CIGNA LIFESOURCE TRANSPLANT NETWORK® CONTRACTED PROGRAMS

Formerly known as “supplemental programs”

Contracted Programs do not meet the Cigna LifeSOURCE Designated Program guidelines for Network Inclusion. For more information, go to https://cignalifesource.com. PLEASE NOTE: Hospital and individual transplant program participation is subject to change without advance notice. Please check the list regularly to make sure you have the most up-to-date information. Cigna LifeSOURCE Transplant Network contracts with over 800 transplant programs at more than 170 independent transplant centers. We provide our clients and customers with the access they need for organ and bone marrow/stem cell transplantation while improving cost containment and reducing their financial risk. Bone Kidney/ Intestinal/ State Facility Heart1 Lung Liver Kidney Pancreas Marrow/ Pancreas Multivisceral Stem Cell ALABAMA Children’s Hospital of Alabama, Birmingham University of Alabama (UAB) Hospital, Adult Adult Birmingham Banner – University Medical Center, ARIZONA Adult Adult Adult Phoenix Banner – University Medical Center, Adult Adult Adult Tucson Mayo Clinic Scottsdale Phoenix Children’s Hospital, Phoenix Scottsdale Shea Medical Center (HonorHealth Cancer Transplant Institute), Scottsdale St. Joseph’s Hospital, Phoenix (Dignity Health) ARKANSAS University of Arkansas for Medical Sciences (UAMS) Medical Center, Little Rock CALIFORNIA California Pacific Medical Center, San Francisco Cedars-Sinai Medical Center, Adult Los Angeles Children’s Hospital Los Angeles Children’s Hospital of Orange County (CHOC Children’s) City of Hope National Medical Center, Duarte Keck Hospital of USC, Los Angeles Adult (LD) Loma Linda University Medical Center and Children’s Hospital, Loma Linda Lucile Salter Packard Children’s Hospital, Palo Alto Rady Children’s Hospital, San Diego Ronald Reagan UCLA Medical Center, Adult Adult Los Angeles

948525 9/1/21 CIGNA LIFESOURCE TRANSPLANT NETWORK CONTRACTED PROGRAM Bone Kidney/ Intestinal/ State Facility Heart1 Lung Liver Kidney Pancreas Marrow/ Pancreas Multivisceral Stem Cell CALIFORNIA Scripps Green Hospital, La Jolla Adult Adult Adult (CONT.) Sharp Memorial Hospital, San Diego Adult Adult Adult Stanford University Medical Center Adult Sutter Medical Center, Sacramento Adult UCSD Medical Center, San Diego Adult UCSF Benioff Children's Hospital Oakland UCSF Medical Center and UCSF Benioff Children’s Hospital, San Francisco COLORADO Children’s Hospital Colorado, Aurora Porter Adventist Hospital (Centura Adult Health) Presbyterian St. Luke's Medical Center (HCA-HealthOne), Denver University of Colorado Hospital, Adult Denver CONNECTICUT Hartford Hospital, Hartford Adult Yale-New Haven Hospital, New Haven Ped. DELAWARE Alfred I. duPont Hospital for Children Ped. (Nemours), Wilmington D.C. Children’s National Medical Center Medstar Georgetown University Hospital6 Medstar Washington Hospital Center6 FLORIDA AdventHealth Orlando (formerly Florida Adult Adult Adult Adult Ped. Hospital), Orlando All Children’s Hospital, St. Petersburg Cleveland Clinic Florida, Weston Adult Both Ped. Jackson Memorial Hospital, Miami (VAD) Joe DiMaggio Children’s Hospital, Hollywood Mayo Clinic Jacksonville Memorial Hospital West, Pembroke Adult Pines Memorial Regional Hospital,Hollywood Adult Moffitt Cancer Center, H. Lee, Tampa Adult 2 Adult Adult Adult Shands Hospital, Gainesville (VAD) Adult Tampa General Hospital University of Miami Hospital and Clinics GEORGIA AU Medical Center, Augusta Children’s HealthCare of Atlanta Emory University Hospital, Atlanta Adult Adult Northside Hospital, Atlanta Piedmont Hospital, Atlanta Adult Adult Adult Adult

