Ultrasound, pelvis
Facility: Johnson Memorial Hospital
Billing Code: 76856 (CPT)
- CPT Billing Code: 76856
- Insurance Median: $73
- Cash Discount Price: $274
- vs. Medicare Baseline: 0.68x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Understanding this gauge: We use the federal Medicare rate of $106.81 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Molina Centennial Care | $20 - $67 | 19% |
| Philadelphia County Funding | $20 - $67 | 19% |
| Cencal Health Plan | $20 - $67 | 19% |
| Vaya Health Lme | $20 - $67 | 19% |
| Cmh Livingston County | $20 - $67 | 19% |
| Cmh Lenawee County | $20 - $67 | 19% |
| Cmh Allegan County | $20 - $67 | 19% |
| Superior Health | $20 - $67 | 19% |
| Partners Behavioral Lme | $20 - $67 | 19% |
| Eastpointe Lme | $20 - $67 | 19% |
| Chhuny | $20 - $67 | 19% |
| Rx 340B Pass Along | $20 - $67 | 19% |
| Cmh North Country | $20 - $67 | 19% |
| Community Care Behavorial Health | $20 - $67 | 19% |
| Lakeland Care Inc | $20 - $67 | 19% |
| Intercommunity Health Ohp | $20 - $67 | 19% |
| Cmh Montcalm County | $20 - $67 | 19% |
| Rx Assistance/Rx Manufacturer Assistance 0 Copay | $20 - $67 | 19% |
| Idaho Dept Health and Wellfare | $20 - $67 | 19% |
| Cmh Cass County | $20 - $67 | 19% |
| Cmh Wayne County/Carelink | $20 - $67 | 19% |
| Cardinal Innovations Lme | $20 - $67 | 19% |
| Idaho Womens Health Check | $20 - $67 | 19% |
| Priority Partners | $20 - $67 | 19% |
| New York Cancer Services Program | $20 - $67 | 19% |
| Cmh West Mi County | $20 - $67 | 19% |
| Cmh Newaygo County | $20 - $67 | 19% |
| Cmh Wayne Cty/Com Liv Svcs | $20 - $67 | 19% |
| Kern Family Health Plan | $20 - $67 | 19% |
| Oregon Screenwise | $20 - $67 | 19% |
| Prestige Health Choice | $20 - $67 | 19% |
| Wi Womens Wellness | $20 - $67 | 19% |
| La Care Health Plan | $20 - $67 | 19% |
| Community Care Partners | $20 - $67 | 19% |
| Ghc Scw Wi Badgercare | $20 - $67 | 19% |
| Iowa Total Care | $20 - $67 | 19% |
| Nextlevel Health | $20 - $67 | 19% |
| Childrens Comm Health Plan | $20 - $67 | 19% |
| Massachusetts Behavioral Health Partnership | $20 - $67 | 19% |
| UnitedHealthcare | $20 - $1,045 | 19% |
| Dph Tb Program | $20 - $67 | 19% |
| Cmh Misc | $20 - $67 | 19% |
| Medi-Cal | $20 - $67 | 19% |
| Community Health Choice | $20 - $67 | 19% |
| Cigna | $20 - $815 | 19% |
| Trillium Community Ohp | $20 - $67 | 19% |
| Peach State Healthplan | $20 - $67 | 19% |
| Albany County Correctional Facility | $20 - $67 | 19% |
| Cmh Genesee County | $20 - $67 | 19% |
| Dscc | $20 - $67 | 19% |
| Community Benefit Health | $20 - $67 | 19% |
| Keystone First | $20 - $67 | 19% |
| Childrens Medical Services Title 19 | $20 - $67 | 19% |
| Paramount Advantage | $20 - $67 | 19% |
| Cmh Muskegon County | $20 - $67 | 19% |
