Health Plan Costs- Jackson Smith

1. 6. Eye exam (out of network) - Pay $91

2. 7. Urgent care visit for broken foot (out of network) - Pay $171

3. 8. Surgery for foot (out of network)- Pay $1080

4. 9. Prescription (generic)- Pay $5

5. 10. Doctor’s visit for annual physical (out of network) - Pay $192

6. 11. Emergency room visit for snow board accident (concussion, broken leg, x-rays, etc.) - Pay $25

7. 12. Urgent care visit for shots (in network)- Pay $10

8. 1. Doctor's office visit for cough (in network) - Pay $5

9. 2. Emergency room visit for stitches - Pay $25

10. 3. Hospital stay for flu (out of network)- Pay $300

11. 4. Appendectomy surgery (in network) - Pay $0

12. 5. Prescription (brand)- Pay $10