Blue Cross Blue Shield FEP Dental
Rates

High – Bi-Weekly

Rating Area: 1
Self Only: $18.39
Self Plus One: $36.77
Self and Family: $54.16

Rating Area: 2
Self Only: $20.60
Self Plus One: $41.20
Self and Family: $61.80

Rating Area: 3
Self Only: $22.43
Self Plus One: $44.85
Self and Family: $67.28

Rating Area: 4
Self Only: $24.29
Self Plus One: $48.58
Self and Family: $72.87

Rating Area: 5
Self Only: $27.19
Self Plus One: $54.37
Self and Family: $81.56

High – Monthly

Rating Area: 1
Self Only: $39.85
Self Plus One: $79.67
Self and Family: $119.51

Rating Area: 2
Self Only: $44.63
Self Plus One: $89.27
Self and Family: $133.90

Rating Area: 3
Self Only: $48.60
Self Plus One: $97.18
Self and Family: $145.77

Rating Area: 4
Self Only: $52.63
Self Plus One: $105.26
Self and Family: $157.89

Rating Area: 5
Self Only: $58.91
Self Plus One: $117.80
Self and Family: $176.71

Standard – Bi-Weekly

Rating Area: 1
Self Only: $9.87
Self Plus One: $19.75
Self and Family: $29.62

Rating Area: 2
Self Only: $10.82
Self Plus One: $21.63
Self and Family: $32.45

Rating Area: 3
Self Only: $12.30
Self Plus One: $24.60
Self and Family: $36.90

Rating Area: 4
Self Only: $13.28
Self Plus One: $26.56
Self and Family: $39.85

Rating Area: 5
Self Only: $14.67
Self Plus One: $29.33
Self and Family: $44.00

Standard - Monthly

Rating Area: 1
Self Only: $21.39
Self Plus One: $42.79
Self and Family: $64.18

Rating Area: 2
Self Only: $23.44
Self Plus One: $46.87
Self and Family: $70.31

Rating Area: 3
Self Only: $26.65
Self Plus One: $53.30
Self and Family: $79.95

Rating Area: 4
Self Only: $28.77
Self Plus One: $57.55
Self and Family: $86.34

Rating Area: 5
Self Only: $31.79
Self Plus One: $63.55
Self and Family: $95.33