| Cmh Ausable Valley | $20 - $67 | 19% |
| Maryland Physicians Care | $20 - $67 | 19% |
| Amish Mennonite | $20 - $67 | 19% |
| Indiana Breast Cervical Cancer | $20 - $67 | 19% |
| Cmh Kalamazoo | $20 - $67 | 19% |
| County Coroner | $20 - $67 | 19% |
| Cmh Macomb | $20 - $67 | 19% |
| Covid19 Hrsa Uninsured Testing and Treatment Fund | $20 - $67 | 19% |
| County Funding Generic | $20 - $67 | 19% |
| Sunshine State Health Plan | $20 - $67 | 19% |
| Maryland Breast & Cervical Program | $20 - $67 | 19% |
| Maryland Healthy Smiles - Scion Dental | $20 - $67 | 19% |
| Cenpatico | $20 - $67 | 19% |
| City of Philadelphia | $20 - $67 | 19% |
| Rx Meridian Rx | $20 - $67 | 19% |
| Hennepin Health | $20 - $67 | 19% |
| Cmh Jackson County/Lifeways | $20 - $67 | 19% |
| Robert F Sing Program | $20 - $67 | 19% |
| Tufts Health Public Plans | $20 - $67 | 19% |
| Care Oregon Ohp | $20 - $67 | 19% |
| Health Safety Net | $20 - $67 | 19% |
| Bcccp-Michigan | $20 - $67 | 19% |
| Aetna | $20 - $264 | 19% |
| Ambetter / Centene | $20 - $67 | 19% |
| Can Community Health Inc | $20 - $67 | 19% |
| Stephenson Cty Health | $20 - $67 | 19% |
| Healthy Blue Ne | $20 - $67 | 19% |
| Cmh Bay-Arenac County | $20 - $67 | 19% |
| Cmh Monroe County | $20 - $67 | 19% |
| Id County Payette | $20 - $67 | 19% |
| Wellsense Health Plan | $20 - $67 | 19% |
| Pace of Southwest Michigan | $20 - $110 | 19% |
| California Health and Wellness | $20 - $67 | 19% |
| Sandhills Center Lme | $20 - $67 | 19% |
| Cmh Kent County | $20 - $67 | 19% |
| Keystone First Chip | $20 - $67 | 19% |
| Harbor Health | $20 - $67 | 19% |
| Ascension St. Vincent Public Safety Medical | $20 - $67 | 19% |
| Humana | $20 - $110 | 19% |
| Bmc Healthnet | $20 - $67 | 19% |
| Ryan White Florida Mssrp | $20 - $67 | 19% |
| Delaware First Health | $20 - $67 | 19% |
| Rx Medi-Cal | $20 - $67 | 19% |
| Presbyterian Centennial Care | $20 - $67 | 19% |
| Cmh Van Buren County | $20 - $67 | 19% |
| Broward County Dept of Health | $20 - $67 | 19% |
| Cmh Northern Lakes County | $20 - $67 | 19% |
| Cmh Oakland County | $20 - $67 | 19% |
| Cmh Detroit Wayne Integrated Health Network | $20 - $67 | 19% |
| Fresno County Ccs | $20 - $67 | 19% |
| Dean Wi Badgercare | $20 - $67 | 19% |
| Cmh Ottawa County | $20 - $67 | 19% |
| Parkland Community Health Plan | $20 - $67 | 19% |
| Id County Canyon | $20 - $67 | 19% |
| Id County Other | $20 - $67 | 19% |
| Cmh Berrien County | $20 - $67 | 19% |
| Bccp | $20 - $67 | 19% |
| Managed Health Services - Indiana | $20 - $67 | 19% |
| Medstar Dc Healthy Family | $20 - $67 | 19% |
| Washtenaw Health Plan | $20 - $67 | 19% |
| Cmh Clinton-Eaton-Ingham County | $20 - $67 | 19% |
| Family Health Network | $20 - $67 | 19% |
| Blue Cross Blue Shield | $20 - $273 | 19% |
