CMS Price Transparency Data
Office visit, established patient (20-29 min)
Facility: Mercyone Oelwein Medical Center
Billing Code: 99213 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 99213
- Insurance Median: $31
- Cash Discount Price: $129
- vs. Medicare Baseline: 0.33x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Mercyone Oelwein Medical Center is $31. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $129. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 0.33x the Medicare baseline. Located in 201 Eighth Avenue Se, Oelwein, IA.
Cash / Self-Pay
$129
Average discount available for prompt cash payment at this facility.
Insurance Median
$31
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$95.19
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $95.19 (100%)
Cash / Self-Pay: $129 (136%)
Insurance Median: $31 (33%)
Cash: $129 (136% of Medicare)
Ins. Median: $31 (33% of Medicare)
Understanding this gauge: We use the federal Medicare rate of $95.19 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 |
|---|---|---|
| Triwest Health Alliance | $10 - $60 | 11% |
| Humana | $10 - $88 | 11% |
| Tricare | $10 - $60 | 11% |
| Us Family Health Plan | $10 - $60 | 11% |
| Veterans Eval Services | $10 - $60 | 11% |
| Champva | $10 - $60 | 11% |
| Medicaid / KanCare | $11 - $72 | 12% |
| Amish Hospital Aid | $12 - $99 | 13% |
| Amps | $12 - $74 | 13% |
| Avera | $13 - $83 | 14% |
| Multiplan | $13 - $177 | 14% |
| Health Partners | $14 - $175 | 15% |
| Blue Shield - Ny Highmark Western | $15 - $93 | 16% |
| Blue Care Network | $15 - $93 | 16% |
| Bcn Domestic | $15 - $93 | 16% |
| Blue Shield - Id (Regence) | $15 - $93 | 16% |
| Newton Correctional Facility | $15 - $92 | 16% |
| Kaiser Domestic | $15 - $93 | 16% |
| Blue Shield - Ca | $15 - $93 | 16% |
| Pre-Employment | $15 - $93 | 16% |
| Health Choices | $15 - $134 | 16% |
| Blue Shield - PA (Highmark) | $15 - $93 | 16% |
| Blue Cross Blue Shield | $15 - $93 | 16% |
| Blue Benefit Administrators of Massachusetts | $15 - $93 | 16% |
| Ambetter / Centene | $15 - $125 | 16% |
| Medical Associates | $15 - $134 | 16% |
| Wc Domestic | $15 - $93 | 16% |
| Blue Shield - Wa (Regence) | $15 - $93 | 16% |
| Blue Shield - Ny Highmark Northeastern | $15 - $93 | 16% |
| Blue Distinction Transplant | $15 - $93 | 16% |
| Sanford Health Plan | $15 - $92 | 16% |
| Oscar | $16 - $101 | 17% |
| Health Smart | $16 - $101 | 17% |
| Lucent Health | $16 - $167 | 17% |
| Ucare | $16 - $97 | 17% |
| Stephenson Cty Health | $16 - $100 | 17% |
| Genex Wc | $17 - $106 | 18% |
| Centivo | $17 - $112 | 18% |
| UnitedHealthcare | $17 - $157 | 18% |
| Geha | $17 - $157 | 18% |
| USA Managed Care | $17 - $106 | 18% |
| Claimdoc | $18 - $150 | 19% |
| The Alliance | $18 - $115 | 19% |
| Wc Align Network | $18 - $113 | 19% |
| Wc Reny Company | $19 - $123 | 20% |
| Wc Velocity | $19 - $123 | 20% |
| Wc Praxis Health Network | $19 - $120 | 20% |
| Meritain | $19 - $167 | 20% |
| Aetna | $19 - $167 | 20% |
