Price of Simple Repair of Scalp/Neck/Axilla/Genital/Trunk Lesion at NYU Langone
Last Updated: 2024-07-01
Locations
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NYU Langone|Tisch Hospital
550 1st Ave., New York, NY 10016About Simple Repair of Scalp/Neck/Axilla/Genital/Trunk Lesion
Service Codes: LOCAL 2020074, CPT 12001
This procedure involves the repair of a skin lesion measuring 2.5 centimeters or less on the scalp, neck, axilla, genital area, or trunk. The purpose is to close the wound to promote healing and minimize scarring.
Pricing Overview
Cash Price
$298.47
Median Price
$1,225.29
Price Range
$53.40 - $13,547.57
Insurance Plan Prices
| Insurance Provider | Plan Type | Price |
|---|---|---|
| Senior Whole Health | All Plans | $221.21 |
| First Health | PPO | $1,225.29 |
| Anthem BCBS HealthPlus | Essential Plan 3 | $609.48 |
| MultiPlan | Global Excel Management | $1,225.29 |
| AgeWell (Deprecated) | Medicare Advantage | $221.21 |
| MetroPlus | Essential Plan 1 | $609.48 |
| HealthSmart | WTC Health Program - Northwell | $221.21 |
| VNS Health | MLTC (Medicaid) | $609.48 |
| EmblemHealth | HIP Access II | $7,558.00 |
| EmblemHealth | CMO Essential Plan 3 | $609.48 |
| EmblemHealth | Select Care Gold Exchange | $9,585.45 |
| Aetna | Global National Transplant | $6,346.39 |
| Three Rivers | All Plans (Home-based Only) | $1,413.80 |
| Aetna | Christian Brothers ASA PPO | $6,346.39 |
| MagnaCare | National Health Plan | $13,547.57 |
| MetroPlus | Medicaid Managed Care | $609.48 |
| Centers Plan for Healthy Living | All Plans | $221.21 |
| UnitedHealthcare | HMO | $4,078.00 |
| MetroPlus | Essential Plan 4 | $609.48 |
| Health Net | PPO | $1,225.29 |
| Aetna | Coresource ASA PPO | $6,346.39 |
| Healthfirst | Child Health Plus (CHP) | $53.40 |
| HealthSmart | WTC Health Program - Mt. Sinai | $221.21 |
| EmblemHealth | HIP PPO | $7,558.00 |
| BCBS (Out of State) | EPO (Suitcase Logo) | $3,810.00 |
| VNS Health | EasyCare Plus (Medicare+Medicaid) | $221.21 |
| EmblemHealth | Essential Plan 4 | $609.48 |
| BCBS (Out of State) | HMO (Suitcase Logo) | $3,810.00 |
| 1199SEIU Funds | Home Care Benefit Fund | $1,250.00 |
| UnitedHealthcare - Oxford | Freedom | $3,210.00 |
| MetroPlus | PlatinumPlus | $438.00 |
| EmblemHealth | GHI Medicare Supplement | $221.21 |
| MetroPlus | GoldPlus | $438.00 |
| Blue Cross Blue Shield | MediBlue (Medicare Advantage) Select/Extra HMO (HCP) | $221.21 |
| Anthem BCBS HealthPlus | Child Health Plus (CHP) | $609.48 |
| Aetna | Starmark ASA PPO | $6,346.39 |
| EmblemHealth | HIP | $7,558.00 |
| Fidelis Care | Essential Plan 2 | $1,310.37 |
| EmblemHealth | American Plan Administrators | $11,277.00 |
| Blue Cross Blue Shield | PPO/EPO (Small Group) | $3,048.00 |
| Cigna | MVP-Cigna Network | $5,418.00 |
| Aetna | Wellnet ASA PPO | $6,346.39 |
| MetroPlus | MedPlus | $438.00 |
| EmblemHealth | HIP VIP Medicare Bold | $221.21 |
| BCBS (Out of State) | EPO | $3,810.00 |
| Anthem BCBS HealthPlus | SOMOS ny medicaid | $639.95 |
| EmblemHealth | BCBS GHI Composite | $3,810.00 |
| MetroPlus | Essential Plan 3 | $609.48 |
| MetroPlus | Essential Plan 1-2, 200-250 | $609.48 |
