For any service or supply, the lesser of (1) the provider’s actual charge to the patient or (2) the amount that would be allowed by Medicare, increased by a percentage determined by Johns Hopkins Employer Health Programs, not to exceed 150% of the amount that would be allowed by Medicare. If Medicare does not provide an allowance for a service or supply, then Allowed Benefit means the prevailing, reasonable fee paid to similar providers for the same service or supply in the same geographic area, as determined by Johns Hopkins Employer Health Programs. EHP Preferred and EHP/CIGNA PPO Network Providers will not charge more than the Allowed Benefit, but Out-of-Network providers Out-of-Network can charge more and you are responsible for charges above the Allowed Benefit
