CMS Price Transparency Data
Echocardiogram (heart ultrasound)
Facility: Saint Alphonsus Medical Center Ontario
Billing Code: 93306 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 93306
- Insurance Median: $121
- Cash Discount Price: $228
- vs. Medicare Baseline: 0.22x Medicare
The contracted insurance negotiated median rate for a Echocardiogram (heart ultrasound) at Saint Alphonsus Medical Center Ontario is $121. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $228. Compared to the federal Medicare reimbursement reference rate of $558.25, this hospital’s rate is 0.22x the Medicare baseline. Located in 351 Sw 9Th Street, Ontario, OR.
Cash / Self-Pay
$228
Average discount available for prompt cash payment at this facility.
Insurance Median
$121
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$558.25
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $558.25 (100%)
Cash / Self-Pay: $228 (41%)
Insurance Median: $121 (22%)
Cash: $228 (41% of Medicare)
Ins. Median: $121 (22% of Medicare)
Understanding this gauge: We use the federal Medicare rate of $558.25 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
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
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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 | $43 - $839 | 8% |
| Aetna | $54 - $2,648 | 10% |
| Albany County Correctional Facility | $54 | 10% |
| Ambetter / Centene | $54 - $839 | 10% |
| Amish Mennonite | $54 - $839 | 10% |
| Ascension St. Vincent Public Safety Medical | $54 | 10% |
| Bcccp-Michigan | $54 - $839 | 10% |
| Bccp | $54 - $839 | 10% |
| Blue Cross Blue Shield | $54 - $2,377 | 10% |
| Bmc Healthnet | $54 - $839 | 10% |
| Breast Grant-Connecticut | $54 - $839 | 10% |
| Broward County Dept Of Health | $54 | 10% |
| California Health And Wellness | $54 - $839 | 10% |
| Can Community Health Inc | $54 | 10% |
| Cardinal Innovations Lme | $54 - $839 | 10% |
| Care Connections Of Northern Iowa | $54 | 10% |
| Care Oregon Ohp | $54 - $839 | 10% |
| Cencal Health Plan | $54 - $839 | 10% |
| Cenpatico | $54 - $839 | 10% |
| Chhuny | $54 - $839 | 10% |
| Childrens Comm Health Plan | $54 - $839 | 10% |
| Childrens Medical Services Title 19 | $54 - $839 | 10% |
| Cigna | $54 - $2,628 | 10% |
| City Of Philadelphia | $54 | 10% |
| Cmh Allegan County | $54 | 10% |
| Cmh Ausable Valley | $54 | 10% |
| Cmh Barry County | $54 | 10% |
| Cmh Bay-Arenac County | $54 | 10% |
| Cmh Berrien County | $54 | 10% |
| Cmh Cass County | $54 | 10% |
| Cmh Central Mi County | $54 | 10% |
| Cmh Clinton-Eaton-Ingham County | $54 | 10% |
| Cmh Detroit Wayne Integrated Health Network | $54 | 10% |
| Cmh Genesee County | $54 | 10% |
| Cmh Ionia County | $54 | 10% |
| Cmh Jackson County/Lifeways | $54 | 10% |
| Cmh Kalamazoo | $54 | 10% |
| Cmh Kent County | $54 | 10% |
| Cmh Lenawee County | $54 | 10% |
| Cmh Livingston County | $54 | 10% |
| Cmh Macomb | $54 | 10% |
| Cmh Misc | $54 | 10% |
| Cmh Monroe County | $54 | 10% |
| Cmh Montcalm County | $54 | 10% |
| Cmh Muskegon County | $54 | 10% |
