Health Cost Plan- Allison Warren

1. 1. Doctor’s office visit for cough- Cost $95 (in network)

1.1. in network I would pay $5

2. #2. . Emergency room visit for stitches - cost $1,152

2.1. I would pay $25 in or out of network

3. 3. Hospital stay for flu (out of network) – Cost $1,500

3.1. I would pay $300

4. 4. Appendectomy surgery (in network) – Cost $10,000

4.1. in network I would pay nothing

5. 5. Prescription (brand) – Cost $185

5.1. I would pay $10

6. 6. Eye exam (out of network)- Cost $454

6.1. I would pay $90.80

7. 7. Urgent care visit for broken foot (out of network) - Cost $855

7.1. I would pay $171

8. 8. Surgery for foot (out of network) – Cost $5400

8.1. I would pay $1080

9. 9. Prescription (generic) - Cost $85

9.1. I would pay $5

10. 10. Doctor’s visit for annual physical (out of network) - Cost $958

10.1. I would pay $191.60

11. 11. Emergency room visit for snow board accident (concussion, broken leg, x-rays, etc.) – Cost $6,500

11.1. I would pay $25

12. 12. Urgent care visit for shots (in network) - Cost $105

12.1. I would pay $10