Table cy_2021_two_plan_model_rates

Table: cy_2021_two_plan_model_rates

rating_period calendar_year model county health_plan category_of_aid lower_bound midpoint upper_bound

1/21-12/21 2021 Two-Plan Alameda Alameda Alliance for Health Adult 268.60 276.99 285.80

1/21-12/21 2021 Two-Plan Alameda Alameda Alliance for Health Adult Expansion 351.92 362.42 373.43

1/21-12/21 2021 Two-Plan Alameda Alameda Alliance for Health Behavioral Health Treatment 0-6 3,281.93 3,374.21 3,469.82

1/21-12/21 2021 Two-Plan Alameda Alameda Alliance for Health Behavioral Health Treatment 7-20 2,333.52 2,399.13 2,467.11

1/21-12/21 2021 Two-Plan Alameda Alameda Alliance for Health Child 98.38 102.56 106.99

1/21-12/21 2021 Two-Plan Alameda Alameda Alliance for Health Health Homes Non-Dual 362.78 367.89 386.16

1/21-12/21 2021 Two-Plan Alameda Alameda Alliance for Health Health Homes Dual 91.12 94.58 98.37

1/21-12/21 2021 Two-Plan Alameda Alameda Alliance for Health Hep C 340B 1,722.85 1,722.85 1,759.31

1/21-12/21 2021 Two-Plan Alameda Alameda Alliance for Health Hep C Non-340B 2,184.11 2,184.11 2,285.16

1/21-12/21 2021 Two-Plan Alameda Alameda Alliance for Health Maternity 8,662.94 8,928.42 9,203.92

1/21-12/21 2021 Two-Plan Alameda Alameda Alliance for Health SPD 983.95 1,010.59 1,038.38

1/21-12/21 2021 Two-Plan Alameda Alameda Alliance for Health SPD Dual 170.62 176.92 183.54

1/21-12/21 2021 Two-Plan Alameda Anthem Blue Cross Adult 238.78 246.26 254.12

1/21-12/21 2021 Two-Plan Alameda Anthem Blue Cross Adult Expansion 277.37 285.79 294.61

1/21-12/21 2021 Two-Plan Alameda Anthem Blue Cross Behavioral Health Treatment 0-6 3,794.26 3,900.95 4,011.48

1/21-12/21 2021 Two-Plan Alameda Anthem Blue Cross Behavioral Health Treatment 7-20 2,726.01 2,802.66 2,882.07

1/21-12/21 2021 Two-Plan Alameda Anthem Blue Cross Child 88.67 92.48 96.53

1/21-12/21 2021 Two-Plan Alameda Anthem Blue Cross Health Homes Non-Dual 369.61 374.59 394.15

1/21-12/21 2021 Two-Plan Alameda Anthem Blue Cross Health Homes Dual 85.59 89.23 93.24

1/21-12/21 2021 Two-Plan Alameda Anthem Blue Cross Hep C 340B 1,722.85 1,722.85 1,759.31

1/21-12/21 2021 Two-Plan Alameda Anthem Blue Cross Hep C Non-340B 2,184.11 2,184.11 2,285.16

1/21-12/21 2021 Two-Plan Alameda Anthem Blue Cross Maternity 8,662.94 8,928.42 9,203.92

1/21-12/21 2021 Two-Plan Alameda Anthem Blue Cross SPD 910.40 935.17 961.02

1/21-12/21 2021 Two-Plan Alameda Anthem Blue Cross SPD Dual 163.99 169.93 176.18

1/21-12/21 2021 Two-Plan Contra Costa Anthem Blue Cross Adult 232.48 239.90 247.68

1/21-12/21 2021 Two-Plan Contra Costa Anthem Blue Cross Adult Expansion 269.92 277.97 286.41

1/21-12/21 2021 Two-Plan Contra Costa Anthem Blue Cross Behavioral Health Treatment 0-6 3,541.69 3,641.27 3,744.45

1/21-12/21 2021 Two-Plan Contra Costa Anthem Blue Cross Behavioral Health Treatment 7-20 2,396.78 2,464.17 2,533.99