| Cmh Newaygo County | $54 | 10% |
| Cmh North Country | $54 | 10% |
| Cmh Northern Lakes County | $54 | 10% |
| Cmh Oakland County | $54 | 10% |
| Cmh Ottawa County | $54 | 10% |
| Cmh Van Buren County | $54 | 10% |
| Cmh Washtenaw County | $54 | 10% |
| Cmh Wayne County/Carelink | $54 | 10% |
| Cmh Wayne Cty/Com Liv Svcs | $54 | 10% |
| Cmh West Mi County | $54 | 10% |
| Community Benefit Health | $54 - $839 | 10% |
| Community Care Behavorial Health | $54 - $839 | 10% |
| Community Care Partners | $54 | 10% |
| Community Health Choice | $54 - $839 | 10% |
| Connections Csp | $54 | 10% |
| County Coroner | $54 | 10% |
| County Funding Generic | $54 | 10% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund | $54 - $839 | 10% |
| Dean Wi Badgercare | $54 - $839 | 10% |
| Delaware County Department Of Health | $54 | 10% |
| Delaware First Health | $54 - $839 | 10% |
| Delta Dental Nj | $54 - $839 | 10% |
| Dph Tb Program | $54 - $839 | 10% |
| Dscc | $54 - $839 | 10% |
| Eastpointe Lme | $54 - $839 | 10% |
| Family Health Network | $54 - $839 | 10% |
| Freedom First Healthcare | $54 - $839 | 10% |
| Fresno County Ccs | $54 | 10% |
| Ghc Scw Wi Badgercare | $54 - $839 | 10% |
| Harbor Health | $54 - $839 | 10% |
| Health Safety Net | $54 - $839 | 10% |
| Healthy Blue Ne | $54 - $839 | 10% |
| Hennepin Health | $54 - $839 | 10% |
| Humana | $54 - $2,460 | 10% |
| Id County Ada | $54 - $839 | 10% |
| Id County Canyon | $54 - $839 | 10% |
| Id County Cat Fund | $54 - $839 | 10% |
| Id County Other | $54 | 10% |
| Id County Payette | $54 - $839 | 10% |
| Idaho Dept Health And Wellfare | $54 | 10% |
| Idaho Womens Health Check | $54 - $839 | 10% |
| Indiana Breast Cervical Cancer | $54 - $839 | 10% |
| Inland Empire Health Plan | $54 - $839 | 10% |
| Intercommunity Health Ohp | $54 - $839 | 10% |
| Iowa Total Care | $54 - $839 | 10% |
| Jai Medical System | $54 - $839 | 10% |
| Kern Family Health Plan | $54 - $839 | 10% |
| Keystone First | $54 - $839 | 10% |
| Keystone First Chip | $54 - $839 | 10% |
| La Care Health Plan | $54 - $839 | 10% |
| Lakeland Care Inc | $54 - $839 | 10% |
| Managed Health Services - Indiana | $54 - $839 | 10% |
| Maryland Breast & Cervical Program | $54 - $839 | 10% |
| Maryland Healthy Smiles - Scion Dental | $54 - $839 | 10% |
| Maryland Physicians Care | $54 - $839 | 10% |
| Massachusetts Behavioral Health Partnership | $54 - $839 | 10% |
| Mdwise | $54 - $839 | 10% |
| Medi-Cal | $54 - $839 | 10% |
| Medi-Cal Healthnet | $54 - $839 | 10% |
| Medstar Dc Healthy Family | $54 - $839 | 10% |
| Medstar Md Health Choice | $54 - $839 | 10% |
| Mo Home State Health Plan | $54 - $839 | 10% |
| Molina Centennial Care | $54 - $839 | 10% |
| Nascentia Health Options | $54 - $839 | 10% |
| Nebraska Total Care | $54 - $839 | 10% |
| New York Cancer Services Program | $54 - $839 | 10% |
| Nextlevel Health | $54 - $839 | 10% |
| Oregon Screenwise | $54 - $839 | 10% |
| Pace Of Southwest Michigan | $54 - $839 | 10% |
| Paramount Advantage | $54 - $839 | 10% |
