | 12% |
| Id County Payette | $11 - $16 | 12% |
| Idaho Dept Health And Wellfare | $11 - $16 | 12% |
| Idaho Womens Health Check | $11 - $16 | 12% |
| Indiana Breast Cervical Cancer | $11 - $16 | 12% |
| Inland Empire Health Plan | $11 - $16 | 12% |
| Intercommunity Health Ohp | $11 - $16 | 12% |
| Iowa Total Care | $11 - $16 | 12% |
| Jai Medical System | $11 - $16 | 12% |
| Kern Family Health Plan | $11 - $16 | 12% |
| Keystone First | $11 - $16 | 12% |
| Keystone First Chip | $11 - $16 | 12% |
| La Care Health Plan | $11 - $16 | 12% |
| Lakeland Care Inc | $11 - $16 | 12% |
| Managed Health Services - Indiana | $11 - $16 | 12% |
| Maryland Breast & Cervical Program | $11 - $16 | 12% |
| Maryland Healthy Smiles - Scion Dental | $11 - $16 | 12% |
| Maryland Physicians Care | $11 - $16 | 12% |
| Massachusetts Behavioral Health Partnership | $11 - $16 | 12% |
| Mdwise | $11 - $16 | 12% |
| Medi-Cal | $11 - $16 | 12% |
| Medi-Cal Healthnet | $11 - $16 | 12% |
| Medicaid / KanCare | $11 - $67 | 12% |
| Medstar Dc Healthy Family | $11 - $16 | 12% |
| Medstar Md Health Choice | $11 - $16 | 12% |
| Mo Home State Health Plan | $11 - $16 | 12% |
| Molina Centennial Care | $11 - $16 | 12% |
| Nascentia Health Options | $11 - $16 | 12% |
| Nebraska Total Care | $11 - $16 | 12% |
| New York Cancer Services Program | $11 - $16 | 12% |
| Nextlevel Health | $11 - $16 | 12% |
| Oregon Screenwise | $11 - $16 | 12% |
| Pace Of Southwest Michigan | $11 - $16 | 12% |
| Paramount Advantage | $11 - $16 | 12% |
| Parkland Community Health Plan | $11 - $16 | 12% |
| Partners Behavioral Lme | $11 - $16 | 12% |
| Peach State Healthplan | $11 - $16 | 12% |
| Philadelphia County Funding | $11 - $16 | 12% |
| Presbyterian Centennial Care | $11 - $16 | 12% |
| Prestige Health Choice | $11 - $16 | 12% |
| Priority Partners | $11 - $16 | 12% |
| Robert F Sing Program | $11 - $16 | 12% |
| Rx 340B Pass Along | $11 - $16 | 12% |
| Rx Assistance/Rx Manufacturer Assistance 0 Copay | $11 - $16 | 12% |
| Rx Medi-Cal | $11 - $16 | 12% |
| Rx Meridian Rx | $11 - $16 | 12% |
| Ryan White Florida Mssrp | $11 - $16 | 12% |
| Sandhills Center Lme | $11 - $16 | 12% |
| Screening For Life | $11 - $16 | 12% |
| St Joseph County Hlth Dpt | $11 - $16 | 12% |
| Stephenson Cty Health | $11 - $16 | 12% |
| Sunshine State Health Plan | $11 - $16 | 12% |
| Superior Health | $11 - $16 | 12% |
| Tenncare | $11 - $16 | 12% |
| Texas Children'S Health Plan | $11 - $16 | 12% |
| Trillium Community Ohp | $11 - $16 | 12% |
| Tufts Health Public Plans | $11 - $16 | 12% |
| UnitedHealthcare | $11 - $181 | 12% |
| Vaya Health Lme | $11 - $16 | 12% |
| Washtenaw Health Plan | $11 - $16 | 12% |
| Wellsense Health Plan | $11 - $16 | 12% |
| Wi Womens Wellness | $11 - $16 | 12% |
| Champva | $15 - $23 | 17% |
| Medicare (plans) | $15 - $49 | 17% |
| Tricare | $15 - $23 | 17% |