| Global Excel | $20 - $124 | 21% |
| Auto Velocity | $20 - $127 | 21% |
| Wc O'Hara Corp | $20 - $127 | 21% |
| Velocity | $21 - $129 | 22% |
| Preferred One | $21 - $132 | 22% |
| Wc Allied | $22 - $141 | 23% |
| Wc Hartford | $22 - $141 | 23% |
| Wc Claims Mgmt Inc | $22 - $141 | 23% |
| Wc Ace | $22 - $141 | 23% |
| Wc Tristar | $22 - $141 | 23% |
| Wc Gallagher Bassett | $22 - $141 | 23% |
| Wc Compone Admin | $22 - $141 | 23% |
| Wc Liberty Mutual | $22 - $141 | 23% |
| Wc Pma | $22 - $141 | 23% |
| Wc Enablecomp | $22 - $141 | 23% |
| Wc Donegal Insurance Group | $22 - $141 | 23% |
| Wc Broadspire | $22 - $141 | 23% |
| Wc Berkley Admin | $22 - $141 | 23% |
| Wc New York Special Funds | $22 - $141 | 23% |
| Wc Intercare Insurance | $22 - $141 | 23% |
| Wc Us Dept of Labor | $22 - $141 | 23% |
| Wc California State Ins Fund | $22 - $141 | 23% |
| Wc Nationwide | $22 - $141 | 23% |
| Wc Troy Ny | $22 - $141 | 23% |
| Wc Intermountain | $22 - $141 | 23% |
| Wc West Bend Mutual/Argent | $22 - $141 | 23% |
| Wc Procura Management | $22 - $141 | 23% |
| Wc Horizon | $22 - $141 | 23% |
| Wc Yankee Trails | $22 - $141 | 23% |
| Wc Fcci | $22 - $141 | 23% |
| Wc Great West Casualty | $22 - $141 | 23% |
| Wc Amtrust | $22 - $141 | 23% |
| Wc Hireright | $22 - $141 | 23% |
| Wc Finley Occupational Health | $22 - $141 | 23% |
| Wc Ford Motor | $22 - $141 | 23% |
| Wc Bunch & Associates | $22 - $141 | 23% |
| Wc Quiktrip | $22 - $141 | 23% |
| Wc Hab | $22 - $141 | 23% |
| Wc Erie | $22 - $141 | 23% |
| Wc Peerless | $22 - $141 | 23% |
| Rx Saif Opdp Wc | $22 - $141 | 23% |
| Wc Price Chopper | $22 - $141 | 23% |
| Group Administrators | $22 - $112 | 23% |
| Wc Unified Health Services | $22 - $141 | 23% |
| Wc Secura | $22 - $141 | 23% |
| Wc Asu Risk Mgt | $22 - $141 | 23% |
| Wc Smile Lodge | $22 - $141 | 23% |
| Wc Ccmsi | $22 - $141 | 23% |
| First Choice Health | $22 - $112 | 23% |
| Wc Mdia | $22 - $141 | 23% |
| Wc Accident Fund | $22 - $141 | 23% |
| Wc Guarantee Insurance | $22 - $141 | 23% |
| Wc Novanet | $22 - $141 | 23% |
| Wc Walmart | $22 - $141 | 23% |
| Wc Taconic (Mro) | $22 - $141 | 23% |
| Wc Mra | $22 - $141 | 23% |
| Wc Sentry | $22 - $141 | 23% |
| Wc Ct Healthcare Trust | $22 - $141 | 23% |
| Wc New York | $22 - $141 | 23% |
| Wc Saif Oregon | $22 - $141 | 23% |
| Njm Insurance Group | $22 - $141 | 23% |
| Wc Winnebago Industries | $22 - $141 | 23% |
| Wc One Call Medical | $22 - $141 | 23% |
| Wc Guard Insurance Company | $22 - $141 | 23% |
| Rx Heatlhcomp | $22 - $141 | 23% |
| Wc Notre Dame | $22 - $141 | 23% |
| Wc Aims | $22 - $141 | 23% |
| Wc California State Comp Ins | $22 - $141 | 23% |
| East Greenbush Central School District | $22 - $141 | 23% |
| Wc Chubb | $22 - $141 | 23% |
| Wc Medical Administrators | $22 - $141 | 23% |
| Wc Travelers | $22 - $141 | 23% |
| Wc Massachusetts | $22 - $141 | 23% |
| Wc Benetech | $22 - $141 | 23% |
| Iowa Dept of Public Health | $22 - $60 | 23% |
| Wc Tyson | $22 - $141 | 23% |
| Jag Source | $22 - $141 | 23% |
