Blue Cross Blue Shield FEP Dental
Rates

High – Bi-Weekly

Rating Area: 1
Self Only: $18.95
Self Plus One: $37.90
Self and Family: $56.84

Rating Area: 2
Self Only: $21.23
Self Plus One: $42.46
Self and Family: $63.69

Rating Area: 3
Self Only: $23.10
Self Plus One: $46.21
Self and Family: $69.31

Rating Area: 4
Self Only: $25.03
Self Plus One: $50.05
Self and Family: $75.08

Rating Area: 5
Self Only: $28.01
Self Plus One: $56.02
Self and Family: $84.03

High – Monthly

Rating Area: 1
Self Only: $41.06
Self Plus One: $82.12
Self and Family: $123.15

Rating Area: 2
Self Only: $46.00
Self Plus One: $92.00
Self and Family: $138.00

Rating Area: 3
Self Only: $50.05
Self Plus One: $100.12
Self and Family: $150.17

Rating Area: 4
Self Only: $54.23
Self Plus One: $108.44
Self and Family: $162.67

Rating Area: 5
Self Only: $60.69
Self Plus One: $121.38
Self and Family: $182.07

Standard – Bi-Weekly

Rating Area: 1
Self Only: $10.19
Self Plus One: $20.39
Self and Family: $30.58

Rating Area: 2
Self Only: $11.17
Self Plus One: $22.33
Self and Family: $33.50

Rating Area: 3
Self Only: $12.69
Self Plus One: $25.38
Self and Family: $38.07

Rating Area: 4
Self Only: $13.70
Self Plus One: $27.40
Self and Family: $41.10

Rating Area: 5
Self Only: $15.12
Self Plus One: $30.24
Self and Family: $45.37

Standard - Monthly

Rating Area: 1
Self Only: $22.08
Self Plus One: $44.18
Self and Family: $66.26

Rating Area: 2
Self Only: $24.20
Self Plus One: $48.38
Self and Family: $72.58

Rating Area: 3
Self Only: $27.50
Self Plus One: $54.99
Self and Family: $82.49

Rating Area: 4
Self Only: $29.68
Self Plus One: $59.37
Self and Family: $89.05

Rating Area: 5
Self Only: $32.76
Self Plus One: $65.52
Self and Family: $98.30