Both = Adult and Pediatric; Ped. = Pediatric; LD = Includes Living Donor; Kidney – all programs include deceased and living donor. 1. Programs listed in the VAD network have been approved for destination therapy and have agreed to participate in this Network. 2. Facility does not accept patients with insurance or a health plan based in Puerto Rico. 3. Hospital’s contract is for Cigna members only. 2 CIGNA LIFESOURCE TRANSPLANT NETWORK CONTRACTED PROGRAM Bone Kidney/ Intestinal/ State Facility Heart1 Lung Liver Kidney Pancreas Marrow/ Pancreas Multivisceral Stem Cell ILLINOIS Cancer Treatment Centers of Adult America, Chicago Loyola University Medical Center, Adult Maywood Lurie Children’s Hospital of Chicago Northwestern Memorial Hospital, Adult Adult Chicago (VAD) Rush University Medical Center, Chicago University of Chicago Medical Ped. Center and Comer Children's Adult Both (LD) Both Adult Adult (VAD) Hospital, Chicago University of Illinois Hospital, Both Adult Adult Chicago INDIANA Indiana Blood and Marrow Adult Transplantation, Beech Grove IUH University Hospital, Indianapolis IUH Methodist Hospital, Indianapolis Riley Hospital for Children at IUH, Indianapolis IOWA University of Iowa Hospital and Adult Clinics, Iowa City (VAD) KANSAS University of Kansas Hospital, Kansas City KENTUCKY UofL Health - Jewish Campus Adult Adult Adult Adult Adult (formerly Jewish Hospital, KY) Adult University of Kentucky, Lexington (VAD) Ped. Adult Adult LOUISIANA Ochsner Clinic Foundation, New Adult Orleans Tulane Medical Center, New Adult Adult Adult Adult Orleans MAINE Maine Medical Center, Portland Ped. MARYLAND Johns Hopkins Hospital, The, Baltimore University of Maryland Medical Adult (LD) Adult Adult Adult Center, Baltimore MASSACHUSETTS Beth Israel Deaconess Medical Adult Adult Center, Boston Boston Children’s Hospital

Brigham and Women’s Hospital Adult Adult and Dana Farber Cancer Institute, (VAD) Boston Lahey Clinic Medical Center, Burlington

Both = Adult and Pediatric; Ped. = Pediatric; LD = Includes Living Donor; Kidney – all programs include deceased and living donor. 1. Programs listed in the VAD network have been approved for destination therapy and have agreed to participate in this Network. 2. Facility does not accept patients with insurance or a health plan based in Puerto Rico. 3. Hospital’s contract is for Cigna members only. 3 CIGNA LIFESOURCE TRANSPLANT NETWORK CONTRACTED PROGRAM Bone Kidney/ Intestinal/ State Facility Heart1 Lung Liver Kidney Pancreas Marrow/ Pancreas Multivisceral Stem Cell MASSACHUSETTS Massachusetts General Hospital, (CONT.) Boston Tufts-New England Medical Both Adult Center, Boston MICHIGAN Henry Ford Hospital, Detroit Adult Adult Karmanos Cancer Center, Detroit Adult University of Michigan Health Adult (LD) Adult Adult Adult System, Ann Arbor William Beaumont Hospital, Royal Oak MINNESOTA Hennepin County Medical Center, Minneapolis Mayo Clinic Rochester Adult Ped. University of Minnesota Medical Center and University of Minnesota Adult Masonic Children’s Hospital, Minneapolis MISSOURI Barnes-Jewish Hospital, St. Louis Children’s Mercy Hospital, Kansas City Research Medical Center, Kansas Adult Adult City St. Louis Children’s Hospital

SSM Health – Cardinal Glennon Ped. Ped. Children’s Hospital, St. Louis SSM Health – St. Louis University Hospital St. Luke’s Hospital of Kansas City NEBRASKA Nebraska Medical Center, The, Adult (LD) Omaha NEW HAMPSHIRE Dartmouth-Hitchcock Medical Adult Adult Center, Lebanon NEW JERSEY Hackensack University Medical Center, Hackensack Newark Beth Israel Medical Adult Center, Newark Adult Robert Wood Johnson University Ped. Hospital, New Brunswick (VAD) St. Barnabas Medical Center, Adult Livingston NEW YORK Albany Medical Center, Albany Adult Adult

Erie County Medical Center, Adult Adult Adult Buffalo Long Island Jewish Medical Center – Cohen Children’s Medical Center, New Hyde Park