| Quiktrip | $22 - $141 | 23% |
| Wc Chartis | $22 - $141 | 23% |
| Wc Heritage Summit | $22 - $141 | 23% |
| Wc Federal Black Lung | $22 - $141 | 23% |
| Wc West Bend | $22 - $141 | 23% |
| Wc Cirma | $22 - $141 | 23% |
| Wc Zenith | $22 - $141 | 23% |
| Wc Meadowbrook Claim | $22 - $141 | 23% |
| Wc Broward County | $22 - $141 | 23% |
| Wc Memic | $22 - $141 | 23% |
| Wc City of Albany | $22 - $141 | 23% |
| Wc Johns Eastern | $22 - $141 | 23% |
| Wc Comp One Admin C/O Manageability | $22 - $141 | 23% |
| Wc Aegis | $22 - $141 | 23% |
| Wc Emc Insurance Company | $22 - $141 | 23% |
| Wc Mitchell Frankenmuth | $22 - $141 | 23% |
| Allied Benefit Systems | $22 - $167 | 23% |
| Wc Advantage | $22 - $141 | 23% |
| Wc Alaska National Ins | $22 - $141 | 23% |
| Wc Key Ins & Benefit Solutions | $22 - $141 | 23% |
| Wc American Claims Mgmt | $22 - $141 | 23% |
| Wc Risico | $22 - $141 | 23% |
| Wc Amerisure | $22 - $141 | 23% |
| Wc Acs Federal Employees | $22 - $141 | 23% |
| Wc Meijers | $22 - $141 | 23% |
| Wc Evolutions | $22 - $141 | 23% |
| Wc Sedgwick | $22 - $141 | 23% |
| Wc Rev Claims | $22 - $141 | 23% |
| Midlands Choice | $22 - $178 | 23% |
| Wc Northeast Health | $22 - $141 | 23% |
| Wc Mercy Workcare | $22 - $141 | 23% |
| Wc Idaho State Ins Fund | $22 - $141 | 23% |
| Wc United Heartland | $22 - $141 | 23% |
| Midlands | $22 - $178 | 23% |
| Wc North American Rishces | $22 - $141 | 23% |
| Rx Worker's Comp | $22 - $141 | 23% |
| Wc Sheakley Unicomp | $22 - $141 | 23% |
| Wc York Risk | $22 - $141 | 23% |
| Healthsmart Workers Comp | $22 - $141 | 23% |
| Wc Triad Group | $22 - $141 | 23% |
| Wc Fed Ex | $22 - $141 | 23% |
| Rx Restat | $22 - $141 | 23% |
| Wc Fresno Unified Emp | $22 - $141 | 23% |
| New York State Insurance Fund | $22 - $141 | 23% |
| Wc Kemberton | $22 - $141 | 23% |
| Wc Zurich | $22 - $141 | 23% |
| Wc Qualcare | $22 - $141 | 23% |
| Wc Hastings | $22 - $141 | 23% |
| Wc Am Trust N America | $22 - $141 | 23% |
| Wc Encore Health Network | $22 - $141 | 23% |
| Wc Acuity | $22 - $141 | 23% |
| Wc Federated | $22 - $141 | 23% |
| Wc Michigan | $22 - $141 | 23% |
| Wc Generic | $22 - $141 | 23% |
| Wc Rural Mutual | $22 - $141 | 23% |
| Wc Mac Risk Management | $22 - $141 | 23% |
| Wc Paradigm | $22 - $141 | 23% |
| Wc Aig | $22 - $141 | 23% |
| Wc General Motors | $22 - $141 | 23% |
| Auxiant | $22 - $178 | 23% |
| Cigna | $22 - $178 | 23% |
| Wc Capitol Area Health Consortium | $22 - $141 | 23% |
| Nebraska Total Care | $22 - $50 | 23% |
| Wc Health Management | $22 - $141 | 23% |
| Andrie Inc | $22 - $141 | 23% |
| Wc Icw Group | $22 - $141 | 23% |
| Wc Nca Comp | $22 - $141 | 23% |
| Wc First Agency/Occunet | $22 - $141 | 23% |
| Wc Esis | $22 - $141 | 23% |
| Wc Occ Health Allen | $22 - $141 | 23% |
| Wc Ohio Bureau | $22 - $141 | 23% |
| Wc Taconic Farms | $22 - $141 | 23% |
| Wc Genex Care for Ohio | $22 - $141 | 23% |
| Wc Employee Mutual | $22 - $141 | 23% |
| Wc Michigan Millers Mutual | $22 - $141 | 23% |
