Blue Cross Blue Shield FEP Dental
Rates

High – Bi-Weekly

Rating Area: 1
Self Only: $19.51
Self Plus One: $39.02
Self and Family: $58.53

Rating Area: 2
Self Only: $21.86
Self Plus One: $43.72
Self and Family: $65.59

Rating Area: 3
Self Only: $23.79
Self Plus One: $47.57
Self and Family: $71.36

Rating Area: 4
Self Only: $25.77
Self Plus One: $51.54
Self and Family: $77.30

Rating Area: 5
Self Only: $28.84
Self Plus One: $57.69
Self and Family: $86.53

High – Monthly

Rating Area: 1
Self Only: $42.27
Self Plus One: $84.54
Self and Family: $126.82

Rating Area: 2
Self Only: $47.36
Self Plus One: $94.73
Self and Family: $142.11

Rating Area: 3
Self Only: $51.55
Self Plus One: $103.07
Self and Family: $154.61

Rating Area: 4
Self Only: $55.84
Self Plus One: $111.67
Self and Family: $167.48

Rating Area: 5
Self Only: $62.49
Self Plus One: $125.00
Self and Family: $187.48

Standard – Bi-Weekly

Rating Area: 1
Self Only: $10.50
Self Plus One: $20.99
Self and Family: $31.49

Rating Area: 2
Self Only: $11.50
Self Plus One: $22.99
Self and Family: $34.49

Rating Area: 3
Self Only: $13.06
Self Plus One: $26.12
Self and Family: $39.18

Rating Area: 4
Self Only: $14.10
Self Plus One: $28.20
Self and Family: $42.30

Rating Area: 5
Self Only: $15.56
Self Plus One: $31.13
Self and Family: $46.69

Standard - Monthly

Rating Area: 1
Self Only: $22.75
Self Plus One: $45.48
Self and Family: $68.23

Rating Area: 2
Self Only: $24.92
Self Plus One: $49.81
Self and Family: $74.73

Rating Area: 3
Self Only: $28.30
Self Plus One: $56.59
Self and Family: $84.89

Rating Area: 4
Self Only: $30.55
Self Plus One: $61.10
Self and Family: $91.65

Rating Area: 5
Self Only: $33.71
Self Plus One: $67.45
Self and Family: $101.16