| Id County Ada | $20 - $67 | 19% |
| Delaware County Department of Health | $20 - $67 | 19% |
| Care Connections of Northern Iowa | $20 - $67 | 19% |
| Breast Grant-Connecticut | $20 - $67 | 19% |
| Connections Csp | $20 - $67 | 19% |
| Tenncare | $20 - $67 | 19% |
| Medstar Md Health Choice | $20 - $67 | 19% |
| Id County Cat Fund | $20 - $67 | 19% |
| Medicaid / KanCare | $20 - $284 | 19% |
| Screening for Life | $20 - $67 | 19% |
| Freedom First Healthcare | $20 - $67 | 19% |
| Cmh Central Mi County | $20 - $67 | 19% |
| Medi-Cal Healthnet | $20 - $67 | 19% |
| Mo Home State Health Plan | $20 - $67 | 19% |
| Cmh Washtenaw County | $20 - $67 | 19% |
| Mdwise | $20 - $67 | 19% |
| Cmh Barry County | $20 - $67 | 19% |
| Inland Empire Health Plan | $20 - $67 | 19% |
| Texas Children's Health Plan | $20 - $67 | 19% |
| Nebraska Total Care | $20 - $67 | 19% |
| Nascentia Health Options | $20 - $67 | 19% |
| Jai Medical System | $20 - $67 | 19% |
| Cmh Ionia County | $20 - $67 | 19% |
| St Joseph County Hlth Dpt | $20 - $67 | 19% |
| Health New England | $30 - $679 | 28% |
| Veterans Eval Services | $32 - $105 | 30% |
| Tricare | $32 - $105 | 30% |
| Triwest Health Alliance | $32 - $105 | 30% |
| Champva | $32 - $105 | 30% |
| Highmark Health Options Dual Plan | $33 - $110 | 31% |
| Us Family Health Plan | $33 - $248 | 31% |
| Wellmed | $33 - $110 | 31% |
| Horizon Nj Total Care | $33 - $110 | 31% |
| Genesys Pace of Genesee County | $33 - $110 | 31% |
| Solis Health Plans | $33 - $110 | 31% |
| The Health Plan | $33 - $110 | 31% |
| Hope Select Pace | $33 - $110 | 31% |
| Cca - Zing Health | $33 - $110 | 31% |
| Provider Partners Health Plan of Illinois | $33 - $110 | 31% |
| Tribute Health Plans | $33 - $110 | 31% |
| Um Health Advantage | $33 - $110 | 31% |
| Eddy Senior Care-Pace | $33 - $110 | 31% |
| Eddy Seniorcare Pace | $33 - $110 | 31% |
| Mercy Life | $33 - $110 | 31% |
| Careplus Health Plans | $33 - $110 | 31% |
| American Health Plan | $33 - $110 | 31% |
| Texan Plus | $33 - $110 | 31% |
| Mass General Brigham McR Adv | $33 - $110 | 31% |
| Meridian Complete | $33 - $110 | 31% |
| Longevity Health Plan | $33 - $110 | 31% |
| Everence | $33 - $110 | 31% |
| Peak Pace Solutions | $33 - $110 | 31% |
| Pace Cny | $33 - $110 | 31% |
| Welbe Health | $33 - $110 | 31% |
| Siouxland Pace | $33 - $110 | 31% |
| Michigan Complete Health | $33 - $110 | 31% |
| Pruitthealth Premier | $33 - $110 | 31% |
| Rx Retiree Rx Care | $33 - $110 | 31% |
| Huron Valley Pace | $33 - $110 | 31% |
| Medipak Advantage | $33 - $110 | 31% |
| Elementcare | $33 - $110 | 31% |
| Longevity IPA of Michigan LLC Health Plan Isnp | $33 - $110 | 31% |
| Lasso Healthcare Msa | $33 - $110 | 31% |
| Lifecircles Pace | $33 - $110 | 31% |
| Cca Senior Care Options | $33 - $125 | 31% |
