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What YOU Would Pay
As a Member In-Network with First Health

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

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%

California TPA License #0M72911
Arizona TPA License #505361387
Mississippi TPA License #15039939

Texas

915-803-4198

California

915-803-4198

Arizona

915-803-4198

Mississippi

915-803-4198

New Mexico

915-803-4198

Five Points Health Benefit Plans, LLC Reserves the Right to the following:

Information on this site pertains to Self-funded Employer Group Plans, Individual & Family Plans, Self-Employed and Student Plans.

 

© 2017-2025 by Five Points Health Benefits Plans, LLC

*Five Points Health Benefits Plans, LLC reserves the right to increase plan pricing to remain competitive in the market place. On your SBC and SOB plan documents, we reserve the right to amend, modify, terminate, or partially terminate benefits at any time without notification.

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