| Triwest Health Alliance | $15 - $23 | 17% |
| Us Family Health Plan | $15 - $23 | 17% |
| Veterans Eval Services | $15 - $23 | 17% |
| Align Senior Care | $16 - $50 | 18% |
| Veterans Administration | $16 - $24 | 18% |
| Access Health | $17 - $35 | 19% |
| Cca - Zing Health | $17 - $26 | 19% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $18 - $57 | 20% |
| 1199 National Benefit Fund | $21 - $173 | 24% |
| Allied National Global Care | $21 - $173 | 24% |
| Asr Health Benefits | $21 - $167 | 24% |
| Asrm - Reliance Standard Life Insurance | $21 - $173 | 24% |
| Christian Care Ministry | $21 - $173 | 24% |
| Dean Health | $21 - $173 | 24% |
| Fallon Health | $21 - $173 | 24% |
| Family Life Insurance Company | $21 - $173 | 24% |
| International Benefit Administrators | $21 - $173 | 24% |
| Lifetime Benefit Solutions | $21 - $173 | 24% |
| Manhattan Life | $21 - $173 | 24% |
| Molina Marketplace | $21 - $84 | 24% |
| Multiplan | $21 - $173 | 24% |
| Mvp | $21 - $173 | 24% |
| Oscar | $21 - $62 | 24% |
| Pai | $21 - $173 | 24% |
| Pan-American Life | $21 - $173 | 24% |
| Phcs | $21 - $173 | 24% |
| Trinity Health Share | $21 - $173 | 24% |
| Wellpath | $21 - $130 | 24% |
| Acclaim | $23 - $180 | 26% |
| Administrative Concepts | $23 - $180 | 26% |
| Allegeant | $23 - $180 | 26% |
| Allied Benefit Systems | $23 - $180 | 26% |
| Ameriben | $23 - $180 | 26% |
| American Family | $23 - $180 | 26% |
| American Healthcare Alliance | $23 - $180 | 26% |
| American National | $23 - $38 | 26% |
| American Republic | $23 - $180 | 26% |
| Amerihealth | $23 - $180 | 26% |
| Aultcare | $23 - $180 | 26% |
| Automated Benefit Services | $23 - $180 | 26% |
| Auxiant | $23 - $180 | 26% |
| Benefit Administrative Systems,Llc | $23 - $180 | 26% |
| Boon Chapman | $23 - $180 | 26% |
| Cam Administrative Services | $23 - $180 | 26% |
| Christian Brother Services | $23 - $180 | 26% |
| Christian Brothers Holy Cross | $23 - $180 | 26% |
| Claimchoice Adminstrators | $23 - $180 | 26% |
| Comprehensive Benefits | $23 - $180 | 26% |
| Consociate | $23 - $180 | 26% |
| Continental Life Insurance | $23 - $180 | 26% |
| Coventry | $23 - $38 | 26% |
| Custom Benefit Administrators | $23 - $180 | 26% |
| Cypress Benefit Administrators | $23 - $180 | 26% |
| Employee Benefit Concepts | $23 - $180 | 26% |
| Employee Benefit Management | $23 - $180 | 26% |
| Enterprise Group Planning | $23 - $180 | 26% |
| First Health | $23 - $182 | 26% |
| Forest County Potawatomi | $23 - $180 | 26% |
| Freedom Life Insurance Company | $23 - $180 | 26% |
| Group Administrators | $23 - $180 | 26% |
| Group Marketing Services | $23 - $180 | 26% |
| Group Pension Administrators | $23 - $173 | 26% |
| Guardian | $23 - $180 | 26% |
| Health America | $23 - $180 | 26% |
| Health Choices | $23 - $180 | 26% |
| Health Smart | $23 - $180 | 26% |
| Healthcare Management Admin | $23 - $38 | 26% |
