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Will a midwife make a better living is she is in network with providers and taking reasonable and customary or if she is out of network and has the ability to balance bill the client if the insurance company does not pay anything close to her full fee?  My feeling is that it does NOT pay to be in network as a solo provider because to make the in network thing profitable you have to be too high volume to make it work as a homebirth midwife.  Any thoughts?  Anyone who has done it both ways?