1/21-12/21 2021 Two-Plan Contra Costa Anthem Blue Cross Child 83.83 87.45 91.30

1/21-12/21 2021 Two-Plan Contra Costa Anthem Blue Cross Hep C 340B 1,722.85 1,722.85 1,759.31

1/21-12/21 2021 Two-Plan Contra Costa Anthem Blue Cross Hep C Non-340B 2,184.11 2,184.11 2,285.16

1/21-12/21 2021 Two-Plan Contra Costa Anthem Blue Cross Maternity 8,962.25 9,236.85 9,521.83

1/21-12/21 2021 Two-Plan Contra Costa Anthem Blue Cross SPD 795.00 816.35 838.63

1/21-12/21 2021 Two-Plan Contra Costa Anthem Blue Cross SPD Dual 147.04 152.27 157.76

1/21-12/21 2021 Two-Plan Contra Costa Contra Costa Health Plan Adult 283.99 293.18 302.83

1/21-12/21 2021 Two-Plan Contra Costa Contra Costa Health Plan Adult Expansion 375.27 386.71 398.69

1/21-12/21 2021 Two-Plan Contra Costa Contra Costa Health Plan Behavioral Health Treatment 0-6 3,399.15 3,494.73 3,593.75

1/21-12/21 2021 Two-Plan Contra Costa Contra Costa Health Plan Behavioral Health Treatment 7-20 2,658.53 2,733.28 2,810.73

1/21-12/21 2021 Two-Plan Contra Costa Contra Costa Health Plan Child 88.19 92.08 96.21

1/21-12/21 2021 Two-Plan Contra Costa Contra Costa Health Plan Hep C 340B 1,722.85 1,722.85 1,759.31

1/21-12/21 2021 Two-Plan Contra Costa Contra Costa Health Plan Hep C Non-340B 2,184.11 2,184.11 2,285.16

1/21-12/21 2021 Two-Plan Contra Costa Contra Costa Health Plan Maternity 8,962.25 9,236.85 9,521.83

1/21-12/21 2021 Two-Plan Contra Costa Contra Costa Health Plan SPD 1,050.76 1,079.68 1,109.85

1/21-12/21 2021 Two-Plan Contra Costa Contra Costa Health Plan SPD Dual 148.16 153.76 159.67

1/21-12/21 2021 Two-Plan Fresno Anthem Blue Cross Adult 226.22 232.82 239.75

1/21-12/21 2021 Two-Plan Fresno Anthem Blue Cross Adult Expansion 264.84 272.30 280.11

1/21-12/21 2021 Two-Plan Fresno Anthem Blue Cross Behavioral Health Treatment 0-6 3,971.16 4,082.81 4,198.50

1/21-12/21 2021 Two-Plan Fresno Anthem Blue Cross Behavioral Health Treatment 7-20 2,630.00 2,703.95 2,780.56

1/21-12/21 2021 Two-Plan Fresno Anthem Blue Cross Child 71.67 74.59 77.69

1/21-12/21 2021 Two-Plan Fresno Anthem Blue Cross Hep C 340B 1,722.85 1,722.85 1,759.31

1/21-12/21 2021 Two-Plan Fresno Anthem Blue Cross Hep C Non-340B 2,184.11 2,184.11 2,285.16

1/21-12/21 2021 Two-Plan Fresno Anthem Blue Cross Maternity 7,935.33 8,178.50 8,430.86

1/21-12/21 2021 Two-Plan Fresno Anthem Blue Cross SPD 723.89 742.08 761.06

1/21-12/21 2021 Two-Plan Fresno Anthem Blue Cross SPD Dual 165.71 171.51 177.60

1/21-12/21 2021 Two-Plan Fresno CalViva Health Adult 260.45 267.80 275.51

1/21-12/21 2021 Two-Plan Fresno CalViva Health Adult Expansion 321.30 330.05 339.22

1/21-12/21 2021 Two-Plan Fresno CalViva Health Behavioral Health Treatment 0-6 3,900.76 4,010.44 4,124.07