Both = Adult and Pediatric; Ped. = Pediatric; LD = Includes Living Donor; Kidney – all programs include deceased and living donor. 1. Programs listed in the VAD network have been approved for destination therapy and have agreed to participate in this Network. 2. Facility does not accept patients with insurance or a health plan based in Puerto Rico. 3. Hospital’s contract is for Cigna members only. 4 CIGNA LIFESOURCE TRANSPLANT NETWORK CONTRACTED PROGRAM Bone Kidney/ Intestinal/ State Facility Heart1 Lung Liver Kidney Pancreas Marrow/ Pancreas Multivisceral Stem Cell NEW YORK Memorial Sloan-Kettering Cancer (CONT.) Center, New York Montefiore Medical Center, Bronx Adult Both Mount Sinai Hospital, The, Adult New York (VAD) New York Presbyterian Hospital Adult Adult Adult Adult (Columbia), New York3 New York Presbyterian Hospital Both Adult Adult (Cornell), New York3 North Shore University Hospital, Manhasset NYU Langone Hospitals, New York Adult Adult Roswell Park Cancer Institute, Buffalo Strong Memorial Hospital, Ped. Rochester SUNY Downstate Medical Center, Both Brooklyn Adult Westchester Medical Center, Adult Both Valhalla (VAD) NORTH CAROLINA Carolinas Medical Center, Adult Ped. Charlotte (VAD) Duke University Hospital, Adult Ped. Durham (VAD) University of North Carolina Adult Ped. Hospitals, Chapel Hill Wake Forest Baptist Medical Center, Winston Salem OHIO Children’s Hospital Medical Center – Cincinnati Christ Hospital, Cincinnati Cleveland Clinic Foundation, Both Adult Adult Ped. Cleveland James Cancer Hospital, The (at Ohio State University), Columbus Jewish Hospital, Cincinnati Adult Nationwide Children’s Hospital, Columbus Adult Ohio State University Wexner Adult Medical Center, The Columbus (VAD) University of Cincinnati Medical Center, Cincinnati Adult University Hospitals Case Medical Adult Adult Ped. Adult Adult Both Center, Cleveland (VAD) OKLAHOMA Integris Baptist Medical Center (Nazih Zuhdi Transplant Institute), Adult Adult Adult Oklahoma City OREGON Legacy Good Samaritan Hospital, Adult Portland Oregon Health & Science University (OHSU) Hospital, Adult Ped. Portland Both = Adult and Pediatric; Ped. = Pediatric; LD = Includes Living Donor; Kidney – all programs include deceased and living door. 1. Programs listed in the VAD network have been approved for destination therapy and have agreed to participate in this Network. 2. Facility does not accept patients with insurance or a health plan based in Puerto Rico. 3. Hospital’s contract is for Cigna members only. 5 CIGNA LIFESOURCE TRANSPLANT NETWORK CONTRACTED PROGRAM Bone Kidney/ Intestinal/ State Facility Heart1 Lung Liver Kidney Pancreas Marrow/ Pancreas Multivisceral Stem Cell PENNSYLVANIA Albert Einstein Medical Center, Adult Adult Adult Philadelphia Allegheny General Hospital, Adult Adult Pittsburgh Children’s Hospital of Philadelphia Children’s Hospital of Pittsburgh of UPMC Penn State Milton S. Hershey Adult Adult Medical Center,Hershey Pinnacle Health – Harrisburg Hospital, Harrisburg Temple University Hospital, Adult Adult Philadelphia Thomas Jefferson University Adult Hospital, Philadelphia (VAD) Hospital of the University of Adult Pennsylvania, Philadelphia (VAD) UPMC Presbyterian, Pittsburgh Adult (LD) Adult Adult Adult West Penn Hospital, Pittsburgh Adult SOUTH CAROLINA Medical University of South Carolina (MUSC) Medical Center, Adult Adult Charleston TENNESSEE Centennial Medical Center, Nashville Erlanger Medical Center, Adult Chattanooga Methodist LeBonheur Healthcare, Adult Memphis Saint Thomas West Hospital, Adult Nashville St. Jude Children's Research Hospital, Memphis Vanderbilt University Medical Adult Adult Adult Center, Nashville TEXAS Children's Medical Center Dallas Cook Children's Medical Center, Ped. Ft. Worth Houston Methodist Hospital Medical City Dallas Hospital Adult Ped. Memorial Hermann Health, Adult Adult Houston Methodist Dallas Medical Center Adult Adult St. David’s South Austin Medical Center Texas Children’s Hospital, Houston

Both = Adult and Pediatric; Ped. = Pediatric; LD = Includes Living Donor; Kidney – all programs include deceased and living donor. 1. Programs listed in the VAD network have been approved for destination therapy and have agreed to participate in this Network. 2. Facility does not accept patients with insurance or a health plan based in Puerto Rico. 3. Hospital’s contract is for Cigna members only. 6 CIGNA LIFESOURCE TRANSPLANT NETWORK CONTRACTED PROGRAM Bone Kidney/ Intestinal/ State Facility Heart1 Lung Liver Kidney Pancreas Marrow/ Pancreas Multivisceral Stem Cell TEXAS (CONT.) Texas Transplant Institute, San Adult Adult Adult Antonio University of Texas M.D. Anderson Cancer Center, The, Ped. Houston William P. Clements Jr. University Hospital (UT Southwestern), Dallas UTAH Intermountain Medical Center, Adult Adult Salt Lake City LDS Hospital, Salt Lake City Primary Children’s Hospital, Salt Lake City University of Utah Hospital, Adult Salt Lake City VERMONT University of Vermont Medical Adult Center, Burlington VIRGINIA Inova Fairfax Hospital, Fairfax Adult Adult VCU Health System, Richmond Ped. (LD) Ped. University of Virginia Hospital, Adult Charlottesville WASHINGTON Seattle Children's Hospital Ped. Swedish Medical Center, Seattle Adult Adult University of Washington Medical Center, Seattle WEST VIRGINIA West Virginia University Hospital, Morgantown WISCONSIN Children’s Hospital of Wisconsin, Milwaukee Froedtert Memorial Lutheran Adult Adult Adult Hospital, Milwaukee University of Wisconsin (UW) Ped. (LD) Hospital and Clinics, Madison

Both = Adult and Pediatric; Ped. = Pediatric; LD = Includes Living Donor; Kidney – all programs include deceased and living donor. 1. Programs listed in the VAD network have been approved for destination therapy and have agreed to participate in this Network. 2. Facility does not accept patients with insurance or a health plan based in Puerto Rico. 3. Hospital’s contract is for Cigna members only.

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