| Horizon BCBS | Direct | $3,810.00 |
| Anthem BCBS HealthPlus | SOMOS Child Health Plus (CHP) | $639.95 |
| Amida Care | Medicaid Managed Care | $609.48 |
| Fidelis Care | Essential Plan 3 | $755.75 |
| UnitedHealthcare | Medicare Advantage | $221.21 |
| Blue Cross Blue Shield | Federal Program | $3,810.00 |
| Anthem BCBS HealthPlus | Family Health Plus (Deprecated) | $609.48 |
| Blue Cross Blue Shield | MediBlue (Medicare Advantage) HMO (HCP) | $221.21 |
| UnitedHealthcare | AARP Medicare Advantage Complete Mosaic | $221.21 |
| EmblemHealth | HIP Optum Health | $7,558.00 |
| EmblemHealth | HIP Montefiore | $7,558.00 |
| UnitedHealthcare | POS | $4,078.00 |
| 1199SEIU Funds | Member Choice Home Care Select | $1,250.00 |
| UnitedHealthcare | Independent | $4,078.00 |
| BCBS (Out of State) | POS (No Suitcase Logo) | $3,810.00 |
| UnitedHealthcare | PPO | $4,078.00 |
| EmblemHealth | Enhanced Care (Medicaid) Child Health Plus (SOMOS) | $639.95 |
| UnitedHealthcare | AARP Medicare Advantage Complete Essentials | $221.21 |
| MultiPlan | US Life Insurance Co | $1,225.29 |
| CenterLight | Direct | $225.63 |
| EmblemHealth | Essential Plan 3 | $609.48 |
| Blue Cross Blue Shield | Blue Access HMO (Small Group) | $3,048.00 |
| EmblemHealth | CMO Essential Plan 1 | $731.37 |
| EmblemHealth | HIP Medicare Supplement | $221.21 |
| UnitedHealthcare | Golden Rule Insurance | $4,078.00 |
| MultiPlan | Nippon Life | $1,225.29 |
| Blue Cross Blue Shield | Blue Access gEPO (Small Group) | $3,048.00 |
| Cigna | NALC PPO | $5,418.00 |
| Anthem BCBS HealthPlus | Special Needs Plan (SNP) | $609.48 |
| MultiPlan | Guardian Life Insurance Co | $1,225.29 |
| UnitedHealthcare | AARP Medicare Advantage Complete | $221.21 |
| Cigna | Great West HMO | $5,418.00 |
| Fidelis Care | Bronze for Children (Exchange) | $1,097.06 |
| Cigna | Wellfleet Student | $5,418.00 |
| EmblemHealth | HIP compre health epo | $7,558.00 |
| BCBS (Out of State) | POS | $3,810.00 |
| MagnaCare | Independent Care Plus | $13,547.57 |
| Partners Health Plan | FIDA | $221.21 |
| EmblemHealth | HIP VIP Medicare Healthcare Partners | $221.21 |
| Cigna | Great West PPO | $5,418.00 |
| MagnaCare | Capital District Physicians Health Plan | $13,547.57 |
| Fidelis Care | Gold (Exchange) | $1,097.06 |
| VNS Health | SelectHealth (Medicaid) | $609.48 |
| UnitedHealthcare | Core | $4,078.00 |
| EmblemHealth | HIP POS | $7,558.00 |
| EmblemHealth | GHI Medicare HMO | $221.21 |
| UnitedHealthcare | Charter | $4,078.00 |
| EmblemHealth | CMO Essential Plan 4 | $609.48 |
| UnitedHealthcare - Oxford | Optum Health | $3,210.00 |
| EmblemHealth | HIP Long Island College Hospital (LICH) | $7,558.00 |
| MultiPlan | PHCS Savility | $1,225.29 |
| Blue Cross Blue Shield | Senior Care Supplemental | $221.21 |
| UnitedHealthcare - Oxford | Liberty | $3,210.00 |
| MultiPlan | Global Health Management | $1,225.29 |
| EmblemHealth | HIP Healthcare Partners HMO | $7,558.00 |
| EmblemHealth | HIP VIP Medicare Affinity | $221.21 |
| EmblemHealth | Enhanced Care (Medicaid) Montefiore | $609.48 |
| MagnaCare | Cement & Concrete Workers District Council | $13,547.57 |