| Provider Partners Health Plan of Indiana | $33 - $110 | 31% |
| Central Valley Medical Services Corp Pace | $33 - $110 | 31% |
| Champion Health Plan McR Advantage | $33 - $110 | 31% |
| Clover Health | $33 - $110 | 31% |
| Pace Southeast | $33 - $110 | 31% |
| Evercare | $33 - $110 | 31% |
| Innovative Integrated Health Community Plans | $33 - $110 | 31% |
| Scan Health Plan McR IPA Meritage Oon | $33 - $110 | 31% |
| Care Resources Pace | $33 - $110 | 31% |
| Blue Care Network Advantage | $33 - $110 | 31% |
| Care Improvement Plus | $33 - $110 | 31% |
| American Health Advantage of Idaho | $33 - $110 | 31% |
| Clear Spring Health | $33 - $110 | 31% |
| Iowa Health Advantage | $33 - $110 | 31% |
| Perennial Advantage | $33 - $110 | 31% |
| Gateway Health Plan | $33 - $110 | 31% |
| Martins Point Generations Advantage | $33 - $110 | 31% |
| Preferred Care Partners | $33 - $110 | 31% |
| Community Pace at Home | $33 - $110 | 31% |
| Reliance Community Care Partners Care Resources Pace | $33 - $110 | 31% |
| Life St Marys Pace | $33 - $110 | 31% |
| Gpa Croell Redi Mix | $33 - $110 | 31% |
| Rx Grane Grnmedd | $33 - $110 | 31% |
| Johns Hopkins Advantage Md | $33 - $110 | 31% |
| Hudson Headwaters Pace | $33 - $110 | 31% |
| Commonwealth Care Alliance | $33 - $112 | 31% |
| Serenity Pace | $33 - $110 | 31% |
| Union Health Service | $33 - $110 | 31% |
| Ally Align Care Adv | $33 - $110 | 31% |
| Blue Shield - De (Highmark) Medciare Advantage | $33 - $110 | 31% |
| Thome Pace | $33 - $110 | 31% |
| Sunnyview-Pace Finance Dept | $33 - $110 | 31% |
| Care Dimensions | $33 - $110 | 31% |
| Aurora Special Needs | $33 - $110 | 31% |
| Osu Prime Care Advantage | $33 - $110 | 31% |
| Presbyterian Senior Plan | $33 - $110 | 31% |
| Rx Allwin | $33 - $110 | 31% |
| Medicare (plans) | $33 - $129 | 31% |
| Todays Options | $33 - $110 | 31% |
| New Centry Health Careplus | $33 - $110 | 31% |
| Pace Iowa Immanuel Pathways | $33 - $110 | 31% |
| Health America Advantra | $33 - $110 | 31% |
| Gold Advantage | $33 - $110 | 31% |
| Pace-Trinity Health | $33 - $110 | 31% |
| Secure Horizons Ma Pffs | $33 - $110 | 31% |
| Nascentia Health Plus | $33 - $110 | 31% |
| Align Senior Care | $33 - $110 | 31% |
| Mercyone Cedar Valley | $33 - $110 | 31% |
| Georgia Health Advantage | $33 - $110 | 31% |
| Veterans Administration | $34 - $113 | 32% |
| Fallon Health | $43 - $239 | 40% |
| Blue Shield - Wa (Regence) | $46 - $273 | 43% |
| Blue Shield - Id (Regence) | $46 - $273 | 43% |
| Blue Shield - Ca | $46 - $273 | 43% |
| Health Choices | $46 - $273 | 43% |
| Blue Distinction Transplant | $46 - $273 | 43% |
| Kaiser Domestic | $46 - $273 | 43% |
| Wc Domestic | $46 - $273 | 43% |
| Blue Care Network | $46 - $273 | 43% |
