|
|
|
|
Blue Cross
Blue Shield of Georgia SmartSense |
SmartSense |
||||||||||||||||
|
|
Male |
Female |
+ Child |
+ Child |
Children |
|
Couple |
|
|
Male |
Female |
+ Child |
+ Child |
Children |
|
Couple |
|
|
|
$223.31 |
$223.31 |
$332.33 |
$332.33 |
$441.34 |
$441.34 |
$446.51 |
$602.56 |
|
$256.76 |
$256.76 |
$382.10 |
$382.10 |
$507.44 |
$507.44 |
$513.39 |
$692.82 |
|
|
99.25 |
99.25 |
208.26 |
208.26 |
317.27 |
317.27 |
198.50 |
354.55 |
|
114.12 |
114.12 |
239.46 |
239.46 |
364.80 |
364.80 |
228.24 |
407.66 |
|
|
117.60 |
145.35 |
226.61 |
254.36 |
335.62 |
363.37 |
260.36 |
416.41 |
|
135.21 |
167.12 |
260.55 |
292.46 |
385.89 |
417.80 |
299.36 |
478.78 |
|
|
137.12 |
173.10 |
246.13 |
282.11 |
373.37 |
412.88 |
304.34 |
491.55 |
|
157.66 |
199.03 |
283.00 |
324.37 |
429.29 |
474.72 |
349.92 |
565.18 |
|
|
147.82 |
215.08 |
256.83 |
324.09 |
399.36 |
468.62 |
346.32 |
567.28 |
|
169.96 |
247.30 |
295.30 |
372.64 |
459.17 |
538.81 |
398.19 |
652.25 |
|
|
167.10 |
247.04 |
276.12 |
356.08 |
418.64 |
500.61 |
393.83 |
614.79 |
|
192.13 |
284.08 |
317.47 |
409.42 |
481.35 |
575.59 |
452.82 |
706.88 |
|
|
192.03 |
272.00 |
301.05 |
381.01 |
465.91 |
532.24 |
442.63 |
686.76 |
|
220.80 |
312.74 |
346.14 |
438.08 |
535.70 |
611.96 |
508.93 |
789.63 |
|
|
211.32 |
286.82 |
320.33 |
395.83 |
490.96 |
556.58 |
479.79 |
724.39 |
|
242.97 |
329.78 |
368.31 |
455.12 |
564.50 |
639.95 |
551.66 |
832.90 |
|
|
230.72 |
301.75 |
339.73 |
410.76 |
510.37 |
571.52 |
514.36 |
758.96 |
|
265.28 |
346.95 |
390.62 |
472.29 |
586.81 |
657.12 |
591.41 |
872.65 |
|
|
269.76 |
343.85 |
378.78 |
452.86 |
545.53 |
596.45 |
572.10 |
798.83 |
|
310.17 |
395.35 |
435.51 |
520.69 |
627.24 |
685.79 |
657.80 |
918.48 |
|
|
295.75 |
370.66 |
404.76 |
479.67 |
571.52 |
623.26 |
622.67 |
849.39 |
|
340.05 |
426.18 |
465.39 |
551.52 |
657.12 |
716.61 |
715.94 |
976.62 |
|
|
321.74 |
381.60 |
430.75 |
490.61 |
594.33 |
632.90 |
664.65 |
875.85 |
|
369.94 |
438.76 |
495.28 |
564.10 |
683.35 |
727.70 |
764.21 |
1007.05 |
|
|
347.73 |
395.71 |
456.74 |
504.72 |
617.03 |
645.84 |
708.52 |
904.19 |
|
399.82 |
454.98 |
525.16 |
580.32 |
709.45 |
742.58 |
814.64 |
1039.63 |
|
|
380.31 |
415.11 |
489.32 |
524.12 |
649.60 |
665.24 |
756.73 |
952.41 |
|
437.27 |
477.29 |
562.61 |
602.63 |
746.90 |
764.88 |
870.08 |
1095.07 |
|
|
415.11 |
436.40 |
524.12 |
545.41 |
687.70 |
654.42 |
808.47 |
983.10 |
|
477.29 |
501.77 |
602.63 |
627.11 |
790.71 |
752.45 |
929.57 |
1130.36 |
|
|
449.92 |
457.68 |
558.93 |
566.69 |
722.51 |
675.71 |
861.04 |
1035.67 |
|
517.31 |
526.24 |
642.65 |
651.58 |
830.73 |
776.92 |
990.01 |
1190.80 |
|
|
528.59 |
496.84 |
637.60 |
605.85 |
773.90 |
714.87 |
958.41 |
1124.45 |
|
607.77 |
571.26 |
733.11 |
696.60 |
889.82 |
821.94 |
1101.96 |
1292.88 |
|
|
633.37 |
500.35 |
742.38 |
659.36 |
851.39 |
768.37 |
1112.46 |
1269.92 |
|
728.24 |
632.78 |
853.58 |
758.12 |
978.92 |
883.46 |
1279.09 |
1460.14 |
|
|
748.85 |
660.07 |
857.86 |
769.08 |
966.87 |
878.09 |
1287.32 |
1432.67 |
|
861.02 |
758.94 |
986.36 |
884.28 |
1111.70 |
1009.62 |
