CMS Price Transparency Data
Office visit, established patient (30-39 min)
Facility: Mercyone Oelwein Medical Center
Billing Code: 99214 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 99214
- Insurance Median: $49
- Cash Discount Price: $187
- vs. Medicare Baseline: 0.36x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Mercyone Oelwein Medical Center is $49. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $187. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.36x the Medicare baseline. Located in 201 Eighth Avenue Se, Oelwein, IA.
Cash / Self-Pay
$187
Average discount available for prompt cash payment at this facility.
Insurance Median
$49
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$135.6
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $135.6 (100%)
Cash / Self-Pay: $187 (138%)
Insurance Median: $49 (36%)
Cash: $187 (138% of Medicare)
Ins. Median: $49 (36% of Medicare)
Understanding this gauge: We use the federal Medicare rate of $135.6 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 |
|---|---|---|
| Tricare | $14 - $89 | 10% |
| Humana | $14 - $129 | 10% |
| Champva | $14 - $89 | 10% |
| Us Family Health Plan | $14 - $89 | 10% |
| Veterans Eval Services | $14 - $89 | 10% |
| Triwest Health Alliance | $14 - $89 | 10% |
| Medicaid / KanCare | $16 - $102 | 12% |
| Amish Hospital Aid | $17 - $141 | 13% |
| Amps | $17 - $108 | 13% |
| Avera | $20 - $122 | 15% |
| Multiplan | $20 - $250 | 15% |
| Medical Associates | $21 - $190 | 15% |
| Health Partners | $21 - $248 | 15% |
| Pre-Employment | $22 - $137 | 16% |
| Blue Benefit Administrators of Massachusetts | $22 - $137 | 16% |
| Blue Shield - Ca | $22 - $137 | 16% |
| Health Choices | $22 - $190 | 16% |
| Ambetter / Centene | $22 - $178 | 16% |
| Blue Shield - Wa (Regence) | $22 - $137 | 16% |
| Blue Distinction Transplant | $22 - $137 | 16% |
| Wc Domestic | $22 - $137 | 16% |
| Sanford Health Plan | $22 - $135 | 16% |
| Blue Shield - Ny Highmark Northeastern | $22 - $137 | 16% |
| Kaiser Domestic | $22 - $137 | 16% |
| Bcn Domestic | $22 - $137 | 16% |
| Blue Shield - Ny Highmark Western | $22 - $137 | 16% |
| Blue Shield - Id (Regence) | $22 - $137 | 16% |
| Newton Correctional Facility | $22 - $136 | 16% |
| Blue Care Network | $22 - $137 | 16% |
| Blue Cross Blue Shield | $22 - $137 | 16% |
| Blue Shield - PA (Highmark) | $22 - $137 | 16% |
| Stephenson Cty Health | $23 - $142 | 17% |
| Lucent Health | $23 - $237 | 17% |
| Ucare | $23 - $143 | 17% |
| Health Smart | $24 - $149 | 18% |
| Oscar | $24 - $148 | 18% |
| Centivo | $25 - $159 | 18% |
| Genex Wc | $25 - $157 | 18% |
| USA Managed Care | $25 - $156 | 18% |
| Wc Align Network | $26 - $167 | 19% |
| Geha | $27 - $223 | 20% |
| Claimdoc | $27 - $213 | 20% |
| UnitedHealthcare | $27 - $223 | 20% |
| The Alliance | $27 - $169 | 20% |
| Wc Praxis Health Network | $28 - $178 | 21% |
| Global Excel | $29 - $182 | 21% |
| Wc Velocity | $29 - $182 | 21% |
| Meritain | $29 - $237 | 21% |
| Wc Reny Company | $29 - $182 | 21% |
