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First Health Network Contracted Rates

 Actual EOB & Savings 

Provider 
Billed Charges
Provider
Contract Rate
Savings on Discount Plan
Savings
Percentage
Actual EOB

X-Ray Shoulder

$88.80

$33.78

$55.02

62%

CT Thorax

$822.00

$283.36

$538.64

66%

Ultrasound -

Pelvic

$565.00

$309.29

$255.71

45%

Ultrasound - Vascular

$338.00

$133.68

$239.16

71%

Ultrasound

$164.00

$31.81

$132.19

81%

Surgery

$24,500.00

$4,593.75

$19,906.25

81%

Pulmonary

$467.00

$174.26

$292.74

63%

Eye Surgery

$3,382.00

$1,007.33

$2,374.67

70%

OB GYN Visit

$104.00

$33.31

$70.69

68%

Pediatrics

$255.00

$92.80

$162.20

64%

Dermatology

$130.00

$50.18

$79.82

61%

MRI Full

$1,382.00

$556.81

$825.19

60%

Clinic

$305.48

$145.00

$160.48

53%

Urgent Care

Not Covered by any Plan
Billed Charges
Negotiated Contract Rate
Negotiated Contract Rate
Savings on Discount Plan
Savings
Percantage
Actual EOB

3 Procedures

$320.00

$240.00

$80.00

25%

4 Procedures

$384.00

$124.95

$259.05

67%

6 Procedures

$375.00

$164.87

$210.13

56%

Labs

Not Covered by any Plan
Billed Charges
Negotiated Contract Rate
Negotiated Contract Rate
Savings on Discount Plan
Savings
Percantage
Actual EOB

1 Lab

$52.87

$5.67

$47.20

89%

5 Labs

$215.00

$49.75

$165.25

77%

6 Labs

$549.90

$47.27

$502.63

91%

7 Labs

$1,101.00

$191.32

$909.68

83%

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