1480.15 |
1647.27 |
|
Blue Cross
Blue Shield of Georgia SmartSense |
SmartSense |
||||||||||||||||
|
|
Male |
Female |
+ Child |
+ Child |
Children |
|
Couple |
|
|
Male |
Female |
+ Child |
+ Child |
Children |
|
Couple |
|
|
|
$151.34 |
$151.34 |
$225.22 |
$225.22 |
$299.10 |
$299.10 |
$302.61 |
$408.36 |
|
$185.98 |
$185.98 |
$276.76 |
$276.76 |
$367.55 |
$367.55 |
$371.86 |
$501.81 |
|
|
67.26 |
67.26 |
141.14 |
141.14 |
215.02 |
215.02 |
134.53 |
240.28 |
|
82.66 |
82.66 |
173.44 |
173.44 |
264.23 |
264.23 |
165.31 |
295.27 |
|
|
79.70 |
98.50 |
153.57 |
172.38 |
227.45 |
246.26 |
176.45 |
282.20 |
|
97.93 |
121.05 |
188.72 |
211.83 |
279.50 |
302.62 |
216.83 |
346.79 |
|
|
92.93 |
117.31 |
166.80 |
191.19 |
253.04 |
279.81 |
206.25 |
333.13 |
|
114.19 |
144.16 |
204.98 |
234.94 |
310.94 |
343.85 |
253.45 |
409.36 |
|
|
100.18 |
145.76 |
174.06 |
219.64 |
270.65 |
317.59 |
234.71 |
384.45 |
|
123.10 |
179.12 |
213.89 |
269.91 |
332.58 |
390.27 |
288.42 |
472.43 |
|
|
113.25 |
167.44 |
187.13 |
241.32 |
283.72 |
339.27 |
266.90 |
416.65 |
|
139.16 |
205.76 |
229.95 |
296.54 |
348.65 |
416.91 |
327.98 |
512.00 |
|
|
130.14 |
184.34 |
204.02 |
258.22 |
315.76 |
360.71 |
299.98 |
465.43 |
|
159.93 |
226.52 |
250.71 |
317.31 |
388.02 |
443.25 |
368.62 |
571.94 |
|
|
143.21 |
194.38 |
217.09 |
268.26 |
332.73 |
377.20 |
325.16 |
490.93 |
|
175.99 |
238.86 |
266.77 |
329.65 |
408.88 |
463.52 |
399.57 |
603.27 |
|
|
156.36 |
204.50 |
230.24 |
278.38 |
345.88 |
387.32 |
348.59 |
514.36 |
|
192.15 |
251.30 |
282.93 |
342.08 |
425.03 |
475.96 |
428.36 |
632.07 |
|
|
182.82 |
233.03 |
256.70 |
306.91 |
369.71 |
404.22 |
387.72 |
541.38 |
|
224.66 |
286.36 |
315.45 |
377.14 |
454.32 |
496.72 |
476.45 |
665.27 |
|
|
200.44 |
251.20 |
274.31 |
325.08 |
387.32 |
422.39 |
421.99 |
575.65 |
|
246.30 |
308.69 |
337.09 |
399.47 |
475.96 |
519.05 |
518.56 |
707.38 |
|
|
218.05 |
258.61 |
291.93 |
332.49 |
402.78 |
428.93 |
450.44 |
593.58 |
|
267.95 |
317.80 |
358.73 |
408.58 |
494.96 |
527.08 |
553.52 |
729.41 |
|
|
235.66 |
268.18 |
309.54 |
342.06 |
418.17 |
437.69 |
480.17 |
612.78 |
|
289.59 |
329.55 |
380.38 |
420.33 |
513.86 |
537.85 |
590.05 |
753.02 |
|
|
257.74 |
281.33 |
331.62 |
355.21 |
440.24 |
450.84 |
512.85 |
645.45 |
|
316.72 |
345.71 |
407.50 |
436.49 |
540.99 |
554.01 |
630.21 |
793.17 |
|
|
281.33 |
295.75 |
355.21 |
369.63 |
466.06 |
443.51 |
547.91 |
666.26 |
|
345.71 |
363.43 |
436.49 |
454.22 |
572.72 |
545.00 |
673.30 |
818.73 |
|
|
304.92 |
310.18 |
378.80 |
384.06 |
489.65 |
457.93 |
583.54 |
701.88 |
|
374.70 |
381.16 |
465.48 |
471.94 |
601.71 |
562.73 |
717.07 |
862.51 |
|
|
358.23 |
336.72 |
432.11 |
410.60 |
524.48 |
484.47 |
649.52 |
762.06 |
|
440.21 |
413.77 |
531.00 |
504.56 |
664.51 |
595.34 |
798.16 |
936.45 |
|
|
429.24 |
372.98 |
503.12 |
446.86 |
577.00 |
520.74 |
753.93 |
860.64 |
|
527.47 |
458.33 |
618.26 |
549.12 |
709.04 |
639.90 |
926.46 |
1057.59 |
|
|
507.51 |
447.34 |
581.38 |
521.21 |
655.26 |
595.09 |
872.43 |
970.94 |
|
623.65 |
549.70 |
714.43 |
640.49 |
805.22 |
731.27 |