| Aetna | $29 - $237 | 21% |
| Wc O'Hara Corp | $30 - $188 | 22% |
| Auto Velocity | $30 - $188 | 22% |
| Velocity | $30 - $189 | 22% |
| Preferred One | $31 - $195 | 23% |
| Wc Notre Dame | $33 - $209 | 24% |
| Healthsmart Workers Comp | $33 - $209 | 24% |
| Auxiant | $33 - $253 | 24% |
| Wc Aegis | $33 - $209 | 24% |
| Wc Allied | $33 - $209 | 24% |
| Wc Icw Group | $33 - $209 | 24% |
| Wc Intercare Insurance | $33 - $209 | 24% |
| Wc Great West Casualty | $33 - $209 | 24% |
| Wc Sedgwick | $33 - $209 | 24% |
| Wc Evolutions | $33 - $209 | 24% |
| Wc New York Special Funds | $33 - $209 | 24% |
| Wc Liberty Mutual | $33 - $209 | 24% |
| Wc Meadowbrook Claim | $33 - $209 | 24% |
| Wc Acs Federal Employees | $33 - $209 | 24% |
| Wc Tristar | $33 - $209 | 24% |
| Group Administrators | $33 - $165 | 24% |
| Wc Genex Care for Ohio | $33 - $209 | 24% |
| Wc Pma | $33 - $209 | 24% |
| Wc American Claims Mgmt | $33 - $209 | 24% |
| Wc Unified Health Services | $33 - $209 | 24% |
| Wc Rural Mutual | $33 - $209 | 24% |
| Wc City of Albany | $33 - $209 | 24% |
| Wc Mdia | $33 - $209 | 24% |
| Quiktrip | $33 - $209 | 24% |
| Wc Claims Mgmt Inc | $33 - $209 | 24% |
| Wc Novanet | $33 - $209 | 24% |
| Wc Medical Administrators | $33 - $209 | 24% |
| Wc Procura Management | $33 - $209 | 24% |
| Wc Encore Health Network | $33 - $209 | 24% |
| Wc New York | $33 - $209 | 24% |
| Wc Johns Eastern | $33 - $209 | 24% |
| Wc Paradigm | $33 - $209 | 24% |
| Wc Guard Insurance Company | $33 - $209 | 24% |
| Cigna | $33 - $253 | 24% |
| Wc Walmart | $33 - $209 | 24% |
| Wc Guarantee Insurance | $33 - $209 | 24% |
| Wc Comp One Admin C/O Manageability | $33 - $209 | 24% |
| Wc Qualcare | $33 - $209 | 24% |
| Wc Compone Admin | $33 - $209 | 24% |
| Wc Us Dept of Labor | $33 - $209 | 24% |
| Wc Northeast Health | $33 - $209 | 24% |
| Wc Accident Fund | $33 - $209 | 24% |
| Wc Triad Group | $33 - $209 | 24% |
| Wc Ace | $33 - $209 | 24% |
| Wc Taconic Farms | $33 - $209 | 24% |
| Wc California State Ins Fund | $33 - $209 | 24% |
| Wc Hastings | $33 - $209 | 24% |
| Wc Hab | $33 - $209 | 24% |
| Wc Berkley Admin | $33 - $209 | 24% |
| Wc Fresno Unified Emp | $33 - $209 | 24% |
| Wc Cirma | $33 - $209 | 24% |
| Wc Alaska National Ins | $33 - $209 | 24% |
| Wc Advantage | $33 - $209 | 24% |
| Wc California State Comp Ins | $33 - $209 | 24% |
| Wc Chartis | $33 - $209 | 24% |
| Wc Broward County | $33 - $209 | 24% |
| Wc Srs | $33 - $209 | 24% |
| Wc Broadspire | $33 - $209 | 24% |
| Wc Federated | $33 - $209 | 24% |
| Wc Yankee Trails | $33 - $209 | 24% |
| Wc Michigan | $33 - $209 | 24% |
| Wc Ohio Bureau | $33 - $209 | 24% |
| Wc Travelers | $33 - $209 | 24% |
| Allied Benefit Systems | $33 - $237 | 24% |
| Wc Horizon | $33 - $209 | 24% |
| Wc Gallagher Bassett | $33 - $209 | 24% |
| Wc Key Ins & Benefit Solutions | $33 - $209 | 24% |
| Wc Donegal Insurance Group | $33 - $209 | 24% |
| Wc Am Trust N America | $33 - $209 | 24% |
| Midlands Choice | $33 - $253 | 24% |
