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Usual, Customary or Reasonable (UCR)

An industry term for the typical rates charged for services in a specific region. For example, if a surgeon in Virginia were to charge twice as much for a surgery as the average cost of that procedure in the area, those charges would not be considered usual, customary or reasonable.

Risk Corridor

Provision designed to manage unpredictability in the insurance market. Plans with lower than anticipated costs are required to pay a portion of their savings into…