| Blue Shield - Ny Highmark Northeastern | $46 - $273 | 43% |
| Blue Shield - Ny Highmark Western | $46 - $273 | 43% |
| Pre-Employment | $46 - $273 | 43% |
| Blue Benefit Administrators of Massachusetts | $46 - $273 | 43% |
| Bcn Domestic | $46 - $273 | 43% |
| Blue Shield - PA (Highmark) | $46 - $273 | 43% |
| Mass General Brigham Health Plan | $47 - $246 | 44% |
| Wellpoint | $54 - $273 | 51% |
| Unicare | $54 - $273 | 51% |
| Connecticare | $56 - $562 | 52% |
| Claimdoc | $59 - $263 | 55% |
| Innovative Health Plan II | $59 - $263 | 55% |
| Multiplan | $65 - $867 | 61% |
| Wc Corvel | $70 - $241 | 66% |
| Health Smart | $70 - $888 | 66% |
| Healthscope | $71 - $237 | 66% |
| Tufts Health Plan | $71 - $248 | 66% |
| Harvard Pilgrim Healthcare | $72 - $234 | 67% |
| Wc Qualcare | $73 - $245 | 68% |
| Wc Cirma | $73 - $245 | 68% |
| Wc Zurich | $73 - $245 | 68% |
| Wc Federal Black Lung | $73 - $245 | 68% |
| Wc Acuity | $73 - $245 | 68% |
| Wc Reny Company | $73 - $245 | 68% |
| Wc Ccmsi | $73 - $245 | 68% |
| Wc Heritage Summit | $73 - $245 | 68% |
| Wc Guarantee Insurance | $73 - $245 | 68% |
| Andrie Inc | $73 - $245 | 68% |
| Wc Tristar | $73 - $245 | 68% |
| Wc Mitchell Frankenmuth | $73 - $245 | 68% |
| Wc Donegal Insurance Group | $73 - $245 | 68% |
| Wc Generic | $73 - $245 | 68% |
| Wc Michigan Millers Mutual | $73 - $245 | 68% |
| Wc Accident Fund | $73 - $245 | 68% |
| Wc Aims | $73 - $245 | 68% |
| Wc Meijers | $73 - $245 | 68% |
| Wc Genex Care for Ohio | $73 - $245 | 68% |
| Wc Praxis Health Network | $73 - $245 | 68% |
| Wc Novanet | $73 - $245 | 68% |
| Wc Smile Lodge | $73 - $245 | 68% |
| Wc Liberty Mutual | $73 - $245 | 68% |
| Wc Am Trust N America | $73 - $245 | 68% |
| Wc Sentry | $73 - $245 | 68% |
| Wc Nationwide | $73 - $245 | 68% |
| Wc Walmart | $73 - $245 | 68% |
| Wc O'Hara Corp | $73 - $245 | 68% |
| Wc Chubb | $73 - $245 | 68% |
| Wc Encore Health Network | $73 - $245 | 68% |
| New York State Insurance Fund | $73 - $245 | 68% |
| Wc Fed Ex | $73 - $245 | 68% |
| Wc Health Management | $73 - $245 | 68% |
| Wc General Motors | $73 - $245 | 68% |
| Wc Ct Healthcare Trust | $73 - $245 | 68% |
| Wc Hab | $73 - $245 | 68% |
| Wc Ford Motor | $73 - $245 | 68% |
| Wc Bunch & Associates | $73 - $245 | 68% |
| Wc Employee Mutual | $73 - $245 | 68% |
| Wc United Heartland | $73 - $245 | 68% |
| Wc Price Chopper | $73 - $245 | 68% |
| Wc Srs | $73 - $245 | 68% |
| Wc West Bend | $73 - $245 | 68% |
| Wc Comp One Admin C/O Manageability | $73 - $245 | 68% |
| Wc Travelers | $73 - $245 | 68% |
| Wc Broward County | $73 - $245 | 68% |
| Wc Allied | $73 - $245 | 68% |
| Wc Claims Mgmt Inc | $73 - $245 | 68% |
| Wc Kemberton | $73 - $245 | 68% |
| Wc Unified Health Services | $73 - $245 | 68% |
| Wc Hireright | $73 - $245 | 68% |