| Healthfirst | Essential Plan 3-4 | $53.40 |
| VNS Health | EasyCare (Medicare Advantage) | $221.21 |
| MultiPlan | PHP Healthcare (Champus) | $1,225.29 |
| Fidelis Care | Essential Plan 1 | $1,310.37 |
| Blue Cross Blue Shield | HMO | $3,810.00 |
| Fidelis Care | Child Health Plus (CHP) | $755.75 |
| Elderplan | FIDA | $221.21 |
| Carelon Behavioral Health | Medicaid Managed Care (Home-based Only) | $609.48 |
| Anthem BCBS HealthPlus | Essential Plan 1, 200-250 | $1,218.95 |
| EmblemHealth | Healthcare Partners Essential Plan 3 | $609.48 |
| Fidelis Care | Silver for Children (Exchange) | $1,097.06 |
| Blue Cross Blue Shield | Healthy New York | $3,810.00 |
| EmblemHealth | Essential Plan 2 | $731.37 |
| Fidelis Care | Catastrophic (Exchange) | $1,097.06 |
| EmblemHealth | Select Care Catastrophic Exchangeu00a0 | $9,585.45 |
| Veterans Choice | Veterans Choice Program | $221.21 |
| Fidelis Care | Platinum for Children (Exchange) | $1,097.06 |
| EmblemHealth | American Plan Administrators c/o H.D.A | $11,277.00 |
| Aetna | Open Access HMO | $6,346.39 |
| Blue Cross Blue Shield | Pathway Enhanced | $731.37 |
| EmblemHealth | Prime Silver | $9,585.45 |
| EmblemHealth | Healthcare Partners Essential Plan 2 | $731.37 |
| EmblemHealth | HIP VIP Medicare Reserve | $221.21 |
| EmblemHealth | Select Care Silver Exchange | $9,585.45 |
| AgeWell (Deprecated) | Medicaid Managed Care | $609.48 |
| Anthem BCBS HealthPlus | Medicaid | $609.48 |
| BCBS (Out of State) | HMO | $3,810.00 |
| Blue Cross Blue Shield | EPO | $3,810.00 |
| Healthfirst | Personal Wellness Plan (HARP) | $609.48 |
| Cigna | Tufts Health Plan | $5,418.00 |
| Partners Health Plan | Medicare Advantage | $221.21 |
| EmblemHealth | Enhanced Care (Medicaid) (SOMOS) | $639.95 |
| MultiPlan | Principal Financial Group | $1,225.29 |
| MagnaCare | JIB Employees Security Fund | $13,547.57 |
| Blue Cross Blue Shield | Hotel Trades Council | $3,810.00 |
| MultiPlan | Kaiser Permanente | $1,225.29 |
| Aetna | Medicare Advantage | $221.21 |
| Maksin Group | Consolidated Health Plan (Home-based only) | $5,418.00 |
| Healthfirst | Senior Health Partners (MLTC) | $53.40 |
| Cigna | PPO | $5,418.00 |
| BCBS (Out of State) | POS (Suitcase Logo) | $3,810.00 |
| Healthfirst | Personal Wellness Plan (HARP) | $53.40 |
| Champus | Unysis Corp | $221.21 |
| EmblemHealth | Healthcare Partners Essential Plan 3-4 | $609.48 |
| Partners Health Plan | Medicare Advantage (Home-based Only) | $221.21 |
| EmblemHealth | Enhanced Care (Medicaid) | $609.48 |
| Blue Cross Blue Shield | Blue Access EPO (Large Group) | $3,429.00 |
| EmblemHealth | Enhanced Care (Medicaid) SNP HARP (SOMOS) | $639.95 |
| EmblemHealth | Select Care Bronze Exchange | $9,585.45 |
| MultiPlan | Humana Health Plan | $1,225.29 |
| HealthSmart | WTC Health Program - Logistic Health Inc | $221.21 |
| MultiPlan | QualCare Inc | $1,225.29 |
| Anthem BCBS HealthPlus | SOMOS Essential Plan 2 | $822.79 |
| MetroPlus | Essential Plan 2 | $609.48 |
| MultiPlan | Paramount Insurance | $1,225.29 |
| Blue Cross Blue Shield | MediBlue (Medicare Advantage) HMO | $221.21 |
