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CoventryOne Authorized Agent |
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$20 Copay Plan $10,000 Deductible |
$35 Copay Plan $7,500 Deductible |
$35 Copay Plan $10,000 Deductible |
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Male |
Female |
Male |
Female |
Male |
Female |
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$207.62 |
$207.62 |
$145.08 |
$145.08 |
$133.65 |
$133.65 |
|
|
124.57 |
124.57 |
87.05 |
87.05 |
80.19 |
80.19 |
|
|
67.63 |
67.63 |
48.22 |
48.22 |
44.41 |
44.41 |
|
|
67.63 |
67.63 |
48.22 |
48.22 |
44.41 |
44.41 |
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|
67.63 |
72.03 |
48.22 |
51.36 |
44.41 |
47.31 |
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67.63 |
76.35 |
48.22 |
54.42 |
44.41 |
50.13 |
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|
67.63 |
78.98 |
48.22 |
56.31 |
44.41 |
51.88 |
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|
67.92 |
87.61 |
48.42 |
61.00 |
44.60 |
56.20 |
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68.69 |
96.75 |
48.98 |
67.37 |
45.11 |
62.07 |
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70.01 |
103.99 |
49.92 |
72.41 |
45.98 |
66.70 |
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70.01 |
103.99 |
49.92 |
72.41 |
45.98 |
66.70 |
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70.57 |
108.75 |
50.30 |
75.72 |
46.22 |
69.76 |
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|
74.26 |
113.44 |
52.17 |
78.59 |
48.05 |
72.39 |
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$20 Copay Plan $10,000 Deductible |
$35 Copay Plan $7,500 Deductible |
$35 Copay Plan $10,000 Deductible |
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Male |
Female |
Male |
Female |
Male |
Female |
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$74.83 |
$115.51 |
$52.57 |
$80.02 |
$48.42 |
$73.72 |
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75.42 |
116.51 |
52.98 |
81.68 |
48.80 |
75.24 |
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|
76.29 |
117.66 |
53.60 |
83.28 |
49.38 |
76.73 |
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|
78.82 |
118.82 |
55.36 |
85.54 |
51.01 |
78.81 |
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83.70 |
119.97 |
58.50 |
88.46 |
53.89 |
81.49 |
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88.59 |
121.74 |
61.92 |
92.34 |
57.04 |
85.07 |
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92.29 |
126.38 |
64.49 |
95.79 |
59.41 |
88.24 |
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93.52 |
131.43 |
65.35 |
97.09 |
60.21 |
89.43 |
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94.75 |
136.49 |
66.22 |
98.81 |
61.00 |
91.02 |
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97.87 |
141.70 |
69.43 |
100.06 |
63.95 |
92.18 |
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102.50 |
145.20 |
72.70 |
101.78 |
66.98 |
93.75 |
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107.02 |
147.04 |
75.91 |
103.08 |
69.94 |
94.96 |
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112.12 |
150.12 |
79.52 |
105.23 |
73.25 |
96.94 |
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116.79 |
152.58 |
82.83 |
106.96 |
76.31 |
98.53 |
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119.97 |
159.33 |
83.54 |
110.95 |
76.96 |
102.21 |
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124.59 |
161.71 |
86.75 |
112.60 |
79.91 |
103.73 |
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127.74 |
164.71 |
88.96 |
114.71 |
81.94 |
105.67 |
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132.20 |
167.40 |
93.05 |
116.57 |
85.72 |
107.38 |
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$20 Copay Plan $10,000 Deductible |
$35 Copay Plan $7,500 Deductible |
$35 Copay Plan $10,000 Deductible |
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Male |
Female |
Male |
Female |
Male |
Female |
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|
139.66 |
170.37 |
102.35 |
118.64 |
94.28 |
109.29 |
|
|
150.12 |
175.48 |
112.60 |
122.20 |
103.73 |
112.56 |
|
|
160.58 |
184.36 |
123.85 |
133.66 |
114.09 |
123.13 |
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171.65 |
193.25 |
136.25 |
145.12 |
125.51 |
133.68 |
|
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180.41 |
200.07 |
149.86 |
158.90 |
138.06 |
146.39 |
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189.33 |
206.55 |
164.86 |
174.00 |
151.86 |
160.30 |
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207.50 |
217.86 |
182.53 |
193.63 |
168.14 |
178.37 |
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225.67 |
228.74 |
192.57 |
200.41 |
177.39 |
184.62 |
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235.18 |
240.20 |
202.18 |
207.86 |
186.25 |
191.48 |
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246.95 |
252.21 |
211.28 |
215.54 |
194.63 |
198.55 |
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260.67 |
264.79 |
224.48 |
226.33 |
206.79 |
208.49 |
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275.70 |
279.83 |
240.63 |
237.41 |
221.66 |
218.71 |
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290.17 |
293.32 |
257.48 |
254.03 |
237.18 |
234.00 |
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304.64 |
306.32 |
271.44 |
266.31 |
250.05 |
245.32 |
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312.92 |
313.84 |
280.12 |
274.30 |
258.04 |
252.69 |
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328.54 |
328.56 |
295.53 |
288.00 |
272.23 |
265.30 |
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376.15 |
344.75 |
311.72 |
306.28 |
287.16 |
282.15 |
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395.03 |
354.39 |
322.62 |
317.00 |
297.20 |
292.02 |
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|
414.79 |
362.77 |
331.98 |
327.26 |
305.81 |
301.47 |
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|
435.43 |
370.81 |
341.10 |
337.08 |
314.23 |
310.52 |
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Male |
Female |
Male |
Female |
Male |
Female |
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$20 Copay Plan $10,000 Deductible |
$35 Copay Plan $7,500 Deductible |
$35 Copay Plan $10,000 Deductible |
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