| Parkland Community Health Plan | $54 - $839 | 10% |
| Partners Behavioral Lme | $54 - $839 | 10% |
| Peach State Healthplan | $54 - $839 | 10% |
| Philadelphia County Funding | $54 | 10% |
| Presbyterian Centennial Care | $54 - $839 | 10% |
| Prestige Health Choice | $54 - $839 | 10% |
| Priority Partners | $54 - $839 | 10% |
| Robert F Sing Program | $54 | 10% |
| Rx 340B Pass Along | $54 - $839 | 10% |
| Rx Assistance/Rx Manufacturer Assistance 0 Copay | $54 - $839 | 10% |
| Rx Medi-Cal | $54 - $839 | 10% |
| Rx Meridian Rx | $54 - $839 | 10% |
| Ryan White Florida Mssrp | $54 | 10% |
| Sandhills Center Lme | $54 - $839 | 10% |
| Screening For Life | $54 - $839 | 10% |
| St Joseph County Hlth Dpt | $54 | 10% |
| Stephenson Cty Health | $54 | 10% |
| Sunshine State Health Plan | $54 - $839 | 10% |
| Superior Health | $54 - $839 | 10% |
| Tenncare | $54 - $839 | 10% |
| Texas Children'S Health Plan | $54 - $839 | 10% |
| Trillium Community Ohp | $54 - $839 | 10% |
| Tufts Health Public Plans | $54 - $839 | 10% |
| UnitedHealthcare | $54 - $2,684 | 10% |
| Vaya Health Lme | $54 - $839 | 10% |
| Washtenaw Health Plan | $54 | 10% |
| Wellsense Health Plan | $54 - $839 | 10% |
| Wi Womens Wellness | $54 - $839 | 10% |
| Champva | $65 | 12% |
| Tricare | $65 | 12% |
| Triwest Health Alliance | $65 | 12% |
| Us Family Health Plan | $65 | 12% |
| Veterans Eval Services | $65 | 12% |
| Align Senior Care | $66 | 12% |
| Ally Align Care Adv | $66 | 12% |
| American Health Plan | $66 | 12% |
| Aurora Special Needs | $66 | 12% |
| Blue Care Network Advantage | $66 | 12% |
| Blue Shield - De (Highmark) Medciare Advantage | $66 | 12% |
| Care Dimensions | $66 | 12% |
| Care Improvement Plus | $66 | 12% |
| Care Resources Pace | $66 | 12% |
| Careplus Health Plans | $66 | 12% |
| Cca - Zing Health | $66 | 12% |
| Cca Senior Care Options | $66 | 12% |
| Central Valley Medical Services Corp Pace | $66 | 12% |
| Champion Health Plan Mcr Advantage | $66 | 12% |
| Clear Spring Health | $66 | 12% |
| Clover Health | $66 | 12% |
| Commonwealth Care Alliance | $66 | 12% |
| Community Pace At Home | $66 | 12% |
| Eddy Senior Care-Pace | $66 | 12% |
| Eddy Seniorcare Pace | $66 | 12% |
| Elementcare | $66 | 12% |
| Evercare | $66 | 12% |
| Everence | $66 | 12% |
| Gateway Health Plan | $66 | 12% |
| Genesys Pace Of Genesee County | $66 | 12% |
| Georgia Health Advantage | $66 | 12% |
| Gold Advantage | $66 | 12% |
| Gpa Croell Redi Mix | $66 | 12% |
| Health America Advantra | $66 | 12% |
| Highmark Health Options Dual Plan | $66 | 12% |
| Hope Select Pace | $66 | 12% |
| Horizon Nj Total Care | $66 | 12% |
| Hudson Headwaters Pace | $66 | 12% |
| Huron Valley Pace | $66 | 12% |
| Innovative Integrated Health Community Plans | $66 | 12% |
| Iowa Health Advantage | $66 | 12% |
| Johns Hopkins Advantage Md | $66 | 12% |
| Lasso Healthcare Msa | $66 | 12% |
| Life St Marys Pace | $66 | 12% |
| Lifecircles Pace | $66 | 12% |
| Longevity Health Plan | $66 | 12% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $66 | 12% |