1072.09 |
1191.13 |
|
Blue Cross
Blue Shield of Georgia SmartSense |
SmartSense |
||||||||||||||||
|
|
Male |
Female |
+ Child |
+ Child |
Children |
|
Couple |
|
|
Male |
Female |
+ Child |
+ Child |
Children |
|
Couple |
|
|
|
$121.31 |
$121.31 |
$180.52 |
$180.52 |
$239.74 |
$239.74 |
$242.55 |
$327.32 |
|
$151.74 |
$151.74 |
$225.81 |
$225.81 |
$299.88 |
$299.88 |
$303.40 |
$409.43 |
|
|
53.91 |
53.91 |
113.13 |
113.13 |
172.35 |
172.35 |
107.83 |
192.60 |
|
67.44 |
67.44 |
141.51 |
141.51 |
215.58 |
215.58 |
134.88 |
240.91 |
|
|
63.88 |
78.96 |
123.10 |
138.17 |
182.31 |
197.39 |
141.43 |
226.20 |
|
79.90 |
98.76 |
153.98 |
172.83 |
228.05 |
246.90 |
176.91 |
282.94 |
|
|
74.48 |
94.03 |
133.70 |
153.25 |
202.82 |
224.28 |
165.32 |
267.02 |
|
93.17 |
117.62 |
167.24 |
191.69 |
253.70 |
280.54 |
206.79 |
334.00 |
|
|
80.30 |
116.84 |
139.51 |
176.05 |
216.94 |
254.56 |
188.13 |
308.16 |
|
100.44 |
146.14 |
174.51 |
220.22 |
271.35 |
318.42 |
235.32 |
385.46 |
|
|
90.77 |
134.24 |
149.99 |
193.43 |
227.41 |
271.94 |
213.93 |
333.96 |
|
113.54 |
167.88 |
187.61 |
241.95 |
284.46 |
340.15 |
267.60 |
417.74 |
|
|
104.32 |
147.75 |
163.53 |
206.97 |
253.09 |
289.12 |
240.44 |
373.06 |
|
130.48 |
184.82 |
204.55 |
258.89 |
316.58 |
361.65 |
300.76 |
466.64 |
|
|
114.79 |
155.80 |
174.01 |
215.02 |
266.70 |
302.34 |
260.63 |
393.50 |
|
143.59 |
194.89 |
217.66 |
268.96 |
333.60 |
378.19 |
326.01 |
492.21 |
|
|
125.33 |
163.92 |
184.55 |
223.13 |
277.24 |
310.45 |
279.41 |
412.28 |
|
156.77 |
205.03 |
230.84 |
279.10 |
346.78 |
388.33 |
349.50 |
515.70 |
|
|
146.54 |
186.78 |
205.76 |
246.00 |
296.34 |
324.00 |
310.77 |
433.93 |
|
183.30 |
233.64 |
257.37 |
307.71 |
370.68 |
405.27 |
388.73 |
542.79 |
|
|
160.66 |
201.35 |
219.87 |
260.56 |
310.45 |
338.56 |
338.24 |
461.40 |
|
200.96 |
251.86 |
275.03 |
325.93 |
388.33 |
423.49 |
423.09 |
577.15 |
|
|
174.77 |
207.29 |
233.99 |
266.51 |
322.85 |
343.80 |
361.05 |
475.78 |
|
218.62 |
259.29 |
292.69 |
333.36 |
403.84 |
430.04 |
451.62 |
595.13 |
|
|
188.89 |
214.95 |
248.11 |
274.17 |
335.18 |
350.83 |
384.87 |
491.17 |
|
236.28 |
268.88 |
310.35 |
342.95 |
419.26 |
438.83 |
481.42 |
614.38 |
|
|
206.59 |
225.50 |
265.80 |
284.71 |
352.87 |
361.37 |
411.07 |
517.36 |
|
258.41 |
282.06 |
332.48 |
356.13 |
441.39 |
452.02 |
514.18 |
647.14 |
|
|
225.50 |
237.06 |
284.71 |
296.27 |
373.57 |
355.49 |
439.17 |
534.03 |
|
282.06 |
296.52 |
356.13 |
370.60 |
467.28 |
444.67 |
549.34 |
668.00 |
|
|
244.40 |
248.62 |
303.62 |
307.84 |
392.48 |
367.05 |
467.73 |
562.59 |
|
305.71 |
310.77 |
379.78 |
385.06 |
490.93 |
459.13 |
585.06 |
703.72 |
|
|
287.14 |
269.89 |
346.36 |
329.11 |
420.39 |
388.32 |
520.62 |
610.82 |
|
359.17 |
337.59 |
433.24 |
411.67 |
525.85 |
485.74 |
651.22 |
764.04 |
|
|
344.06 |
298.96 |
403.27 |
358.17 |
462.49 |
417.39 |
604.30 |
689.84 |
|
430.36 |
373.95 |
504.43 |
448.02 |
578.51 |
522.099 |
755.89 |
862.88 |
|
|
406.79 |
358.56 |
466.00 |
417.77 |
525.22 |
476.99 |
699.29 |
778.25 |
|
508.83 |
448.50 |
582.90 |
522.57 |
656.97 |
596.64 |
874.71 |