| Healthez | $23 - $180 | 26% |
| Healthgram | $23 - $180 | 26% |
| Healthscope | $23 - $180 | 26% |
| Insight | $23 - $180 | 26% |
| Intercare | $23 - $180 | 26% |
| Jfp Benefit Management | $23 - $180 | 26% |
| Jp Farley Corporation | $23 - $180 | 26% |
| Key Benefit Administrator | $23 - $180 | 26% |
| Liberty Union Life Assurance Co | $23 - $180 | 26% |
| Lucent Health | $23 - $180 | 26% |
| Luminare Health | $23 - $180 | 26% |
| Luminare Health (Detroit) | $23 - $180 | 26% |
| Magnacare | $23 - $38 | 26% |
| Medben | $23 - $180 | 26% |
| Medcost | $23 - $180 | 26% |
| Medical Mutual | $23 - $180 | 26% |
| Mutual Health Services | $23 - $180 | 26% |
| Mutual Of Omaha | $23 - $180 | 26% |
| Ncas | $23 - $180 | 26% |
| Nippon Life Ins | $23 - $180 | 26% |
| Nova | $23 - $180 | 26% |
| Painters Union Insurance Fund | $23 - $180 | 26% |
| Partners Direct Health - Brio | $23 - $35 | 26% |
| Physicians Mutual | $23 - $180 | 26% |
| Plumbers Local 98 Insurance Fund | $23 - $180 | 26% |
| Prairie States | $23 - $180 | 26% |
| Preferred One | $23 - $38 | 26% |
| Primary Physician Care | $23 - $180 | 26% |
| Professional Benefit Administrators | $23 - $180 | 26% |
| Secureone Preferred United Plans | $23 - $180 | 26% |
| Siho Insurance Services | $23 - $38 | 26% |
| Sisco Benefits | $23 - $38 | 26% |
| The Health Plan | $23 - $38 | 26% |
| The Loomis Company | $23 - $180 | 26% |
| Trustmark Small Business Benefits | $23 - $180 | 26% |
| Unicare | $23 - $180 | 26% |
| Unified Group Services | $23 - $180 | 26% |
| Valenz | $23 - $180 | 26% |
| Wc Accident Fund | $23 - $159 | 26% |
| Wc Advantage | $23 - $159 | 26% |
| Wc Aig | $23 - $159 | 26% |
| Wc Allied | $23 - $159 | 26% |
| Wc Amerisure | $23 - $159 | 26% |
| Wc Amtrust | $23 - $159 | 26% |
| Wc Asu Risk Mgt | $23 - $159 | 26% |
| Wc Berkley Admin | $23 - $159 | 26% |
| Wc Broadspire | $23 - $159 | 26% |
| Wc Bunch & Associates | $23 - $159 | 26% |
| Wc Ccmsi | $23 - $159 | 26% |
| Wc Emc Insurance Company | $23 - $159 | 26% |
| Wc Esis | $23 - $159 | 26% |
| Wc Fcci | $23 - $159 | 26% |
| Wc Federated | $23 - $159 | 26% |
| Wc Gallagher Bassett | $23 - $159 | 26% |
| Wc Genex Care For Ohio | $23 - $159 | 26% |
| Wc Guard Insurance Company | $23 - $159 | 26% |
| Wc Hartford | $23 - $159 | 26% |
| Wc Liberty Mutual | $23 - $159 | 26% |
| Wc Meijers | $23 - $159 | 26% |
| Wc Michigan | $23 - $159 | 26% |
| Wc Mitchell Frankenmuth | $23 - $159 | 26% |
| Wc Pma | $23 - $159 | 26% |
| Wc Sedgwick | $23 - $159 | 26% |
| Wc Sentry | $23 - $159 | 26% |
| Wc Travelers | $23 - $159 | 26% |
| Wc Tristar | $23 - $159 | 26% |
| Wc Walmart | $23 - $159 | 26% |
| Wc Zurich | $23 - $159 | 26% |
| Webtpa | $23 - $38 | 26% |
| Western & Southern Financial Group | $23 - $180 | 26% |
| Wps | $23 - $180 | 26% |
| Claimdoc | $24 - $37 | 27% |
| Kent County Jail | $24 - $37 | 27% |
| Muskegon County Jail | $24 - $37 | 27% |