| Martins Point Generations Advantage | $66 | 12% |
| Mass General Brigham Mcr Adv | $66 | 12% |
| Medicare (plans) | $66 - $683 | 12% |
| Medipak Advantage | $66 | 12% |
| Mercy Life | $66 | 12% |
| Mercyone Cedar Valley | $66 | 12% |
| Meridian Complete | $66 | 12% |
| Michigan Complete Health | $66 | 12% |
| Nascentia Health Plus | $66 | 12% |
| New Centry Health Careplus | $66 | 12% |
| Osu Prime Care Advantage | $66 | 12% |
| Pace Cny | $66 | 12% |
| Pace Iowa Immanuel Pathways | $66 | 12% |
| Pace Southeast | $66 | 12% |
| Pace-Trinity Health | $66 | 12% |
| Peak Pace Solutions | $66 | 12% |
| Perennial Advantage | $66 | 12% |
| Preferred Care Partners | $66 | 12% |
| Presbyterian Senior Plan | $66 | 12% |
| Provider Partners Health Plan Of Illinois | $66 | 12% |
| Provider Partners Health Plan Of Indiana | $66 | 12% |
| Pruitthealth Premier | $66 | 12% |
| Reliance Community Care Partners Care Resources Pace | $66 | 12% |
| Rx Allwin | $66 | 12% |
| Rx Grane Grnmedd | $66 | 12% |
| Rx Retiree Rx Care | $66 | 12% |
| Scan Health Plan Mcr Ipa Meritage Oon | $66 | 12% |
| Secure Horizons Ma Pffs | $66 | 12% |
| Serenity Pace | $66 | 12% |
| Siouxland Pace | $66 | 12% |
| Solis Health Plans | $66 | 12% |
| Sunnyview-Pace Finance Dept | $66 | 12% |
| Texan Plus | $66 | 12% |
| The Health Plan | $66 | 12% |
| Thome Pace | $66 | 12% |
| Todays Options | $66 | 12% |
| Tribute Health Plans | $66 | 12% |
| Um Health Advantage | $66 | 12% |
| Union Health Service | $66 | 12% |
| Welbe Health | $66 | 12% |
| Wellmed | $66 | 12% |
| Veterans Administration | $67 | 12% |
| American Health Advantage Of Idaho | $68 - $663 | 12% |
| Asuris Northwest Health | $110 | 20% |
| Blue Shield - Id (Regence) | $110 - $2,065 | 20% |
| Healthcare Management Admin | $110 - $2,052 | 20% |
| Pacificsource Health Plans | $115 - $2,628 | 21% |
| Moda Health | $118 - $2,712 | 21% |
| Mountain Health Co-Op | $118 - $1,678 | 21% |
| Selecthealth | $118 - $2,516 | 21% |
| First Choice Health | $119 - $2,516 | 21% |
| Providence | $119 - $2,656 | 21% |
| Webtpa | $120 - $2,516 | 21% |
| Andrie Inc | $121 | 22% |
| East Greenbush Central School District | $121 | 22% |
| Genex Wc | $121 | 22% |
| Healthsmart Workers Comp | $121 | 22% |
| Jag Source | $121 | 22% |
| New York State Insurance Fund | $121 | 22% |
| Njm Insurance Group | $121 | 22% |
| Rx Heatlhcomp | $121 | 22% |
| Rx Restat | $121 | 22% |
| Rx Saif Opdp Wc | $121 | 22% |
| Rx Worker'S Comp | $121 | 22% |
| Wc Accident Fund | $121 | 22% |
| Wc Ace | $121 | 22% |
| Wc Acs Federal Employees | $121 | 22% |
| Wc Acuity | $121 | 22% |
| Wc Advantage | $121 | 22% |
| Wc Aegis | $121 | 22% |
| Wc Aig | $121 | 22% |
| Wc Aims | $121 | 22% |
| Wc Alaska National Ins | $121 | 22% |
| Wc Align Network | $121 | 22% |
| Wc Allied | $121 | 22% |
| Wc Am Trust N America | $121 | 22% |
| Wc American Claims Mgmt | $121 | 22% |
| Wc Amerisure | $121 | 22% |
| Wc Amtrust | $121 | 22% |
| Wc Asu Risk Mgt | $121 | 22% |
| Wc Benetech | $121 | 22% |
| Wc Berkley Admin | $121 | 22% |