973.47 |
|
Blue Cross
Blue Shield of Georgia SmartSense |
SmartSense |
||||||||||||||||
|
|
Male |
Female |
+ Child |
+ Child |
Children |
|
Couple |
|
|
Male |
Female |
+ Child |
+ Child |
Children |
|
Couple |
|
|
|
$98.34 |
$98.34 |
$146.34 |
$146.34 |
$194.34 |
$194.34 |
$196.62 |
$265.34 |
|
123.95 |
123.95 |
184.46 |
184.46 |
244.97 |
244.97 |
247.84 |
334.45 |
|
|
43.71 |
43.71 |
91.71 |
91.71 |
139.71 |
139.71 |
87.41 |
156.13 |
|
55.09 |
55.09 |
115.60 |
115.60 |
176.10 |
176.10 |
110.18 |
196.80 |
|
|
51.78 |
64.00 |
99.79 |
112.01 |
147.79 |
160.01 |
114.65 |
183.36 |
|
65.27 |
80.68 |
125.78 |
141.18 |
186.29 |
201.69 |
144.51 |
231.13 |
|
|
60.38 |
76.23 |
108.38 |
124.23 |
164.41 |
181.81 |
134.02 |
216.45 |
|
76.11 |
96.08 |
136.61 |
156.59 |
207.24 |
229.17 |
168.92 |
272.84 |
|
|
65.09 |
94.71 |
113.09 |
142.71 |
175.86 |
206.36 |
152.50 |
249.80 |
|
82.05 |
119.38 |
142.55 |
179.89 |
221.66 |
260.11 |
192.23 |
314.87 |
|
|
73.58 |
108.80 |
121.59 |
156.80 |
184.35 |
220.44 |
173.42 |
270.72 |
|
92.75 |
137.14 |
153.26 |
197.64 |
232.37 |
277.86 |
218.00 |
341.24 |
|
|
84.56 |
119.77 |
132.57 |
167.78 |
205.17 |
234.37 |
194.91 |
302.41 |
|
106.59 |
150.97 |
167.10 |
211.48 |
258.61 |
295.42 |
245.68 |
381.19 |
|
|
93.05 |
126.30 |
141.06 |
174.30 |
215.20 |
245.09 |
211.28 |
318.99 |
|
117.29 |
159.20 |
177.80 |
219.71 |
272.51 |
308.93 |
266.31 |
402.08 |
|
|
101.60 |
132.88 |
149.60 |
180.88 |
224.74 |
251.67 |
226.50 |
334.21 |
|
128.06 |
167.49 |
188.57 |
228.00 |
283.28 |
317.22 |
285.50 |
421.27 |
|
|
118.79 |
151.41 |
166.79 |
199.42 |
240.22 |
262.65 |
251.93 |
351.76 |
|
149.73 |
190.86 |
210.24 |
251.36 |
302.80 |
331.06 |
317.55 |
443.39 |
|
|
130.24 |
163.22 |
178.24 |
211.22 |
251.67 |
274.45 |
274.19 |
374.03 |
|
164.16 |
205.74 |
224.67 |
266.25 |
317.22 |
345.94 |
345.62 |
471.46 |
|
|
141.68 |
168.04 |
189.68 |
216.04 |
261.71 |
278.70 |
292.68 |
385.68 |
|
178.58 |
211.81 |
239.09 |
272.32 |
329.89 |
351.29 |
368.92 |
486.15 |
|
|
153.12 |
174.25 |
201.13 |
222.25 |
271.71 |
284.39 |
311.99 |
398.16 |
|
193.01 |
219.64 |
253.52 |
280.15 |
342.48 |
358.47 |
393.26 |
501.88 |
|
|
167.47 |
182.80 |
215.47 |
230.80 |
286.05 |
292.94 |
333.23 |
419.39 |
|
221.09 |
230.41 |
271.60 |
290.92 |
360.56 |
369.24 |
420.03 |
528.64 |
|
|
182.80 |
192.17 |
230.80 |
240.17 |
302.83 |
288.17 |
356.01 |
432.91 |
|
230.41 |
242.22 |
290.92 |
302.73 |
381.71 |
363.24 |
448.75 |
545.68 |
|
|
198.12 |
201.54 |
246.13 |
249.54 |
318.16 |
297.55 |
379.16 |
456.06 |
|
249.73 |
254.04 |
310.24 |
314.55 |
401.03 |
375.05 |
477.92 |
574.85 |
|
|
232.77 |
218.78 |
280.77 |
266.79 |
3410.79 |
314.79 |
422.03 |
495.15 |
|
293.40 |
275.77 |
351.91 |
336.28 |
429.56 |
396.79 |
531.97 |
624.13 |
|
|
278.91 |
242.35 |
326.91 |
290.35 |
374.91 |
338.35 |
489.87 |
559.21 |
|
351.56 |
305.47 |
412.06 |
365.98 |
475.57 |
426.49 |
617.47 |
704.87 |
|
|
329.76 |
290.66 |
377.76 |
338.66 |
425.76 |
386.67 |
566.87 |
630.88 |
|
415.65 |
366.37 |
476.16 |
426.88 |
536.67 |
487.39 |
714.53 |
795.21 |
|
Blue Cross
