What YOU Would Pay
60/40 Plan
No Copays
No Deductibles

What would YOU Pay 29 Jun 2021.jpg
Urgent Care YOU Pay 29 June 2021.jpg
Provider
Billing Charges
Member
Cost
Savings on Member Plan
Savings
Percentage
Actual EOB

X-Ray Shoulder

$88.80

$13.51

$75.29

85%

CT Thorax

$822.00

$113.34

$708.66

86%

Ultrasound -

Pelvic

$565.00

$123.72

$441.28

78%

Ultrasound - Vascular

$338.00

$53.47

$284.53

84%

Ultrasound

$164.00

$12.72

$151.28

92%

Surgery

$24,500.00

$1,837.50

$22,662.50

93%

Pulmonary

$467.00

$69.70

$397.30

85%

Eye Surgery

$3,382.00

$402.93

$2,979.07

88%

OB GYN Visit

$104.00

$13.32

$90.68

87%

Pediatrics

$255.00

$37.12

$217.88

85%

Dermatology

$130.00

$20.07

$109.93

85%

MRI Full

$222.72

$1,382.00

$1,159.28

84%

Clinic

$305.48

$58.00

$247.48

81%

Urgent Care

Provider
Billing Charges
Member
Cost
Savings on Discount Plan
Savings
Percantage
Actual EOB

Med Post Urgent Care

$320.00

$96.00

$224.00

70%

South West Urgent Care 

$384.00

$49.98

$334.02

87%

Upper Valley Urgent Care

$375.00

$65.95

$309.05

82%

Labs

Labs YOU Pay 29 June 2021.jpg
Provider
Billing Charges
Negotiated Contract Rate
Member
Cost
Savings on Discount Plan
Savings
Percantage
Actual EOB

Quest Labs 

$52.87

$2.27

$50.60

96%

LabCorp

$215.00

$19.90

$195.10

91%

Quest Diagnostic

$549.90

$18.91

$530.99

97%

LabCorp

$1,101.00

$76.53

$1,024.47

93%