| Wc Memic | $33 - $209 | 24% |
| Wc Capitol Area Health Consortium | $33 - $209 | 24% |
| Wc Occ Health Allen | $33 - $209 | 24% |
| Wc United Heartland | $33 - $209 | 24% |
| Wc Enablecomp | $33 - $209 | 24% |
| Wc Idaho State Ins Fund | $33 - $209 | 24% |
| Wc Federal Black Lung | $33 - $209 | 24% |
| Wc First Agency/Occunet | $33 - $209 | 24% |
| Wc Society | $33 - $209 | 24% |
| Wc Michigan Millers Mutual | $33 - $209 | 24% |
| Wc Tyson | $33 - $209 | 24% |
| Wc Bunch & Associates | $33 - $209 | 24% |
| Wc Mac Risk Management | $33 - $209 | 24% |
| Nebraska Total Care | $33 - $75 | 24% |
| Wc Mercy Workcare | $33 - $209 | 24% |
| Iowa Dept of Public Health | $33 - $89 | 24% |
| Wc Esis | $33 - $209 | 24% |
| Andrie Inc | $33 - $209 | 24% |
| Wc Aims | $33 - $209 | 24% |
| Wc Taconic (Mro) | $33 - $209 | 24% |
| Midlands | $33 - $253 | 24% |
| Wc Quiktrip | $33 - $209 | 24% |
| Wc General Motors | $33 - $209 | 24% |
| Wc Hireright | $33 - $209 | 24% |
| Wc Winnebago Industries | $33 - $209 | 24% |
| Wc Asu Risk Mgt | $33 - $209 | 24% |
| Wc Chubb | $33 - $209 | 24% |
| Wc Smile Lodge | $33 - $209 | 24% |
| Wc Finley Occupational Health | $33 - $209 | 24% |
| Wc Zurich | $33 - $209 | 24% |
| Wc Saif Oregon | $33 - $209 | 24% |
| Wc Health Management | $33 - $209 | 24% |
| Wc Benetech | $33 - $209 | 24% |
| East Greenbush Central School District | $33 - $209 | 24% |
| Wc Mitchell Frankenmuth | $33 - $209 | 24% |
| Wc Fed Ex | $33 - $209 | 24% |
| Wc Kemberton | $33 - $209 | 24% |
| Rx Saif Opdp Wc | $33 - $209 | 24% |
| Wc Acuity | $33 - $209 | 24% |
| Wc Risico | $33 - $209 | 24% |
| Wc Erie | $33 - $209 | 24% |
| Wc Cna | $33 - $209 | 24% |
| Wc Emc Insurance Company | $33 - $209 | 24% |
| Jag Source | $33 - $209 | 24% |
| Wc Amtrust | $33 - $209 | 24% |
| Wc Aig | $33 - $209 | 24% |
| Wc Ford Motor | $33 - $209 | 24% |
| Wc One Call Medical | $33 - $209 | 24% |
| Wc West Bend | $33 - $209 | 24% |
| Wc Peerless | $33 - $209 | 24% |
| Wc Meijers | $33 - $209 | 24% |
| Wc Ccmsi | $33 - $209 | 24% |
| Wc City of Sioux City | $33 - $209 | 24% |
| Wc Nca Comp | $33 - $209 | 24% |
| Wc Zenith | $33 - $209 | 24% |
| Wc Secura | $33 - $209 | 24% |
| Wc West Bend Mutual/Argent | $33 - $209 | 24% |
| Rx Worker's Comp | $33 - $209 | 24% |
| Rx Heatlhcomp | $33 - $209 | 24% |
| Wc Massachusetts | $33 - $209 | 24% |
| Njm Insurance Group | $33 - $209 | 24% |
| Wc Hartford | $33 - $209 | 24% |
| Wc Nationwide | $33 - $209 | 24% |
| Wc Price Chopper | $33 - $209 | 24% |
| Wc Troy Ny | $33 - $209 | 24% |
| Wc Mra | $33 - $209 | 24% |
| Wc Employee Mutual | $33 - $209 | 24% |
| Wc Rev Claims | $33 - $209 | 24% |
| Wc North American Rishces | $33 - $209 | 24% |
| New York State Insurance Fund | $33 - $209 | 24% |
| Wc Sentry | $33 - $209 | 24% |
| Wc York Risk | $33 - $209 | 24% |
| First Choice Health | $33 - $165 | 24% |
| Wc Amerisure | $33 - $209 | 24% |
| Wc Fcci | $33 - $209 | 24% |
| Rx Restat | $33 - $209 | 24% |
| Wc Generic | $33 - $209 | 24% |
| Wc Sheakley Unicomp | $33 - $209 | 24% |