Blue Shield of Georgia SmartSense |
SmartSense |
||||||||||||||||
|
|
Male |
Female |
+ Child |
+ Child |
Children |
|
Couple |
|
|
Male |
Female |
+ Child |
+ Child |
Children |
|
Couple |
|
|
|
$88.86 |
$88.86 |
$132.24 |
$132.24 |
$175.62 |
$175.62 |
$177.68 |
$239.78 |
|
$113.53 |
$113.53 |
$168.95 |
$168.95 |
$224.37 |
$224.37 |
$227.00 |
$306.34 |
|
|
39.50 |
39.50 |
82.87 |
82.87 |
126025 |
126.25 |
78.99 |
141.09 |
|
50.46 |
50.46 |
105.88 |
105.88 |
161.30 |
161.30 |
100.92 |
180.25 |
|
|
46.80 |
57.84 |
90.17 |
101.22 |
133.55 |
144.60 |
103.60 |
165.70 |
|
59.79 |
73.89 |
115.21 |
129.32 |
170.63 |
184.74 |
132.36 |
211.70 |
|
|
54.56 |
68.88 |
97.94 |
112.26 |
148.57 |
164.30 |
121.11 |
195.60 |
|
69.71 |
88.00 |
125.13 |
143.42 |
189.82 |
209.91 |
154.72 |
249.90 |
|
|
58.82 |
85.59 |
102.20 |
128.97 |
158.92 |
186.48 |
137.81 |
225.74 |
|
75.15 |
109.35 |
130.57 |
164.77 |
203.03 |
238.24 |
176.07 |
288.40 |
|
|
66.50 |
98.32 |
109.88 |
141.70 |
166.59 |
199.21 |
156.72 |
244.65 |
|
84.95 |
125.61 |
140.38 |
181.03 |
212.84 |
254.51 |
200.22 |
312.56 |
|
|
76.42 |
108.24 |
119.80 |
151.62 |
185.40 |
211.79 |
176.14 |
273.28 |
|
97.63 |
138.28 |
153.05 |
193.70 |
236.87 |
270.59 |
225.03 |
349.15 |
|
|
84.09 |
114.13 |
127.47 |
157.51 |
195.37 |
221.48 |
190.92 |
288.26 |
|
107.43 |
145.82 |
162.85 |
201.24 |
249.60 |
2825.96 |
243.92 |
368.28 |
|
|
91.81 |
120.08 |
135.19 |
163.46 |
203.09 |
227.42 |
204.68 |
302.02 |
|
117.30 |
153.41 |
172.72 |
208.83 |
259.47 |
290.56 |
261.50 |
385.85 |
|
|
107.35 |
136.83 |
150.73 |
180.21 |
217.08 |
237.35 |
227.66 |
317.88 |
|
137.15 |
174.81 |
192.57 |
230.23 |
277.34 |
303.23 |
290.85 |
406.12 |
|
|
117.69 |
147.50 |
161.07 |
190.88 |
227.42 |
248.01 |
247.78 |
338.00 |
|
150.36 |
188.44 |
205.78 |
243.86 |
290.56 |
316.86 |
316.56 |
431.83 |
|
|
128.03 |
151.85 |
171.41 |
195.23 |
236.50 |
251.85 |
264.49 |
348.53 |
|
163.57 |
194.00 |
218.99 |
249.42 |
302.15 |
321.76 |
337.91 |
445.28 |
|
|
138.37 |
157.47 |
181.75 |
200.84 |
245.53 |
257.00 |
281.94 |
359.81 |
|
176.78 |
201.18 |
232.21 |
256.60 |
313.69 |
328.34 |
360.21 |
459.69 |
|
|
151.34 |
165.19 |
194.71 |
208.57 |
258.50 |
264.72 |
301.13 |
378.99 |
|
193.35 |
211.04 |
248.77 |
266.46 |
330.25 |
338.20 |
384.72 |
484.20 |
|
|
165.19 |
173.66 |
208.57 |
217.04 |
273.66 |
260.42 |
321.72 |
391.21 |
|
211.04 |
221.86 |
266.46 |
277.28 |
349.62 |
332.70 |
411.02 |
499.80 |
|
|
179.04 |
182.13 |
222.42 |
225.51 |
287.51 |
268.89 |
342.63 |
412.13 |
|
228.74 |
232.68 |
284.16 |
288.10 |
367.32 |
343.53 |
437.75 |
526.53 |
|
|
210.34 |
197.71 |
253.72 |
241.09 |
307.96 |
284.47 |
381.38 |
447.46 |
|
268.73 |
252.59 |
324.16 |
308.01 |
393.45 |
363.43 |
487.25 |
571.67 |
|
|
252.04 |
219.00 |
295.42 |
262.38 |
338.80 |
305.76 |
442.68 |
505.34 |
|
322.00 |
279.79 |
377.42 |
335.22 |
432.84 |
390.64 |
565.57 |
645.62 |
|
|
297.99 |
262.66 |
341.37 |
306.04 |
384.75 |
349.42 |
512.27 |
570.11 |
|
380.71 |
335.57 |
436.13 |
391.00 |
491.55 |
446.42 |
654.47 |
728.36 |
|
Blue Cross
Blue Shield of Georgia SmartSense POS |
