Health Plan Costs – Ethan Duckworth

1. 4. Appendectomy surgery                  cost $10,000

1.1. You Pay Nothing

2. 5. Prescription (Brand)                     cost $185

2.1. You Pay $10 (Brand)

3. 7. Urgent Care for Broken Foot              cost $855

3.1. You Pay 20% of the Cost

4. 8. Surgery for Foot                                  cost $5400

4.1. You Pay 20% of the cost

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

5.1. You pay $25

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

6.1. You pay $10

7. 1. Doctor’s office visit for cough cost $95

7.1. In Network you pay $5

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

8.1. You pay $25

9. 3. Hospital stay for flu                        cost $1,500

9.1. Out of Network you pay 20% of cost

10. 6. Eye exam                                     cost $454

10.1. You Pay 20% of the Cost

11. 9. Prescription (Generic)                          cost $85

11.1. You pay $5 (Generic)

12. 10. Doctor’s visit for annual physical cost $958

12.1. You pay 20% of costs