| Andrie Inc | $25 - $38 | 28% |
| East Greenbush Central School District | $25 - $38 | 28% |
| Genex Wc | $25 - $38 | 28% |
| Healthsmart Workers Comp | $25 - $38 | 28% |
| Jag Source | $25 - $38 | 28% |
| Meritain | $25 - $160 | 28% |
| New York State Insurance Fund | $25 - $38 | 28% |
| Njm Insurance Group | $25 - $38 | 28% |
| Rx Heatlhcomp | $25 - $38 | 28% |
| Rx Restat | $25 - $38 | 28% |
| Rx Saif Opdp Wc | $25 - $38 | 28% |
| Rx Worker'S Comp | $25 - $38 | 28% |
| Wc Ace | $25 - $38 | 28% |
| Wc Acs Federal Employees | $25 - $38 | 28% |
| Wc Acuity | $25 - $38 | 28% |
| Wc Aegis | $25 - $38 | 28% |
| Wc Aims | $25 - $38 | 28% |
| Wc Alaska National Ins | $25 - $38 | 28% |
| Wc Align Network | $25 - $38 | 28% |
| Wc Am Trust N America | $25 - $38 | 28% |
| Wc American Claims Mgmt | $25 - $38 | 28% |
| Wc Benetech | $25 - $38 | 28% |
| Wc Broward County | $25 - $38 | 28% |
| Wc California State Comp Ins | $25 - $38 | 28% |
| Wc California State Ins Fund | $25 - $38 | 28% |
| Wc Capitol Area Health Consortium | $25 - $38 | 28% |
| Wc Chartis | $25 - $38 | 28% |
| Wc Chubb | $25 - $38 | 28% |
| Wc Cirma | $25 - $38 | 28% |
| Wc City Of Albany | $25 - $38 | 28% |
| Wc City Of Sioux City | $25 - $38 | 28% |
| Wc Claims Mgmt Inc | $25 - $38 | 28% |
| Wc Cna | $25 - $38 | 28% |
| Wc Comp One Admin C/O Manageability | $25 - $38 | 28% |
| Wc Compone Admin | $25 - $38 | 28% |
| Wc Corvel | $25 - $38 | 28% |
| Wc Ct Healthcare Trust | $25 - $38 | 28% |
| Wc Donegal Insurance Group | $25 - $38 | 28% |
| Wc Employee Mutual | $25 - $38 | 28% |
| Wc Enablecomp | $25 - $38 | 28% |
| Wc Encore Health Network | $25 - $38 | 28% |
| Wc Erie | $25 - $38 | 28% |
| Wc Evolutions | $25 - $38 | 28% |
| Wc Fed Ex | $25 - $38 | 28% |
| Wc Federal Black Lung | $25 - $38 | 28% |
| Wc Finley Occupational Health | $25 - $38 | 28% |
| Wc First Agency/Occunet | $25 - $38 | 28% |
| Wc Ford Motor | $25 - $38 | 28% |
| Wc Fresno Unified Emp | $25 - $38 | 28% |
| Wc General Motors | $25 - $38 | 28% |
| Wc Generic | $25 - $38 | 28% |
| Wc Great West Casualty | $25 - $38 | 28% |
| Wc Guarantee Insurance | $25 - $38 | 28% |
| Wc Hab | $25 - $38 | 28% |
| Wc Hastings | $25 - $38 | 28% |
| Wc Health Management | $25 - $38 | 28% |
| Wc Heritage Summit | $25 - $38 | 28% |
| Wc Hireright | $25 - $38 | 28% |
| Wc Horizon | $25 - $38 | 28% |
| Wc Icw Group | $25 - $38 | 28% |
| Wc Idaho State Ins Fund | $25 - $38 | 28% |
| Wc Intercare Insurance | $25 - $38 | 28% |
| Wc Intermountain | $25 - $38 | 28% |
| Wc Johns Eastern | $25 - $38 | 28% |
| Wc Kemberton | $25 - $38 | 28% |
| Wc Key Ins & Benefit Solutions | $25 - $38 | 28% |
| Wc Mac Risk Management | $25 - $38 | 28% |
| Wc Massachusetts | $25 - $38 | 28% |
| Wc Mdia | $25 - $38 | 28% |
| Wc Meadowbrook Claim | $25 - $38 | 28% |
| Wc Medical Administrators | $25 - $38 | 28% |
| Wc Memic | $25 - $38 | 28% |