| BCBS (Out of State) | Medicare (No Suitcase Logo) | $221.21 |
| Partners Health Plan | Medicaid MLTC | $609.48 |
| Cigna | Open Access | $5,418.00 |
| EmblemHealth | Select Care Silver Small Group | $9,585.45 |
| Fidelis Care | Native American (Exchange) | $1,097.06 |
| Blue Cross Blue Shield | MediBlue (Medicare Advantage) PPO | $221.21 |
| MagnaCare | Direct Plus | $13,547.57 |
| Humana | All Commercial Plans | $1,225.29 |
| EmblemHealth | Prime Bronze | $9,585.45 |
| UnitedHealthcare | Choice (North Shore - LIJ) | $4,078.00 |
| Blue Cross Blue Shield | Blue Access EPO (Small Group) | $3,048.00 |
| EmblemHealth | Select Care Healthcare Partners | $9,585.45 |
| Fidelis Care | Silver 250 (Exchange) | $1,097.06 |
| EmblemHealth | CMO Essential Plan 2 | $731.37 |
| Blue Cross Blue Shield | POS | $3,810.00 |
| UnitedHealthcare | AARP | $221.21 |
| Anthem BCBS HealthPlus | Medicare Advantage | $221.21 |
| Blue Cross Blue Shield | Global Transplants | $3,810.00 |
| Anthem BCBS HealthPlus | SOMOS Essential Plan 3 | $639.95 |
| EmblemHealth | GHI HMO | $11,277.00 |
| EmblemHealth | Healthcare Partners Essential Plan 1-2 | $731.37 |
| MultiPlan | PHCS Director Guild | $1,225.29 |
| EmblemHealth | Select Care Platinum Small Group | $9,585.45 |
| Anthem BCBS HealthPlus | Essential Plan 2 | $1,218.95 |
| MultiPlan | Fiserv Health | $1,225.29 |
| MetroPlus | Essential Plan 3-4 | $609.48 |
| VA Community Care Network | Optum | $221.21 |
| Blue Cross Blue Shield | Blue Access gEPO (Large Group) | $3,429.00 |
| Blue Cross Blue Shield | Local 32 BJ | $3,810.00 |
| Cigna | Premier Plus | $5,418.00 |
| MultiPlan | Administrative Concepts | $1,225.29 |
| Anthem BCBS | Optum | $3,810.00 |
| EmblemHealth | Select Care Basic Exchange | $9,585.45 |
| HealthSmart | WTC Health Program - FDNY | $221.21 |
| Cigna | Indemnity | $5,418.00 |
| BCBS (Out of State) | PPO | $3,810.00 |
| Blue Cross Blue Shield | Pathway | $731.37 |
| Cigna | LifeSOURCE | $5,418.00 |
| Blue Cross Blue Shield | Open Access HMO (Home-based Only) | $3,810.00 |
| EmblemHealth | Vytra HMO | $7,558.00 |
| Fidelis Care | Wellcare Medicare Advantage | $221.21 |
| MultiPlan | Capital District Physicians Health Plan | $1,225.29 |
| EmblemHealth | HIP VIP Medicare Montefiore | $221.21 |
| Cigna | Cigna Managed Care/POS | $5,418.00 |
| HealthSmart | WTC Health Program - NYCHHC | $221.21 |
| BCBS (Out of State) | EPO (No Suitcase Logo) | $3,810.00 |
| MetroPlus | Child Health Plus (CHP) | $609.48 |
| UnitedHealthcare | Choice | $4,078.00 |
| UnitedHealthcare | WTC Health Program | $221.21 |
| EmblemHealth | Healthcare Partners Essential Plan 4 | $609.48 |
| Partners Health Plan | Medicaid | $609.48 |
| Fidelis Care | Silver (Exchange) | $1,097.06 |
| Blue Cross Blue Shield | Blue Connection | $3,810.00 |
| Blue Cross Blue Shield | Pathway X Enhanced | $731.37 |
| Cigna | Evernorth Behavioral Health | $5,418.00 |
| MultiPlan | Screen Actors Guild | $1,225.29 |
| UnitedHealthcare | POMCO (UMR) | $1,225.29 |
| MetroPlus | GoldCare 2 | $609.48 |
| Anthem BCBS HealthPlus | All Exchange Plans | $731.37 |
| EmblemHealth | GHI EPO | $11,277.00 |