SmartSense POS |
||||||||||||||||
|
|
Male |
Female |
+ Child |
+ Child |
Children |
|
Couple |
|
|
Male |
Female |
+ Child |
+ Child |
Children |
|
Couple |
|
|
|
$81.74 |
$81.74 |
$121.64 |
$121.64 |
$161.54 |
$161.54 |
$163.44 |
$220.56 |
|
$104.45 |
$104.45 |
$155.44 |
$155.44 |
$206.43 |
$206.43 |
$208.85 |
$281.84 |
|
|
36.33 |
36.33 |
76.23 |
76.23 |
116.13 |
116.13 |
72.66 |
129.78 |
|
46.42 |
46.42 |
97.41 |
97.41 |
148.40 |
148.40 |
92.85 |
165.84 |
|
|
43.04 |
53.20 |
82.95 |
93.10 |
122.85 |
133.00 |
95.30 |
152.42 |
|
55.00 |
67399 |
105.99 |
118.98 |
156.98 |
169.97 |
121.78 |
194.77 |
|
|
50.19 |
63.36 |
90.09 |
103.26 |
136.66 |
151.13 |
111.40 |
179.92 |
|
64.14 |
80.97 |
115.13 |
131.96 |
174.64 |
193.12 |
142.35 |
229.92 |
|
|
54.11 |
78.73 |
94.01 |
118.63 |
146.18 |
171.53 |
126.76 |
207.64 |
|
69.14 |
100.60 |
120.13 |
151.59 |
186.80 |
219.19 |
161.99 |
265.34 |
|
|
61.17 |
90.43 |
101.07 |
130.34 |
153.24 |
183.24 |
144.15 |
225.03 |
|
78.16 |
115.57 |
129.15 |
166.55 |
195.82 |
234.16 |
184.21 |
287.57 |
|
|
70.29 |
99.56 |
110.19 |
139.46 |
170.54 |
194.82 |
162.02 |
251.37 |
|
89.82 |
127.23 |
140.81 |
178.22 |
217.93 |
248.95 |
207.04 |
321.23 |
|
|
77.35 |
104.98 |
117.25 |
144.88 |
179.71 |
203.73 |
175.62 |
265.15 |
|
98.84 |
134.16 |
149.83 |
185.15 |
229.65 |
260.34 |
224.42 |
338.83 |
|
|
84.45 |
110.45 |
124.35 |
150.35 |
186.81 |
209.19 |
188.27 |
277.80 |
|
107.92 |
141.14 |
158.91 |
192.13 |
238.72 |
267.32 |
240.59 |
355.0 |
|
|
98.74 |
125.86 |
138.64 |
165.76 |
199.68 |
218.32 |
209.41 |
292.40 |
|
126.18 |
160.83 |
177.17 |
211.82 |
255.17 |
278.98 |
167.60 |
373.65 |
|
|
108.25 |
135.67 |
148.16 |
175.58 |
209.19 |
228.13 |
227.92 |
310.90 |
|
138.34 |
173.38 |
189.33 |
224.36 |
267.32 |
291.53 |
291.25 |
397.30 |
|
|
117.77 |
139.68 |
157.67 |
179.58 |
217.54 |
231.66 |
243.28 |
320.59 |
|
150.49 |
178.49 |
201.48 |
229.48 |
277.99 |
296.04 |
310.89 |
409.68 |
|
|
127.28 |
144.84 |
167.18 |
184.74 |
225.85 |
236.40 |
259.34 |
330.96 |
|
162.65 |
185.09 |
213.64 |
236.08 |
288.61 |
302.09 |
331.40 |
422.93 |
|
|
139.20 |
151.94 |
179.10 |
191.85 |
237.77 |
243.50 |
276.99 |
348.61 |
|
177.89 |
194.17 |
228.88 |
245.16 |
303.85 |
311.16 |
353.96 |
445.48 |
|
|
151.94 |
159.74 |
191.85 |
199.64 |
251.72 |
239.54 |
295.93 |
359.85 |
|
194.17 |
204.12 |
245.16 |
255.11 |
321.67 |
306.10 |
378.16 |
459.84 |
|
|
164.69 |
167.53 |
204.59 |
207.43 |
264.46 |
247.33 |
315.17 |
379.09 |
|
210.45 |
214.08 |
261.44 |
265.07 |
337.95 |
316.06 |
402.75 |
484.43 |
|
|
193.48 |
181.86 |
233.38 |
221.76 |
283.27 |
261.66 |
350.81 |
411.58 |
|
247.25 |
232.40 |
298.24 |
283.39 |
361.99 |
334.37 |
448.29 |
525.96 |
|
|
231.83 |
201.44 |
271.73 |
241.35 |
311.64 |
281.25 |
407.19 |
464.83 |
|
296.26 |
257.42 |
347.25 |
308.41 |
398.24 |
359.40 |
520.35 |
594.00 |
|
|
274.10 |
241.60 |
314.00 |
281.51 |
353.91 |
321.41 |
471.20 |
524.40 |
|
350.27 |
308.74 |
401.26 |
359.73 |
452.25 |
410.72 |
602.14 |
670.12 |
|
Blue Cross
Blue Shield of Georgia SmartSense |
SmartSense |
||||||||||||||||