| Wc Great West Casualty | $73 - $245 | 68% |
| Wc Massachusetts | $73 - $245 | 68% |
| Wc Northeast Health | $73 - $245 | 68% |
| Wc Hastings | $73 - $245 | 68% |
| Wc Notre Dame | $73 - $245 | 68% |
| Wc Intermountain | $73 - $245 | 68% |
| Njm Insurance Group | $73 - $245 | 68% |
| Wc New York | $73 - $245 | 68% |
| Wc Ace | $73 - $245 | 68% |
| Wc Fresno Unified Emp | $73 - $245 | 68% |
| Wc Amerisure | $73 - $245 | 68% |
| Wc Yankee Trails | $73 - $245 | 68% |
| Genex Wc | $73 - $245 | 68% |
| Rx Restat | $73 - $245 | 68% |
| Wc New York Special Funds | $73 - $245 | 68% |
| Wc Advantage | $73 - $245 | 68% |
| Wc Erie | $73 - $245 | 68% |
| Wc Winnebago Industries | $73 - $245 | 68% |
| Wc Rev Claims | $73 - $245 | 68% |
| Wc Acs Federal Employees | $73 - $245 | 68% |
| Wc Meadowbrook Claim | $73 - $245 | 68% |
| Wc Mercy Workcare | $73 - $245 | 68% |
| Wc California State Comp Ins | $73 - $245 | 68% |
| Wc Rural Mutual | $73 - $245 | 68% |
| Wc Hartford | $73 - $245 | 68% |
| Wc Enablecomp | $73 - $245 | 68% |
| Wc Key Ins & Benefit Solutions | $73 - $245 | 68% |
| Wc Taconic (Mro) | $73 - $245 | 68% |
| Wc Amtrust | $73 - $245 | 68% |
| Wc Memic | $73 - $245 | 68% |
| East Greenbush Central School District | $73 - $245 | 68% |
| Wc Align Network | $73 - $245 | 68% |
| Wc Asu Risk Mgt | $73 - $245 | 68% |
| Wc One Call Medical | $73 - $245 | 68% |
| Wc Intercare Insurance | $73 - $245 | 68% |
| Wc North American Rishces | $73 - $245 | 68% |
| Wc Taconic Farms | $73 - $245 | 68% |
| Wc Aig | $73 - $245 | 68% |
| Wc Benetech | $73 - $245 | 68% |
| Wc Emc Insurance Company | $73 - $245 | 68% |
| Wc Berkley Admin | $73 - $245 | 68% |
| Wc Alaska National Ins | $73 - $245 | 68% |
| Wc Gallagher Bassett | $73 - $245 | 68% |
| Wc Horizon | $73 - $245 | 68% |
| Wc Evolutions | $73 - $245 | 68% |
| Wc Federated | $73 - $245 | 68% |
| Wc Chartis | $73 - $245 | 68% |
| Rx Worker's Comp | $73 - $245 | 68% |
| Wc Procura Management | $73 - $245 | 68% |
| Wc Saif Oregon | $73 - $245 | 68% |
| Wc Risico | $73 - $245 | 68% |
| Wc Triad Group | $73 - $245 | 68% |
| Wc California State Ins Fund | $73 - $245 | 68% |
| Wc West Bend Mutual/Argent | $73 - $245 | 68% |
| Wc Mdia | $73 - $245 | 68% |
| Wc Society | $73 - $245 | 68% |
| Wc Fcci | $73 - $245 | 68% |
| Wc Esis | $73 - $245 | 68% |
| Wc Mra | $73 - $245 | 68% |
| Wc Peerless | $73 - $245 | 68% |
| Wc Broadspire | $73 - $245 | 68% |
| Rx Saif Opdp Wc | $73 - $245 | 68% |
| Wc Compone Admin | $73 - $245 | 68% |
| Wc Quiktrip | $73 - $245 | 68% |
| Wc Aegis | $73 - $245 | 68% |
| Wc Nca Comp | $73 - $245 | 68% |
| Wc Occ Health Allen | $73 - $245 | 68% |
| Wc City of Albany | $73 - $245 | 68% |
| Healthsmart Workers Comp | $73 - $245 | 68% |
| Wc Troy Ny | $73 - $245 | 68% |