| Wc Heritage Summit | $33 - $209 | 24% |
| Wc Ct Healthcare Trust | $33 - $209 | 24% |
| Wc Intermountain | $33 - $209 | 24% |
| Prestige Health Choice | $49 | 36% |
| Childrens Comm Health Plan | $49 | 36% |
| Texas Children's Health Plan | $49 | 36% |
| Healthy Blue Ne | $49 | 36% |
| Cmh Barry County | $49 | 36% |
| Keystone First Chip | $49 | 36% |
| Lakeland Care Inc | $49 | 36% |
| County Coroner | $49 | 36% |
| Cmh Wayne Cty/Com Liv Svcs | $49 | 36% |
| Community Benefit Health | $49 | 36% |
| Cmh Kent County | $49 | 36% |
| Cardinal Innovations Lme | $49 | 36% |
| Cmh Muskegon County | $49 | 36% |
| Delaware County Department of Health | $49 | 36% |
| Cmh North Country | $49 | 36% |
| Hennepin Health | $49 | 36% |
| Robert F Sing Program | $49 | 36% |
| Superior Health | $49 | 36% |
| Nextlevel Health | $49 | 36% |
| Cmh Bay-Arenac County | $49 | 36% |
| Cmh Detroit Wayne Integrated Health Network | $49 | 36% |
| Cmh Misc | $49 | 36% |
| Rx Medi-Cal | $49 | 36% |
| Cmh Lenawee County | $49 | 36% |
| Peach State Healthplan | $49 | 36% |
| Medstar Md Health Choice | $49 | 36% |
| Massachusetts Behavioral Health Partnership | $49 | 36% |
| Id County Other | $49 | 36% |
| Medi-Cal | $49 | 36% |
| Kern Family Health Plan | $49 | 36% |
| Cenpatico | $49 | 36% |
| Dean Wi Badgercare | $49 | 36% |
| Parkland Community Health Plan | $49 | 36% |
| Eastpointe Lme | $49 | 36% |
| Cmh Ottawa County | $49 | 36% |
| Cmh Genesee County | $49 | 36% |
| Ghc Scw Wi Badgercare | $49 | 36% |
| Tenncare | $49 | 36% |
| Albany County Correctional Facility | $49 | 36% |
| Cmh Cass County | $49 | 36% |
| Paramount Advantage | $49 | 36% |
| Ryan White Florida Mssrp | $49 | 36% |
| Idaho Dept Health and Wellfare | $49 | 36% |
| County Funding Generic | $49 | 36% |
| Cmh Berrien County | $49 | 36% |
| Wi Womens Wellness | $49 | 36% |
| Cmh Clinton-Eaton-Ingham County | $49 | 36% |
| Dph Tb Program | $49 | 36% |
| Cmh Newaygo County | $49 | 36% |
| Delta Dental Nj | $49 | 36% |
| Connections Csp | $49 | 36% |
| Inland Empire Health Plan | $49 | 36% |
| Can Community Health Inc | $49 | 36% |
| Freedom First Healthcare | $49 | 36% |
| Philadelphia County Funding | $49 | 36% |
| Cmh Central Mi County | $49 | 36% |
| Breast Grant-Connecticut | $49 | 36% |
| Indiana Breast Cervical Cancer | $49 | 36% |
| Chhuny | $49 | 36% |
| Maryland Physicians Care | $49 | 36% |
| Washtenaw Health Plan | $49 | 36% |
| Rx 340B Pass Along | $49 | 36% |
| Molina Centennial Care | $49 | 36% |
| Community Health Choice | $49 | 36% |
| Bmc Healthnet | $49 | 36% |
| Id County Payette | $49 | 36% |
| Cmh Washtenaw County | $49 | 36% |
| Family Health Network | $49 | 36% |
| Cmh Ausable Valley | $49 | 36% |
| Care Connections of Northern Iowa | $49 | 36% |
| Community Care Behavorial Health | $49 | 36% |
| Cmh Allegan County | $49 | 36% |
| Cmh Northern Lakes County | $49 | 36% |
| Rx Assistance/Rx Manufacturer Assistance 0 Copay | $49 | 36% |
| La Care Health Plan | $49 | 36% |