|
|
Male |
Female |
+ Child |
+ Child |
Children |
|
Couple |
|
|
Male |
Female |
+ Child |
+ Child |
Children |
|
Couple |
|
|
|
$72.92 |
$72.92 |
$108.51 |
$108.51 |
$144.11 |
$144.11 |
$145.80 |
$196.75 |
|
$95.63 |
$95.63 |
$142.32 |
$142.32 |
$189.00 |
$189.00 |
$191.22 |
$258.04 |
|
|
32.41 |
32.41 |
68.00 |
68.00 |
103.60 |
103.60 |
64.82 |
115.7 |
|
42.50 |
42.50 |
89.19 |
89.19 |
135.87 |
135.87 |
85.01 |
151.83 |
|
|
38.40 |
47.46 |
73.99 |
83.06 |
109.59 |
118.65 |
85.01 |
135.97 |
|
50.36 |
62.24 |
97.04 |
108.93 |
143.73 |
155.61 |
111.50 |
178.32 |
|
|
44.77 |
56.52 |
80.37 |
92.12 |
121.92 |
134.82 |
99.38 |
160.51 |
|
58.72 |
74.13 |
105.40 |
120.81 |
159.89 |
176.81 |
130.33 |
210.50 |
|
|
48.27 |
70.23 |
83.86 |
105.83 |
130.40 |
153.02 |
113.08 |
185.23 |
|
63.30 |
92.11 |
109.99 |
138.79 |
171.02 |
200.68 |
148.31 |
242.93 |
|
|
54.56 |
80.68 |
90.16 |
116.27 |
136.70 |
163.46 |
128.60 |
20075 |
|
71.56 |
105.81 |
118.24 |
152.49 |
179.28 |
214.38 |
168.65 |
263.28 |
|
|
62.70 |
88.82 |
98.30 |
124.41 |
152.13 |
173.79 |
144.53 |
224.25 |
|
82.24 |
116.48 |
128.92 |
163.17 |
199.52 |
227.93 |
189.55 |
294.10 |
|
|
69.00 |
93.65 |
104.60 |
129.25 |
160.31 |
181.74 |
156.67 |
236.53 |
|
90.50 |
122.83 |
137.18 |
169.51 |
210.25 |
238.35 |
205.47 |
310.22 |
|
|
75.34 |
98.53 |
110.93 |
134.13 |
166.65 |
186.62 |
167.95 |
247.82 |
|
98.81 |
129.22 |
145.49 |
175.91 |
218.56 |
244.75 |
220.27 |
325.02 |
|
|
88.09 |
112.28 |
123.68 |
147.87 |
178.13 |
194.76 |
186.81 |
260.84 |
|
115.52 |
147.25 |
162.21 |
193.93 |
233.62 |
255.42 |
245.00 |
342.09 |
|
|
96.57 |
121.03 |
132.17 |
156.63 |
186.62 |
203.51 |
203.32 |
277.35 |
|
126.65 |
158.73 |
173.34 |
205.42 |
244.75 |
266.91 |
266.65 |
363.75 |
|
|
105.06 |
124.60 |
140.65 |
160.20 |
194.07 |
206.66 |
217.03 |
285.99 |
|
137.78 |
163.42 |
184.47 |
210.10 |
254.52 |
271.04 |
284.63 |
375.08 |
|
|
113.54 |
129.21 |
149.14 |
164.81 |
201.48 |
210.88 |
231.35 |
295.25 |
|
148.91 |
169.46 |
195.60 |
216.14 |
264.24 |
276.58 |
303.42 |
387.22 |
|
|
124.18 |
135.55 |
159.78 |
171.14 |
212.11 |
217.22 |
247.09 |
310.99 |
|
162.86 |
177.77 |
209.55 |
224.45 |
278.19 |
284.88 |
324.06 |
407.86 |
|
|
135.55 |
142.50 |
171.14 |
178.09 |
224.55 |
213.69 |
263.99 |
321.01 |
|
177.77 |
186.88 |
224.45 |
233.57 |
294.50 |
280.25 |
346.22 |
421.01 |
|
|
146.91 |
149.45 |
182.51 |
185.04 |
235.92 |
220.64 |
281.15 |
338.18 |
|
192.68 |
196.00 |
239.36 |
242.68 |
309.41 |
289.37 |
368.73 |
443.52 |
|
|
172.60 |
162.23 |
208.20 |
197.83 |
252.70 |
233.42 |
312.95 |
367.17 |
|
226.37 |
212.77 |
273.05 |
259.45 |
331.42 |
306.14 |
410.43 |
481.54 |
|
|
206.81 |
179.70 |
242.41 |
215.30 |
278.00 |
250.90 |
363.25 |
414.66 |
|
271.24 |
235.68 |
317.92 |
282.37 |
364.60 |
329.05 |
476.40 |
543.83 |
|
|
244.52 |
215.53 |
280.12 |
251.13 |
315.71 |
286.72 |
420.35 |
467.81 |
|
320.69 |
282.67 |
367.37 |
329.35 |
414.06 |
376.04 |
551.29 |
613.53 |
|
Blue Cross
Blue Shield of Georgia SmartSense |
SmartSense |
||||||||||||||||
|
|
Male |
Female |
+ Child |
+ Child |
Children |