| Wc City of Sioux City | $22 - $141 | 23% |
| Wc Cna | $22 - $141 | 23% |
| Wc Srs | $22 - $141 | 23% |
| Wc Society | $22 - $141 | 23% |
| Nextlevel Health | $31 | 33% |
| Cmh Macomb | $31 | 33% |
| Cmh Oakland County | $31 | 33% |
| La Care Health Plan | $31 | 33% |
| Albany County Correctional Facility | $31 | 33% |
| Breast Grant-Connecticut | $31 | 33% |
| Maryland Breast & Cervical Program | $31 | 33% |
| Tenncare | $31 | 33% |
| Community Benefit Health | $31 | 33% |
| Wellsense Health Plan | $31 | 33% |
| Cmh Ottawa County | $31 | 33% |
| Id County Cat Fund | $31 | 33% |
| Care Oregon Ohp | $31 | 33% |
| Medstar Md Health Choice | $31 | 33% |
| Cmh Kent County | $31 | 33% |
| Rx Assistance/Rx Manufacturer Assistance 0 Copay | $31 | 33% |
| Healthy Blue Ne | $31 | 33% |
| Cmh Bay-Arenac County | $31 | 33% |
| Broward County Dept of Health | $31 | 33% |
| Id County Other | $31 | 33% |
| Kern Family Health Plan | $31 | 33% |
| Bmc Healthnet | $31 | 33% |
| Lakeland Care Inc | $31 | 33% |
| Vaya Health Lme | $31 | 33% |
| Cmh Kalamazoo | $31 | 33% |
| Parkland Community Health Plan | $31 | 33% |
| Bcccp-Michigan | $31 | 33% |
| Cardinal Innovations Lme | $31 | 33% |
| Cmh Northern Lakes County | $31 | 33% |
| Care Connections of Northern Iowa | $31 | 33% |
| Ghc Scw Wi Badgercare | $31 | 33% |
| Cmh Central Mi County | $31 | 33% |
| Id County Ada | $31 | 33% |
| Cmh Barry County | $31 | 33% |
| Amish Mennonite | $31 | 33% |
| Philadelphia County Funding | $31 | 33% |
| New York Cancer Services Program | $31 | 33% |
| Indiana Breast Cervical Cancer | $31 | 33% |
| Mo Home State Health Plan | $31 | 33% |
| Keystone First Chip | $31 | 33% |
| Sunshine State Health Plan | $31 | 33% |
| Cmh Lenawee County | $31 | 33% |
| Tufts Health Public Plans | $31 | 33% |
| Rx Meridian Rx | $31 | 33% |
| Medi-Cal Healthnet | $31 | 33% |
| Maryland Physicians Care | $31 | 33% |
| Trillium Community Ohp | $31 | 33% |
| Molina Centennial Care | $31 | 33% |
| Rx 340B Pass Along | $31 | 33% |
| Cmh Ausable Valley | $31 | 33% |
| Delaware First Health | $31 | 33% |
| Freedom First Healthcare | $31 | 33% |
| Cmh Genesee County | $31 | 33% |
| Maryland Healthy Smiles - Scion Dental | $31 | 33% |
| Idaho Womens Health Check | $31 | 33% |
| Community Care Partners | $31 | 33% |
| Sandhills Center Lme | $31 | 33% |
| Covid19 Hrsa Uninsured Testing and Treatment Fund | $31 | 33% |
| Cmh Cass County | $31 | 33% |
| Jai Medical System | $31 | 33% |
| County Funding Generic | $31 | 33% |
| Mdwise | $31 | 33% |
| Eastpointe Lme | $31 | 33% |
| Medi-Cal | $31 | 33% |
| Family Health Network | $31 | 33% |
| Cenpatico | $31 | 33% |
| Bccp | $31 | 33% |
| Intercommunity Health Ohp | $31 | 33% |
| Cencal Health Plan | $31 | 33% |
| Id County Canyon | $31 | 33% |
| Ascension St. Vincent Public Safety Medical | $31 | 33% |
| Ryan White Florida Mssrp | $31 | 33% |
| Screening for Life | $31 | 33% |
| Cmh Monroe County | $31 | 33% |
| Cmh Allegan County | $31 | 33% |
| Priority Partners | $31 | 33% |