| Screening for Life | $49 | 36% |
| Oregon Screenwise | $49 | 36% |
| Priority Partners | $49 | 36% |
| St Joseph County Hlth Dpt | $49 | 36% |
| Dscc | $49 | 36% |
| Cmh Van Buren County | $49 | 36% |
| Id County Ada | $49 | 36% |
| Medi-Cal Healthnet | $49 | 36% |
| Childrens Medical Services Title 19 | $49 | 36% |
| Idaho Womens Health Check | $49 | 36% |
| Wellsense Health Plan | $49 | 36% |
| Intercommunity Health Ohp | $49 | 36% |
| Pace of Southwest Michigan | $49 - $79 | 36% |
| California Health and Wellness | $49 | 36% |
| Cmh Monroe County | $49 | 36% |
| Harbor Health | $49 | 36% |
| Cencal Health Plan | $49 | 36% |
| Id County Canyon | $49 | 36% |
| Bccp | $49 | 36% |
| Cmh Macomb | $49 | 36% |
| Id County Cat Fund | $49 | 36% |
| Sandhills Center Lme | $49 | 36% |
| Cmh Kalamazoo | $49 | 36% |
| Mo Home State Health Plan | $49 | 36% |
| Presbyterian Centennial Care | $49 | 36% |
| Managed Health Services - Indiana | $49 | 36% |
| Maryland Breast & Cervical Program | $49 | 36% |
| Bcccp-Michigan | $49 | 36% |
| City of Philadelphia | $49 | 36% |
| Trillium Community Ohp | $49 | 36% |
| Amish Mennonite | $49 | 36% |
| Sunshine State Health Plan | $49 | 36% |
| Community Care Partners | $49 | 36% |
| Cmh Oakland County | $49 | 36% |
| Cmh Ionia County | $49 | 36% |
| Health Safety Net | $49 | 36% |
| Mdwise | $49 | 36% |
| Rx Meridian Rx | $49 | 36% |
| Nascentia Health Options | $49 | 36% |
| Vaya Health Lme | $49 | 36% |
| Jai Medical System | $49 | 36% |
| Cmh Jackson County/Lifeways | $49 | 36% |
| Fresno County Ccs | $49 | 36% |
| Cmh West Mi County | $49 | 36% |
| Maryland Healthy Smiles - Scion Dental | $49 | 36% |
| Care Oregon Ohp | $49 | 36% |
| Delaware First Health | $49 | 36% |
| Tufts Health Public Plans | $49 | 36% |
| Ascension St. Vincent Public Safety Medical | $49 | 36% |
| Covid19 Hrsa Uninsured Testing and Treatment Fund | $49 | 36% |
| Cmh Wayne County/Carelink | $49 | 36% |
| Partners Behavioral Lme | $49 | 36% |
| Broward County Dept of Health | $49 | 36% |
| Medstar Dc Healthy Family | $49 | 36% |
| Cmh Livingston County | $49 | 36% |
| Keystone First | $49 | 36% |
| Cmh Montcalm County | $49 | 36% |
| New York Cancer Services Program | $49 | 36% |
| Iowa Total Care | $50 - $100 | 37% |
| Wellpoint | $51 | 38% |
| Wc Corvel | $76 | 56% |
| Huron Valley Pace | $79 | 58% |
| Pace-Trinity Health | $79 | 58% |
| Evercare | $79 | 58% |
| Welbe Health | $79 | 58% |
| Central Valley Medical Services Corp Pace | $79 | 58% |
| Blue Care Network Advantage | $79 | 58% |
| Community Pace at Home | $79 | 58% |
| Rx Retiree Rx Care | $79 | 58% |
| Cca Senior Care Options | $79 | 58% |
| Align Senior Care | $79 | 58% |
| Pace Cny | $79 | 58% |
| Presbyterian Senior Plan | $79 | 58% |
| Highmark Health Options Dual Plan | $79 | 58% |
| Care Dimensions | $79 | 58% |
| Elementcare | $79 | 58% |
| Longevity Health Plan | $79 | 58% |
| Sunnyview-Pace Finance Dept | $79 | 58% |
| Horizon Nj Total Care | $79 | 58% |
| Gpa Croell Redi Mix | $79 | 58% |