|
Couple |
|
|
Male |
Female |
+ Child |
+ Child |
Children |
|
Couple |
|
|
|
$62.97 |
$62.97 |
$93.71 |
$93.71 |
$124.45 |
$124.45 |
$125.91 |
$169.92 |
|
$80.79 |
$80.79 |
$120.23 |
$120.23 |
$159.67 |
$159.67 |
$161.54 |
$218.00 |
|
|
27.99 |
27.99 |
58.73 |
58.73 |
89.47 |
89.47 |
55.98 |
99.98 |
|
35.91 |
35.91 |
75.35 |
75.35 |
114.79 |
114.79 |
71.82 |
128.27 |
|
|
33.16 |
40.99 |
63.90 |
71.73 |
94.64 |
102.47 |
73.42 |
117.42 |
|
42.54 |
52.59 |
81.98 |
92.02 |
121.42 |
131.46 |
94.19 |
150.65 |
|
|
38.67 |
48.81 |
69.41 |
79.55 |
105.29 |
116.43 |
85.82 |
138.61 |
|
49.61 |
62.63 |
89.05 |
102.07 |
135.08 |
149.37 |
110.11 |
177.84 |
|
|
41.68 |
60.65 |
72.42 |
91.39 |
112.61 |
132.15 |
97.66 |
159.97 |
|
53.48 |
77.81 |
92.92 |
117.25 |
144.48 |
169.54 |
125.29 |
205.24 |
|
|
47.12 |
69.67 |
77.86 |
100.41 |
118.05 |
141.17 |
111.06 |
173.37 |
|
60.46 |
89.39 |
99.90 |
128.83 |
151.46 |
181.11 |
142.48 |
222.42 |
|
|
54.15 |
76.70 |
84.89 |
107.44 |
131.38 |
150.09 |
124.82 |
193.66 |
|
69.48 |
98.41 |
108.91 |
137.85 |
168.56 |
192.56 |
160.14 |
248.46 |
|
|
59.59 |
80.88 |
90.33 |
111.62 |
138.45 |
156.95 |
135.30 |
204.27 |
|
76.45 |
103.77 |
115.89 |
143.21 |
177.62 |
201.36 |
173.58 |
262.08 |
|
|
65.06 |
85.09 |
95.80 |
115.83 |
143.92 |
161.16 |
145.05 |
214.02 |
|
83.47 |
109.17 |
122.91 |
148.61 |
184.64 |
206.77 |
186.09 |
274.58 |
|
|
76.07 |
96.96 |
106.81 |
127.70 |
153.83 |
168.19 |
161.33 |
225.26 |
|
97.60 |
124.40 |
137.04 |
163.84 |
197.37 |
215.79 |
206.98 |
289.01 |
|
|
83.40 |
104.52 |
114.14 |
135.26 |
161.16 |
175.75 |
175.59 |
239.52 |
|
107.00 |
134.10 |
146.44 |
173.54 |
206.77 |
225.49 |
225.27 |
307.30 |
|
|
90.73 |
107.61 |
121.47 |
138.35 |
167.60 |
178.47 |
187.43 |
246.98 |
|
116.40 |
138.06 |
155.84 |
177.50 |
215.02 |
228.98 |
240.46 |
316.87 |
|
|
98.06 |
111.59 |
128.80 |
142.33 |
174.00 |
182.12 |
199.79 |
254.97 |
|
125.81 |
143.16 |
165.24 |
182.60 |
223.23 |
233.66 |
256.33 |
327.13 |
|
|
107.24 |
117.06 |
137.98 |
147.80 |
183.18 |
187.59 |
213.39 |
268.57 |
|
137.59 |
150.18 |
177.03 |
189.62 |
235.02 |
240.68 |
273.78 |
344.57 |
|
|
117.06 |
123.06 |
147.80 |
153.80 |
193.92 |
184.54 |
227.98 |
277.22 |
|
150.18 |
157.88 |
189.62 |
197.32 |
248.80 |
236.76 |
292.50 |
355.67 |
|
|
126.87 |
129.06 |
157.61 |
159.80 |
203.74 |
190.54 |
242.80 |
292.05 |
|
162.78 |
165.58 |
202.22 |
205.02 |
261.40 |
244.46 |
311.51 |
374.69 |
|
|
149.06 |
140.10 |
179.80 |
170.84 |
218.23 |
201.58 |
270.26 |
317.08 |
|
191.24 |
179.75 |
230.68 |
219.19 |
279.99 |
258.63 |
346.74 |
406.81 |
|
|
178.60 |
155.19 |
209.34 |
185.93 |
240.08 |
216.67 |
313.70 |
358.10 |
|
229.15 |
199.11 |
268.59 |
238.55 |
308.02 |
277.99 |
402.47 |
459.44 |
|
|
211.17 |
186.13 |
241.91 |
216.87 |
272.65 |
247.61 |
363.01 |
404.00 |
|
270.93 |
238.80 |
310.36 |
278.24 |
349.80 |
317.68 |
465.74 |
518.32 |
|
|
||||
|
Blue Cross and Blue Shield of GeorgiaI nc. and Greater Georgia Life Insurance Company are independent licensees of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association.
|
||||