| Cmh Clinton-Eaton-Ingham County | $31 | 33% |
| Health Safety Net | $31 | 33% |
| Cmh Misc | $31 | 33% |
| Cmh Livingston County | $31 | 33% |
| Idaho Dept Health and Wellfare | $31 | 33% |
| Keystone First | $31 | 33% |
| Cmh Muskegon County | $31 | 33% |
| Pace of Southwest Michigan | $31 - $54 | 33% |
| Cmh Ionia County | $31 | 33% |
| Fresno County Ccs | $31 | 33% |
| Cmh Washtenaw County | $31 | 33% |
| Prestige Health Choice | $31 | 33% |
| Childrens Medical Services Title 19 | $31 | 33% |
| Washtenaw Health Plan | $31 | 33% |
| Can Community Health Inc | $31 | 33% |
| Cmh West Mi County | $31 | 33% |
| Superior Health | $31 | 33% |
| Managed Health Services - Indiana | $31 | 33% |
| Partners Behavioral Lme | $31 | 33% |
| Community Care Behavorial Health | $31 | 33% |
| Medstar Dc Healthy Family | $31 | 33% |
| Cmh Jackson County/Lifeways | $31 | 33% |
| Cmh Wayne Cty/Com Liv Svcs | $31 | 33% |
| Wi Womens Wellness | $31 | 33% |
| Cmh Berrien County | $31 | 33% |
| Chhuny | $31 | 33% |
| Massachusetts Behavioral Health Partnership | $31 | 33% |
| Iowa Total Care | $31 - $71 | 33% |
| Harbor Health | $31 | 33% |
| Rx Medi-Cal | $31 | 33% |
| Dph Tb Program | $31 | 33% |
| Cmh Van Buren County | $31 | 33% |
| Delta Dental Nj | $31 | 33% |
| Dscc | $31 | 33% |
| Childrens Comm Health Plan | $31 | 33% |
| Cmh Wayne County/Carelink | $31 | 33% |
| Paramount Advantage | $31 | 33% |
| St Joseph County Hlth Dpt | $31 | 33% |
| Cmh Detroit Wayne Integrated Health Network | $31 | 33% |
| Inland Empire Health Plan | $31 | 33% |
| Texas Children's Health Plan | $31 | 33% |
| Id County Payette | $31 | 33% |
| Cmh North Country | $31 | 33% |
| Dean Wi Badgercare | $31 | 33% |
| Cmh Montcalm County | $31 | 33% |
| Robert F Sing Program | $31 | 33% |
| Delaware County Department of Health | $31 | 33% |
| Oregon Screenwise | $31 | 33% |
| Nascentia Health Options | $31 | 33% |
| Presbyterian Centennial Care | $31 | 33% |
| Hennepin Health | $31 | 33% |
| California Health and Wellness | $31 | 33% |
| Connections Csp | $31 | 33% |
| County Coroner | $31 | 33% |
| Cmh Newaygo County | $31 | 33% |
| City of Philadelphia | $31 | 33% |
| Community Health Choice | $31 | 33% |
| Peach State Healthplan | $31 | 33% |
| Wellpoint | $32 | 34% |
| Wc Corvel | $52 | 55% |
| Commonwealth Care Alliance | $54 | 57% |
| Pace Cny | $54 | 57% |
| Pace-Trinity Health | $54 | 57% |
| Blue Shield - De (Highmark) Medciare Advantage | $54 | 57% |
| Innovative Integrated Health Community Plans | $54 | 57% |
| Longevity Health Plan | $54 | 57% |
| Scan Health Plan McR IPA Meritage Oon | $54 | 57% |
| Presbyterian Senior Plan | $54 | 57% |
| Texan Plus | $54 | 57% |
| Careplus Health Plans | $54 | 57% |
| Osu Prime Care Advantage | $54 | 57% |
| Johns Hopkins Advantage Md | $54 | 57% |
| Siouxland Pace | $54 | 57% |
| Everence | $54 | 57% |
| Pace Southeast | $54 | 57% |
| American Health Advantage of Idaho | $54 | 57% |
| Care Dimensions | $54 | 57% |
| New Centry Health Careplus | $54 | 57% |