| Meridian Complete | $79 | 58% |
| Champion Health Plan McR Advantage | $79 | 58% |
| Peak Pace Solutions | $79 | 58% |
| Tribute Health Plans | $79 | 58% |
| Nascentia Health Plus | $79 | 58% |
| Clover Health | $79 | 58% |
| Serenity Pace | $79 | 58% |
| Martins Point Generations Advantage | $79 | 58% |
| Union Health Service | $79 | 58% |
| Mercyone Cedar Valley | $79 | 58% |
| Lasso Healthcare Msa | $79 | 58% |
| Michigan Complete Health | $79 | 58% |
| Scan Health Plan McR IPA Meritage Oon | $79 | 58% |
| Todays Options | $79 | 58% |
| Mass General Brigham McR Adv | $79 | 58% |
| Provider Partners Health Plan of Indiana | $79 | 58% |
| Hope Select Pace | $79 | 58% |
| Careplus Health Plans | $79 | 58% |
| Gold Advantage | $79 | 58% |
| The Health Plan | $79 | 58% |
| Pruitthealth Premier | $79 | 58% |
| Health America Advantra | $79 | 58% |
| New Centry Health Careplus | $79 | 58% |
| Georgia Health Advantage | $79 | 58% |
| Innovative Integrated Health Community Plans | $79 | 58% |
| American Health Advantage of Idaho | $79 | 58% |
| Clear Spring Health | $79 | 58% |
| Medipak Advantage | $79 | 58% |
| Reliance Community Care Partners Care Resources Pace | $79 | 58% |
| Pace Southeast | $79 | 58% |
| Pace Iowa Immanuel Pathways | $79 | 58% |
| Perennial Advantage | $79 | 58% |
| Ally Align Care Adv | $79 | 58% |
| Texan Plus | $79 | 58% |
| Secure Horizons Ma Pffs | $79 | 58% |
| Rx Allwin | $79 | 58% |
| Solis Health Plans | $79 | 58% |
| Gateway Health Plan | $79 | 58% |
| Life St Marys Pace | $79 | 58% |
| Um Health Advantage | $79 | 58% |
| Osu Prime Care Advantage | $79 | 58% |
| Care Improvement Plus | $79 | 58% |
| Lifecircles Pace | $79 | 58% |
| Longevity IPA of Michigan LLC Health Plan Isnp | $79 | 58% |
| Eddy Senior Care-Pace | $79 | 58% |
| Mercy Life | $79 | 58% |
| Preferred Care Partners | $79 | 58% |
| Wellmed | $79 | 58% |
| Everence | $79 | 58% |
| Thome Pace | $79 | 58% |
| Siouxland Pace | $79 | 58% |
| Blue Shield - De (Highmark) Medciare Advantage | $79 | 58% |
| Genesys Pace of Genesee County | $79 | 58% |
| Hudson Headwaters Pace | $79 | 58% |
| Provider Partners Health Plan of Illinois | $79 | 58% |
| Eddy Seniorcare Pace | $79 | 58% |
| Commonwealth Care Alliance | $79 | 58% |
| Johns Hopkins Advantage Md | $79 | 58% |
| Medicare (plans) | $79 - $110 | 58% |
| Care Resources Pace | $79 | 58% |
| Rx Grane Grnmedd | $79 | 58% |
| Cca - Zing Health | $79 | 58% |
| Aurora Special Needs | $79 | 58% |
| Veterans Administration | $80 | 59% |
| Iowa Health Advantage | $83 | 61% |
| American Health Plan | $83 | 61% |
| Nova | $213 | 157% |
| Luminare Health | $237 | 175% |
| Medical Mutual | $237 | 175% |
| Webtpa | $237 | 175% |
| 1199 National Benefit Fund | $237 | 175% |
| Christian Brother Services | $237 | 175% |
| Trustmark Small Business Benefits | $237 | 175% |
| Asr Health Benefits | $237 | 175% |
| First Health | $237 | 175% |
| Coventry | $237 | 175% |
| Medica | $253 | 187% |
| Crime Victim Assistance | $258 | 190% |