1/21-12/21 2021 Two-Plan Fresno CalViva Health Behavioral Health Treatment 7-20 2,621.97 2,695.69 2,772.07

1/21-12/21 2021 Two-Plan Fresno CalViva Health Child 78.14 81.27 84.59

1/21-12/21 2021 Two-Plan Fresno CalViva Health Hep C 340B 1,722.85 1,722.85 1,759.31

1/21-12/21 2021 Two-Plan Fresno CalViva Health Hep C Non-340B 2,184.11 2,184.11 2,285.16

1/21-12/21 2021 Two-Plan Fresno CalViva Health Maternity 7,935.33 8,178.50 8,430.86

1/21-12/21 2021 Two-Plan Fresno CalViva Health SPD 912.46 934.67 957.83

1/21-12/21 2021 Two-Plan Fresno CalViva Health SPD Dual 177.48 183.59 189.99

1/21-12/21 2021 Two-Plan Kern Health Net of California Adult 240.87 248.08 255.65

1/21-12/21 2021 Two-Plan Kern Health Net of California Adult Expansion 300.90 309.48 318.47

1/21-12/21 2021 Two-Plan Kern Health Net of California Behavioral Health Treatment 0-6 3,293.17 3,385.76 3,481.70

1/21-12/21 2021 Two-Plan Kern Health Net of California Behavioral Health Treatment 7-20 2,328.61 2,394.08 2,461.92

1/21-12/21 2021 Two-Plan Kern Health Net of California Child 67.36 70.28 73.38

1/21-12/21 2021 Two-Plan Kern Health Net of California Health Homes Non-Dual 328.15 332.74 348.94

1/21-12/21 2021 Two-Plan Kern Health Net of California Health Homes Dual 73.11 75.81 78.76

1/21-12/21 2021 Two-Plan Kern Health Net of California Hep C 340B 1,722.85 1,722.85 1,759.31

1/21-12/21 2021 Two-Plan Kern Health Net of California Hep C Non-340B 2,184.11 2,184.11 2,285.16

1/21-12/21 2021 Two-Plan Kern Health Net of California Maternity 6,837.85 7,047.39 7,264.85

1/21-12/21 2021 Two-Plan Kern Health Net of California SPD 841.84 863.33 885.75

1/21-12/21 2021 Two-Plan Kern Health Net of California SPD Dual 155.69 161.11 166.81

1/21-12/21 2021 Two-Plan Kern Kern Health Systems Adult 281.84 290.25 299.07

1/21-12/21 2021 Two-Plan Kern Kern Health Systems Adult Expansion 342.31 351.99 362.13

1/21-12/21 2021 Two-Plan Kern Kern Health Systems Behavioral Health Treatment 0-6 4,316.67 4,438.05 4,563.80

1/21-12/21 2021 Two-Plan Kern Kern Health Systems Behavioral Health Treatment 7-20 3,098.25 3,185.36 3,275.62

1/21-12/21 2021 Two-Plan Kern Kern Health Systems Child 75.47 78.69 82.11

1/21-12/21 2021 Two-Plan Kern Kern Health Systems Health Homes Non-Dual 312.68 317.06 332.88

1/21-12/21 2021 Two-Plan Kern Kern Health Systems Health Homes Dual 69.01 71.55 74.32

1/21-12/21 2021 Two-Plan Kern Kern Health Systems Hep C 340B 1,722.85 1,722.85 1,759.31

1/21-12/21 2021 Two-Plan Kern Kern Health Systems Hep C Non-340B 2,184.11 2,184.11 2,285.16

1/21-12/21 2021 Two-Plan Kern Kern Health Systems Maternity 6,837.85 7,047.39 7,264.85

1/21-12/21 2021 Two-Plan Kern Kern Health Systems SPD 927.20 950.84 975.51

1/21-12/21 2021 Two-Plan Kern Kern Health Systems SPD Dual 184.49 190.91 197.66

1/21-12/21 2021 Two-Plan Kings Anthem Blue Cross Adult 218.00 224.51 231.33

1/21-12/21 2021 Two-Plan Kings Anthem Blue Cross Adult Expansion 283.36 291.55 300.14