| Wc Mercy Workcare | $25 - $38 | 28% |
| Wc Michigan Millers Mutual | $25 - $38 | 28% |
| Wc Mra | $25 - $38 | 28% |
| Wc Nationwide | $25 - $38 | 28% |
| Wc Nca Comp | $25 - $38 | 28% |
| Wc New York | $25 - $38 | 28% |
| Wc New York Special Funds | $25 - $38 | 28% |
| Wc North American Rishces | $25 - $38 | 28% |
| Wc Northeast Health | $25 - $38 | 28% |
| Wc Notre Dame | $25 - $38 | 28% |
| Wc Novanet | $25 - $38 | 28% |
| Wc O'Hara Corp | $25 - $38 | 28% |
| Wc Occ Health Allen | $25 - $38 | 28% |
| Wc Ohio Bureau | $25 - $38 | 28% |
| Wc One Call Medical | $25 - $38 | 28% |
| Wc Paradigm | $25 - $38 | 28% |
| Wc Peerless | $25 - $38 | 28% |
| Wc Praxis Health Network | $25 - $38 | 28% |
| Wc Price Chopper | $25 - $38 | 28% |
| Wc Procura Management | $25 - $38 | 28% |
| Wc Qualcare | $25 - $38 | 28% |
| Wc Quiktrip | $25 - $38 | 28% |
| Wc Reny Company | $25 - $38 | 28% |
| Wc Rev Claims | $25 - $38 | 28% |
| Wc Risico | $25 - $38 | 28% |
| Wc Rural Mutual | $25 - $38 | 28% |
| Wc Saif Oregon | $25 - $38 | 28% |
| Wc Secura | $25 - $38 | 28% |
| Wc Sheakley Unicomp | $25 - $38 | 28% |
| Wc Smile Lodge | $25 - $38 | 28% |
| Wc Society | $25 - $38 | 28% |
| Wc Srs | $25 - $38 | 28% |
| Wc Taconic (Mro) | $25 - $38 | 28% |
| Wc Taconic Farms | $25 - $38 | 28% |
| Wc Triad Group | $25 - $38 | 28% |
| Wc Troy Ny | $25 - $38 | 28% |
| Wc Tyson | $25 - $38 | 28% |
| Wc Unified Health Services | $25 - $38 | 28% |
| Wc United Heartland | $25 - $38 | 28% |
| Wc Us Dept Of Labor | $25 - $38 | 28% |
| Wc Velocity | $25 - $38 | 28% |
| Wc West Bend | $25 - $38 | 28% |
| Wc West Bend Mutual/Argent | $25 - $38 | 28% |
| Wc Winnebago Industries | $25 - $38 | 28% |
| Wc Yankee Trails | $25 - $38 | 28% |
| Wc York Risk | $25 - $38 | 28% |
| Wc Zenith | $25 - $38 | 28% |
| American Postal Workers Secondary | $26 - $39 | 29% |
| Blue Care Network | $27 - $172 | 30% |
| Blue Benefit Administrators Of Massachusetts | $28 - $172 | 31% |
| Blue Distinction Transplant | $28 - $172 | 31% |
| Blue Shield - Ca | $28 - $172 | 31% |
| Blue Shield - Id (Regence) | $28 - $172 | 31% |
| Blue Shield - Ny Highmark Northeastern | $28 - $172 | 31% |
| Blue Shield - Ny Highmark Western | $28 - $172 | 31% |
| Blue Shield - Pa (Highmark) | $28 - $172 | 31% |
| Blue Shield - Wa (Regence) | $28 - $172 | 31% |
| Priority Health | $28 - $181 | 31% |
| Varipro | $28 - $185 | 31% |
| Nomi Health | $31 - $113 | 35% |
| Bcccp-Michigan | $40 - $65 | 45% |
| U Of M Health Plan | $40 - $180 | 45% |
| Us Health And Life | $40 - $180 | 45% |
| Blue Care Network Advantage | $49 | 55% |
| Correctional Recovery | $50 | 56% |
| Vitalcore | $67 | 75% |
| Hospice Of Michigan | $111 | 125% |
| Bcn Domestic | $172 | 193% |
| Kaiser Domestic | $172 | 193% |
| Ghc Scw | $173 | 195% |
| Medi Share | $173 | 195% |
| Paramount Hmo | $173 | 195% |
| Caresource | $179 | 201% |