Blue Cross Blue Shield FEP Dental
Rates

High – Bi-Weekly

Rating Area: 1
Self Only: $18.02
Self Plus One: $36.05
Self and Family: $54.07

Rating Area: 2
Self Only: $20.19
Self Plus One: $40.38
Self and Family: $60.57

Rating Area: 3
Self Only: $21.98
Self Plus One: $43.97
Self and Family: $65.95

Rating Area: 4
Self Only: $23.81
Self Plus One: $47.62
Self and Family: $71.43

Rating Area: 5
Self Only: $26.65
Self Plus One: $53.29
Self and Family: $79.94

High – Monthly

Rating Area: 1
Self Only: $39.04
Self Plus One: $78.11
Self and Family: $117.15

Rating Area: 2
Self Only: $43.75
Self Plus One: $87.49
Self and Family: $131.24

Rating Area: 3
Self Only: $47.62
Self Plus One: $95.27
Self and Family: $142.89

Rating Area: 4
Self Only: $51.59
Self Plus One: $103.18
Self and Family: $154.77

Rating Area: 5
Self Only: $57.74
Self Plus One: $115.46
Self and Family: $173.20

Standard – Bi-Weekly

Rating Area: 1
Self Only: $9.19
Self Plus One: $18.38
Self and Family: $27.58

Rating Area: 2
Self Only: $10.07
Self Plus One: $20.15
Self and Family: $30.22

Rating Area: 3
Self Only: $11.45
Self Plus One: $22.89
Self and Family: $34.31

Rating Area: 4
Self Only: $12.36
Self Plus One: $24.70
Self and Family: $37.03

Rating Area: 5
Self Only: $13.65
Self Plus One: $27.31
Self and Family: $40.96

Standard - Monthly

Rating Area: 1
Self Only: $19.91
Self Plus One: $39.82
Self and Family: $59.76

Rating Area: 2
Self Only: $21.82
Self Plus One: $43.66
Self and Family: $65.48

Rating Area: 3
Self Only: $24.81
Self Plus One: $49.60
Self and Family: $74.34

Rating Area: 4
Self Only: $26.78
Self Plus One: $53.52
Self and Family: $80.23

Rating Area: 5
Self Only: $29.58
Self Plus One: $59.17
Self and Family: $88.75