1/21-12/21 2021 Two-Plan Kings Anthem Blue Cross Behavioral Health Treatment 0-6 3,424.21 3,520.49 3,620.24

1/21-12/21 2021 Two-Plan Kings Anthem Blue Cross Behavioral Health Treatment 7-20 2,571.64 2,643.95 2,718.86

1/21-12/21 2021 Two-Plan Kings Anthem Blue Cross Child 65.56 68.33 71.26

1/21-12/21 2021 Two-Plan Kings Anthem Blue Cross Hep C 340B 1,722.85 1,722.85 1,759.31

1/21-12/21 2021 Two-Plan Kings Anthem Blue Cross Hep C Non-340B 2,184.11 2,184.11 2,285.16

1/21-12/21 2021 Two-Plan Kings Anthem Blue Cross Maternity 8,025.62 8,271.54 8,526.76

1/21-12/21 2021 Two-Plan Kings Anthem Blue Cross SPD 675.04 691.27 708.21

1/21-12/21 2021 Two-Plan Kings Anthem Blue Cross SPD Dual 134.13 138.94 144.00

1/21-12/21 2021 Two-Plan Kings CalViva Health Adult 259.96 267.56 275.53

1/21-12/21 2021 Two-Plan Kings CalViva Health Adult Expansion 346.55 356.46 366.82

1/21-12/21 2021 Two-Plan Kings CalViva Health Behavioral Health Treatment 0-6 3,369.92 3,464.67 3,562.84

1/21-12/21 2021 Two-Plan Kings CalViva Health Behavioral Health Treatment 7-20 2,518.18 2,588.99 2,662.35

1/21-12/21 2021 Two-Plan Kings CalViva Health Child 69.76 72.71 75.83

1/21-12/21 2021 Two-Plan Kings CalViva Health Hep C 340B 1,722.85 1,722.85 1,759.31

1/21-12/21 2021 Two-Plan Kings CalViva Health Hep C Non-340B 2,184.11 2,184.11 2,285.16

1/21-12/21 2021 Two-Plan Kings CalViva Health Maternity 8,025.62 8,271.54 8,526.76

1/21-12/21 2021 Two-Plan Kings CalViva Health SPD 765.61 783.65 802.47

1/21-12/21 2021 Two-Plan Kings CalViva Health SPD Dual 142.41 147.52 152.90

1/21-12/21 2021 Two-Plan Los Angeles Health Net of California Health Homes Non-Dual 382.76 387.99 407.10

1/21-12/21 2021 Two-Plan Los Angeles Health Net of California Health Homes Dual 92.85 96.15 99.77

1/21-12/21 2021 Two-Plan Los Angeles Health Net of California Adult 200.88 206.93 213.27

1/21-12/21 2021 Two-Plan Los Angeles Health Net of California Adult Expansion 289.55 297.80 306.45

1/21-12/21 2021 Two-Plan Los Angeles Health Net of California Behavioral Health Treatment 0-6 3,030.70 3,115.92 3,204.21

1/21-12/21 2021 Two-Plan Los Angeles Health Net of California Behavioral Health Treatment 7-20 2,373.04 2,439.77 2,508.90

1/21-12/21 2021 Two-Plan Los Angeles Health Net of California Child 72.60 75.61 78.79

1/21-12/21 2021 Two-Plan Los Angeles Health Net of California Hep C 340B 1,722.85 1,722.85 1,759.31

1/21-12/21 2021 Two-Plan Los Angeles Health Net of California Hep C Non-340B 2,184.11 2,184.11 2,285.16

1/21-12/21 2021 Two-Plan Los Angeles Health Net of California Maternity 7,350.22 7,575.48 7,809.25

1/21-12/21 2021 Two-Plan Los Angeles Health Net of California SPD 652.13 668.20 684.97

1/21-12/21 2021 Two-Plan Los Angeles Health Net of California SPD Dual 144.12 148.89 153.90