| Wc Broadspire | $121 | 22% |
| Wc Broward County | $121 | 22% |
| Wc Bunch & Associates | $121 | 22% |
| Wc California State Comp Ins | $121 | 22% |
| Wc California State Ins Fund | $121 | 22% |
| Wc Capitol Area Health Consortium | $121 | 22% |
| Wc Ccmsi | $121 | 22% |
| Wc Chartis | $121 | 22% |
| Wc Chubb | $121 | 22% |
| Wc Cirma | $121 | 22% |
| Wc City Of Albany | $121 | 22% |
| Wc City Of Sioux City | $121 | 22% |
| Wc Claims Mgmt Inc | $121 | 22% |
| Wc Cna | $121 | 22% |
| Wc Comp One Admin C/O Manageability | $121 | 22% |
| Wc Compone Admin | $121 | 22% |
| Wc Corvel | $121 | 22% |
| Wc Ct Healthcare Trust | $121 | 22% |
| Wc Donegal Insurance Group | $121 | 22% |
| Wc Emc Insurance Company | $121 | 22% |
| Wc Employee Mutual | $121 | 22% |
| Wc Enablecomp | $121 | 22% |
| Wc Encore Health Network | $121 | 22% |
| Wc Erie | $121 | 22% |
| Wc Esis | $121 | 22% |
| Wc Evolutions | $121 | 22% |
| Wc Fcci | $121 | 22% |
| Wc Fed Ex | $121 | 22% |
| Wc Federal Black Lung | $121 | 22% |
| Wc Federated | $121 | 22% |
| Wc Finley Occupational Health | $121 | 22% |
| Wc First Agency/Occunet | $121 | 22% |
| Wc Ford Motor | $121 | 22% |
| Wc Fresno Unified Emp | $121 | 22% |
| Wc Gallagher Bassett | $121 | 22% |
| Wc General Motors | $121 | 22% |
| Wc Generic | $121 | 22% |
| Wc Genex Care For Ohio | $121 | 22% |
| Wc Great West Casualty | $121 | 22% |
| Wc Guarantee Insurance | $121 | 22% |
| Wc Guard Insurance Company | $121 | 22% |
| Wc Hab | $121 | 22% |
| Wc Hartford | $121 | 22% |
| Wc Hastings | $121 | 22% |
| Wc Health Management | $121 | 22% |
| Wc Heritage Summit | $121 | 22% |
| Wc Hireright | $121 | 22% |
| Wc Horizon | $121 | 22% |
| Wc Icw Group | $121 | 22% |
| Wc Idaho State Ins Fund | $121 | 22% |
| Wc Intercare Insurance | $121 | 22% |
| Wc Intermountain | $121 | 22% |
| Wc Johns Eastern | $121 | 22% |
| Wc Kemberton | $121 | 22% |
| Wc Key Ins & Benefit Solutions | $121 | 22% |
| Wc Liberty Mutual | $121 | 22% |
| Wc Mac Risk Management | $121 | 22% |
| Wc Massachusetts | $121 | 22% |
| Wc Mdia | $121 | 22% |
| Wc Meadowbrook Claim | $121 | 22% |
| Wc Medical Administrators | $121 | 22% |
| Wc Meijers | $121 | 22% |
| Wc Memic | $121 | 22% |
| Wc Mercy Workcare | $121 | 22% |
| Wc Michigan | $121 | 22% |
| Wc Michigan Millers Mutual | $121 | 22% |
| Wc Mitchell Frankenmuth | $121 | 22% |
| Wc Mra | $121 | 22% |
| Wc Nationwide | $121 | 22% |
| Wc Nca Comp | $121 | 22% |
| Wc New York | $121 | 22% |
| Wc New York Special Funds | $121 | 22% |
| Wc North American Rishces | $121 | 22% |
| Wc Northeast Health | $121 | 22% |
| Wc Notre Dame | $121 | 22% |
| Wc Novanet | $121 | 22% |
| Wc O'Hara Corp | $121 | 22% |
| Wc Occ Health Allen | $121 | 22% |
| Wc Ohio Bureau | $121 | 22% |
| Wc One Call Medical | $121 | 22% |
| Wc Paradigm | $121 | 22% |
| Wc Peerless | $121 | 22% |
| Wc Pma | $121 | 22% |
| Wc Praxis Health Network | $121 | 22% |
| Wc Price Chopper | $121 | 22% |
| Wc Procura Management | $121 | 22% |
| Wc Qualcare | $121 | 22% |
| Wc Quiktrip | $121 | 22% |