| Elementcare | $54 | 57% |
| Horizon Nj Total Care | $54 | 57% |
| Gold Advantage | $54 | 57% |
| Hope Select Pace | $54 | 57% |
| Tribute Health Plans | $54 | 57% |
| Peak Pace Solutions | $54 | 57% |
| Provider Partners Health Plan of Illinois | $54 | 57% |
| Mercyone Cedar Valley | $54 | 57% |
| Hudson Headwaters Pace | $54 | 57% |
| Thome Pace | $54 | 57% |
| Champion Health Plan McR Advantage | $54 | 57% |
| Um Health Advantage | $54 | 57% |
| Highmark Health Options Dual Plan | $54 | 57% |
| Health America Advantra | $54 | 57% |
| Georgia Health Advantage | $54 | 57% |
| Care Improvement Plus | $54 | 57% |
| Clear Spring Health | $54 | 57% |
| Sunnyview-Pace Finance Dept | $54 | 57% |
| Medicare (plans) | $54 - $78 | 57% |
| Evercare | $54 | 57% |
| The Health Plan | $54 | 57% |
| Rx Allwin | $54 | 57% |
| Perennial Advantage | $54 | 57% |
| Mass General Brigham McR Adv | $54 | 57% |
| Longevity IPA of Michigan LLC Health Plan Isnp | $54 | 57% |
| Michigan Complete Health | $54 | 57% |
| Union Health Service | $54 | 57% |
| Gateway Health Plan | $54 | 57% |
| Serenity Pace | $54 | 57% |
| Meridian Complete | $54 | 57% |
| Align Senior Care | $54 | 57% |
| Wellmed | $54 | 57% |
| Clover Health | $54 | 57% |
| Nascentia Health Plus | $54 | 57% |
| Care Resources Pace | $54 | 57% |
| Lasso Healthcare Msa | $54 | 57% |
| Gpa Croell Redi Mix | $54 | 57% |
| Rx Retiree Rx Care | $54 | 57% |
| Cca - Zing Health | $54 | 57% |
| Mercy Life | $54 | 57% |
| Huron Valley Pace | $54 | 57% |
| Blue Care Network Advantage | $54 | 57% |
| Eddy Senior Care-Pace | $54 | 57% |
| Pruitthealth Premier | $54 | 57% |
| Aurora Special Needs | $54 | 57% |
| Solis Health Plans | $54 | 57% |
| Welbe Health | $54 | 57% |
| Secure Horizons Ma Pffs | $54 | 57% |
| Central Valley Medical Services Corp Pace | $54 | 57% |
| Cca Senior Care Options | $54 | 57% |
| Community Pace at Home | $54 | 57% |
| Martins Point Generations Advantage | $54 | 57% |
| Provider Partners Health Plan of Indiana | $54 | 57% |
| Eddy Seniorcare Pace | $54 | 57% |
| Todays Options | $54 | 57% |
| Lifecircles Pace | $54 | 57% |
| Ally Align Care Adv | $54 | 57% |
| Rx Grane Grnmedd | $54 | 57% |
| Life St Marys Pace | $54 | 57% |
| Medipak Advantage | $54 | 57% |
| Preferred Care Partners | $54 | 57% |
| Pace Iowa Immanuel Pathways | $54 | 57% |
| Genesys Pace of Genesee County | $54 | 57% |
| Reliance Community Care Partners Care Resources Pace | $54 | 57% |
| Veterans Administration | $55 | 58% |
| Iowa Health Advantage | $56 | 59% |
| American Health Plan | $56 | 59% |
| Nova | $150 | 158% |
| Christian Brother Services | $167 | 175% |
| Medical Mutual | $167 | 175% |
| Webtpa | $167 | 175% |
| Luminare Health | $167 | 175% |
| 1199 National Benefit Fund | $167 | 175% |
| First Health | $167 | 175% |
| Trustmark Small Business Benefits | $167 | 175% |
| Coventry | $167 | 175% |
| Asr Health Benefits | $167 | 175% |
| Medica | $178 | 187% |
| Crime Victim Assistance | $182 | 191% |