| Anthem BCBS | All Plans | $3,810.00 |
| EmblemHealth | Select Care HMO | $9,585.45 |
| UnitedHealthcare | Medicare Advantage Complete Choice Regional PPO | $221.21 |
| EmblemHealth | Enhanced Care (Medicaid) Essential Plan 2 (SOMOS) | $822.79 |
| EmblemHealth | Select Care PPOu00a0 | $9,585.45 |
| Aetna | HMO | $6,346.39 |
| EmblemHealth | VIP Prime HMO Medicare Advantage | $221.21 |
| UnitedHealthcare | Optum Health | $4,078.00 |
| Aetna | Indemnity | $1,272.42 |
| UnitedHealthcare | Student Resources | $4,078.00 |
| 1199SEIU Funds | PPO | $1,250.00 |
| MagnaCare | JIB Members | $13,547.57 |
| HealthSmart | WTC Health Program - UMDNJ Rutgers | $221.21 |
| GEHA | All Plans | $6,346.39 |
| MultiPlan | Healthnet of California | $1,225.29 |
| UnitedHealthcare | Choice (NY Power Authority) | $4,078.00 |
| MultiPlan | PHCS | $1,225.29 |
| MetroPlus | Medicare Advantage | $221.21 |
| EmblemHealth | Select Care EPO | $9,585.45 |
| MetroPlus | Gold | $609.48 |
| Elderplan | All Plans | $221.21 |
| BCBS (Out of State) | Medicare (Suitcase Logo) | $221.21 |
| BCBS (Out of State) | Indemnity | $3,810.00 |
| CenterLight | PACE | $225.63 |
| MetroPlus | BronzePlus | $438.00 |
| VillageCareMAX | All Plans | $221.21 |
| Fidelis Care | Bronze (Exchange) | $1,097.06 |
| Anthem BCBS HealthPlus | SOMOS Essential Plan 1 & 200-250 | $822.79 |
| Fidelis Care | Medicaid Managed Care | $755.75 |
| EmblemHealth | GHI Comprehensive Benefits Plan (CBP) | $11,277.00 |
| EmblemHealth | HIP Prime Basic | $9,585.45 |
| UnitedHealthcare | POMCO (UMR) | $4,078.00 |
| EmblemHealth | Prime Platinum | $9,585.45 |
| Healthfirst | Essential Plan 4 | $53.40 |
| Fidelis Care | Essential Plan 4 | $755.75 |
| Blue Cross Blue Shield | UniCare | $3,810.00 |
| Fidelis Care | Platinum (Exchange) | $1,097.06 |
| BCBS (Out of State) | HMO (No Suitcase Logo) | $3,810.00 |
| HealthSmart | WTC Health Program - NYU | $221.21 |
| MultiPlan | Mutual of Omaha | $1,225.29 |
| EmblemHealth | GHI PPO | $11,277.00 |
| CenterLight | PACE Medicare HMO | $225.63 |
| EmblemHealth | Enhanced Care (Medicaid) Essential Plan 1, 200-250 (SOMOS) | $822.79 |
| EmblemHealth | Bridge | $7,558.00 |
| Aetna | Allied ASA PPO | $6,346.39 |
| Blue Cross Blue Shield | Blue Access PPO (Large Group) | $3,429.00 |
| UnitedHealthcare | EPO | $4,078.00 |
| MagnaCare | Direct Plus Preferred | $13,547.57 |
| EmblemHealth | GHI composite | $11,277.00 |
| Healthfirst | Medicaid Managed Care | $53.40 |
| Anthem BCBS HealthPlus | Essential Plan 4 | $609.48 |
| Blue Cross Blue Shield | Blue Priority HMO | $3,810.00 |
| Blue Cross Blue Shield | Open Access PPO (Home-based Only) | $3,810.00 |
| Blue Cross Blue Shield | Child Health Plus (CHP) | $609.48 |
| Hamaspik | Medicare Advantage | $442.42 |
| EmblemHealth | IUOE Local 14-14B | $11,277.00 |
| EmblemHealth | Healthcare Partners Essential Plan 1, 200-250 | $731.37 |
| Aetna | Signature Administrators PPO | $6,346.39 |
| Sedgwick | WTC Health Program - Northwell | $221.21 |
| Cigna | Open Access PPO | $5,418.00 |
| EmblemHealth | Enhanced Care (Medicaid) Healthcare Partners | $609.48 |
| First Health | Commercial HMO | $1,319.55 |