| Wc Reny Company | $121 | 22% |
| Wc Rev Claims | $121 | 22% |
| Wc Risico | $121 | 22% |
| Wc Rural Mutual | $121 | 22% |
| Wc Saif Oregon | $121 | 22% |
| Wc Secura | $121 | 22% |
| Wc Sedgwick | $121 | 22% |
| Wc Sentry | $121 | 22% |
| Wc Sheakley Unicomp | $121 | 22% |
| Wc Smile Lodge | $121 | 22% |
| Wc Society | $121 | 22% |
| Wc Srs | $121 | 22% |
| Wc Taconic (Mro) | $121 | 22% |
| Wc Taconic Farms | $121 | 22% |
| Wc Travelers | $121 | 22% |
| Wc Triad Group | $121 | 22% |
| Wc Tristar | $121 | 22% |
| Wc Troy Ny | $121 | 22% |
| Wc Tyson | $121 | 22% |
| Wc Unified Health Services | $121 | 22% |
| Wc United Heartland | $121 | 22% |
| Wc Us Dept Of Labor | $121 | 22% |
| Wc Velocity | $121 | 22% |
| Wc Walmart | $121 | 22% |
| Wc West Bend | $121 | 22% |
| Wc West Bend Mutual/Argent | $121 | 22% |
| Wc Winnebago Industries | $121 | 22% |
| Wc Yankee Trails | $121 | 22% |
| Wc York Risk | $121 | 22% |
| Wc Zenith | $121 | 22% |
| Wc Zurich | $121 | 22% |
| Molina Marketplace | $130 | 23% |
| Geha | $141 - $2,684 | 25% |
| Allied National Global Care | $143 - $2,516 | 26% |
| Asrm - Reliance Standard Life Insurance | $143 - $2,516 | 26% |
| Bcn Domestic | $143 - $148 | 26% |
| Blue Benefit Administrators Of Massachusetts | $143 - $2,065 | 26% |
| Blue Care Network | $143 - $2,065 | 26% |
| Blue Distinction Transplant | $143 - $2,065 | 26% |
| Blue Shield - Ca | $143 - $2,065 | 26% |
| Blue Shield - Ny Highmark Northeastern | $143 - $2,065 | 26% |
| Blue Shield - Ny Highmark Western | $143 - $2,065 | 26% |
| Blue Shield - Pa (Highmark) | $143 - $2,065 | 26% |
| Blue Shield - Wa (Regence) | $143 - $2,065 | 26% |
| Christian Care Ministry | $143 - $2,516 | 26% |
| Dean Health | $143 - $2,516 | 26% |
| Fallon Health | $143 - $2,516 | 26% |
| Family Life Insurance Company | $143 - $2,516 | 26% |
| Ghc Scw | $143 - $2,516 | 26% |
| Health Choices | $143 - $148 | 26% |
| International Benefit Administrators | $143 - $2,516 | 26% |
| Kaiser Domestic | $143 - $148 | 26% |
| Lifetime Benefit Solutions | $143 - $2,516 | 26% |
| Manhattan Life | $143 - $2,516 | 26% |
| Medi Share | $143 - $2,656 | 26% |
| Multiplan | $143 - $203 | 26% |
| Pai | $143 - $2,516 | 26% |
| Pan-American Life | $143 - $2,516 | 26% |
| Paramount Hmo | $143 - $2,516 | 26% |
| Phcs | $143 - $2,516 | 26% |
| Pre-Employment | $143 - $148 | 26% |
| Trinity Health Share | $143 - $2,516 | 26% |
| Wc Domestic | $143 - $148 | 26% |
| Ada County Jail Inmate Ins | $839 | 150% |
| Centurion Of Idaho | $839 | 150% |
| Allegiance | $2,125 | 381% |
| Correctional Health Partners | $2,181 | 391% |
| Columbia Health Network | $2,237 | 401% |
| Healthnet | $2,349 | 421% |
| Lifewise | $2,600 | 466% |
| Priority Health | $2,628 | 471% |
| Allied Benefit Systems | $2,648 | 474% |
| Ameriben | $2,648 | 474% |
| Asr Health Benefits | $2,648 | 474% |
| Christian Brother Services | $2,648 | 474% |
| Healthez | $2,648 | 474% |
| Luminare Health (Detroit) | $2,648 | 474% |
| Rural Carrier Health Benefit Plan | $2,648 | 474% |
| First Health | $2,656 | 476% |