| Wc Medical Administrators | $73 - $245 | 68% |
| Wc Ohio Bureau | $73 - $245 | 68% |
| Wc York Risk | $73 - $245 | 68% |
| Wc Mac Risk Management | $73 - $245 | 68% |
| Wc Tyson | $73 - $245 | 68% |
| Wc Icw Group | $73 - $245 | 68% |
| Wc Capitol Area Health Consortium | $73 - $245 | 68% |
| Wc Zenith | $73 - $245 | 68% |
| Wc Pma | $73 - $245 | 68% |
| Wc American Claims Mgmt | $73 - $245 | 68% |
| Wc Secura | $73 - $245 | 68% |
| Wc Sedgwick | $73 - $245 | 68% |
| Wc Paradigm | $73 - $245 | 68% |
| Wc Idaho State Ins Fund | $73 - $245 | 68% |
| Wc Us Dept of Labor | $73 - $245 | 68% |
| Wc Michigan | $73 - $245 | 68% |
| Wc Johns Eastern | $73 - $245 | 68% |
| Wc First Agency/Occunet | $73 - $245 | 68% |
| Wc Guard Insurance Company | $73 - $245 | 68% |
| Wc Finley Occupational Health | $73 - $245 | 68% |
| Rx Heatlhcomp | $73 - $245 | 68% |
| Jag Source | $73 - $245 | 68% |
| Wc Sheakley Unicomp | $73 - $245 | 68% |
| Wc Cna | $73 - $245 | 68% |
| Wc Velocity | $73 - $245 | 68% |
| Wc City of Sioux City | $73 - $245 | 68% |
| Centivo | $78 - $292 | 73% |
| First Health | $80 - $264 | 75% |
| Meritain | $80 - $264 | 75% |
| Coventry | $80 - $264 | 75% |
| Guardian | $80 - $264 | 75% |
| Prime Health Services | $81 - $836 | 76% |
| Delta Dental Nj | $82 - $284 | 77% |
| Liberty Dental | $82 - $284 | 77% |
| Delta Dental Ny | $82 - $284 | 77% |
| Delta Dental Oh | $82 - $284 | 77% |
| Delta Dental PA | $82 - $284 | 77% |
| Delta Dental Mo | $82 - $284 | 77% |
| Delta Dental Mi | $82 - $284 | 77% |
| Delta Dental Ga | $82 - $284 | 77% |
| Delta Dental Wa | $82 - $284 | 77% |
| Delta Dental Or | $82 - $284 | 77% |
| Delta Dental VA | $82 - $284 | 77% |
| Connecticut Dept of Correction | $116 | 109% |
| Geha | $179 | 168% |
| Gravie Admin Services | $246 | 230% |
| 1199 National Benefit Fund | $246 | 230% |
| Allied Benefit Systems | $246 | 230% |
| Hap | $246 | 230% |
| Luminare Health | $246 | 230% |
| Nippon Life Ins | $246 | 230% |
| Webtpa | $246 | 230% |
| Diversified Administrators | $263 | 246% |
| Magnacare | $593 | 555% |
| Allegiance | $593 | 555% |
| Health Partners | $593 | 555% |
| Paramount HMO | $867 | 812% |
| Asrm - Reliance Standard Life Insurance | $867 | 812% |
| Pai | $867 | 812% |
| Dean Health | $867 | 812% |
| PHCS | $867 | 812% |
| Trinity Health Share | $867 | 812% |
| Medi Share | $867 | 812% |
| Pan-American Life | $867 | 812% |
| International Benefit Administrators | $867 | 812% |
| Christian Care Ministry | $867 | 812% |
| Manhattan Life | $867 | 812% |
| Mvp | $867 | 812% |
| Allied National Global Care | $867 | 812% |
| Lifetime Benefit Solutions | $867 | 812% |
| Family Life Insurance Company | $867 | 812% |
| Ghc Scw | $867 | 812% |
| United Behavioral Health Eap | $1,045 | 978% |