| EmblemHealth | Enhanced Care (Medicaid) Essential Plan 3 (SOMOS) | $639.95 |
| Aetna | Student Health | $6,346.39 |
| BCBS (Out of State) | Medicare | $221.21 |
| EmblemHealth | GHI Medicare PPO | $221.21 |
| MagnaCare | PPO | $13,547.57 |
| Cigna | Open Access HMO | $5,418.00 |
| MagnaCare | American Plan Administrators | $13,547.57 |
| EmblemHealth | HIP SmartStart | $7,558.00 |
| Blue Cross Blue Shield | PPO | $3,810.00 |
| UnitedHealthcare - Oxford | Metro | $3,210.00 |
| EmblemHealth | Healthcare Partners Essential Plans | $731.37 |
| MultiPlan | AXA Global Insurance | $1,225.29 |
| MultiPlan | PPO | $1,225.29 |
| BCBS (Out of State) | PPO (No Suitcase Logo) | $3,810.00 |
| Carelon Behavioral Health | All Exchange Plans (Home-based Only) | $221.21 |
| Blue Cross Blue Shield | Blue Priority PPO | $3,810.00 |
| Carelon Behavioral Health | Medicare Advantage (Home-based Only) | $221.21 |
| EmblemHealth | HIP Child Health Plus | $609.48 |
| Aetna | POS | $6,346.39 |
| Healthfirst | Essential Plan 3 | $53.40 |
| EmblemHealth | Essential Plan 1, 200-250 | $731.37 |
| EmblemHealth | HIP Access I | $7,558.00 |
| Blue Cross Blue Shield | MediBlue (Medicare Advantage) Select HMO/Extra HMO | $221.21 |
| Aetna | Chesterfield Resources ASA PPO | $6,346.39 |
| Aetna | PPO | $6,346.39 |
| MultiPlan | Meritain Health | $1,225.29 |
| EmblemHealth | Select Care Bronze Small Group | $9,585.45 |
| EmblemHealth | Enhanced Care (Medicaid) Essential Plan 4 (SOMOS) | $639.95 |
| Aetna | Healthscope ASA PPO | $6,346.39 |
| Better Health Plan | All Plans | $1,319.55 |
| Cigna | HMO | $5,418.00 |
| Riverspring Health Plans | Medicare Advantage | $221.21 |
| EmblemHealth | HIP EPO | $7,558.00 |
| EmblemHealth | GHI Behavioral Management Program | $11,277.00 |
| Anthem BCBS | Empire Plan, Value Options | $3,810.00 |
| MetroPlus | SilverPlus | $438.00 |
| MultiPlan | Diversified Admin Corp | $1,225.29 |
| EmblemHealth | HIP HMO | $7,558.00 |
| Fidelis Care | Gold for Children (Exchange) | $1,097.06 |
| VNS Health | Total (Medicare + Medicaid) | $221.21 |
| Anthem BCBS HealthPlus | SOMOS Special Needs HARP | $639.95 |
| Blue Cross Blue Shield | Blue Priority EPO (Small Group) | $3,048.00 |
| Aetna | Open Access Elect Choice EPO | $6,346.39 |
| EmblemHealth | HIP compre health | $7,558.00 |
| Anthem BCBS HealthPlus | SOMOS Essential Plan 4 | $639.95 |
| Aetna | Meritain Health | $6,346.39 |
| EmblemHealth | WLNY-TV | $11,277.00 |
| UnitedHealthcare | Navigate | $4,078.00 |
| EmblemHealth | Prime Gold | $9,585.45 |
| MultiPlan | Teamsters Allied Benefits | $1,225.29 |
| HealthSmart | WTC Health Program - Stony Brook | $221.21 |
| EmblemHealth | Select Care Gold Small Group | $9,585.45 |
| Blue Cross Blue Shield | Blue Access EPO (Large Group) (NY LI Local 1199SEIU) | $3,429.00 |
| EmblemHealth | Select Care Platinum Exchange | $9,585.45 |
| UnitedHealthcare - Oxford | Medicare Advantage | $221.21 |
| Blue Cross Blue Shield | Indemnity | $3,810.00 |
| Aetna | Nippon Life ASA PPO | $6,346.39 |
| BCBS (Out of State) | PPO (Suitcase Logo) | $3,810.00 |
| CenterLight | Select | $225.63 |