1/21-12/21 2021 Two-Plan Los Angeles LA Care Adult 210.25 216.59 223.26

1/21-12/21 2021 Two-Plan Los Angeles LA Care Adult Expansion 294.65 303.10 311.96

1/21-12/21 2021 Two-Plan Los Angeles LA Care Behavioral Health Treatment 0-6 3,045.69 3,131.33 3,220.05

1/21-12/21 2021 Two-Plan Los Angeles LA Care Behavioral Health Treatment 7-20 2,375.69 2,442.48 2,511.69

1/21-12/21 2021 Two-Plan Los Angeles LA Care Child 77.88 81.10 84.51

1/21-12/21 2021 Two-Plan Los Angeles LA Care Hep C 340B 1,722.85 1,722.85 1,759.31

1/21-12/21 2021 Two-Plan Los Angeles LA Care Hep C Non-340B 2,184.11 2,184.11 2,285.16

1/21-12/21 2021 Two-Plan Los Angeles LA Care Maternity 7,350.22 7,575.48 7,809.25

1/21-12/21 2021 Two-Plan Los Angeles LA Care SPD 787.69 807.01 827.15

1/21-12/21 2021 Two-Plan Los Angeles LA Care SPD Dual 134.52 138.98 143.68

1/21-12/21 2021 Two-Plan Los Angeles LA Care Health Homes Non-Dual 385.87 391.10 410.50

1/21-12/21 2021 Two-Plan Los Angeles LA Care Health Homes Dual 97.35 101.07 105.15

1/21-12/21 2021 Two-Plan Madera Anthem Blue Cross Adult 206.66 212.40 218.42

1/21-12/21 2021 Two-Plan Madera Anthem Blue Cross Adult Expansion 264.06 271.06 278.39

1/21-12/21 2021 Two-Plan Madera Anthem Blue Cross Behavioral Health Treatment 0-6 3,666.05 3,769.13 3,875.93

1/21-12/21 2021 Two-Plan Madera Anthem Blue Cross Behavioral Health Treatment 7-20 2,689.21 2,764.82 2,843.16

1/21-12/21 2021 Two-Plan Madera Anthem Blue Cross Child 65.38 67.92 70.62

1/21-12/21 2021 Two-Plan Madera Anthem Blue Cross Hep C 340B 1,722.85 1,722.85 1,759.31

1/21-12/21 2021 Two-Plan Madera Anthem Blue Cross Hep C Non-340B 2,184.11 2,184.11 2,285.16

1/21-12/21 2021 Two-Plan Madera Anthem Blue Cross Maternity 7,094.08 7,311.48 7,537.10

1/21-12/21 2021 Two-Plan Madera Anthem Blue Cross SPD 734.72 752.24 770.50

1/21-12/21 2021 Two-Plan Madera Anthem Blue Cross SPD Dual 140.92 145.62 150.54

1/21-12/21 2021 Two-Plan Madera CalViva Health Adult 257.67 264.67 272.00

1/21-12/21 2021 Two-Plan Madera CalViva Health Adult Expansion 320.66 328.81 337.34

1/21-12/21 2021 Two-Plan Madera CalViva Health Behavioral Health Treatment 0-6 3,650.91 3,753.56 3,859.91

1/21-12/21 2021 Two-Plan Madera CalViva Health Behavioral Health Treatment 7-20 2,649.93 2,724.43 2,801.63

1/21-12/21 2021 Two-Plan Madera CalViva Health Child 70.67 73.40 76.30

1/21-12/21 2021 Two-Plan Madera CalViva Health Hep C 340B 1,722.85 1,722.85 1,759.31

1/21-12/21 2021 Two-Plan Madera CalViva Health Hep C Non-340B 2,184.11 2,184.11 2,285.16

1/21-12/21 2021 Two-Plan Madera CalViva Health Maternity 7,094.08 7,311.48 7,537.10

1/21-12/21 2021 Two-Plan Madera CalViva Health SPD 927.82 949.93 972.99

1/21-12/21 2021 Two-Plan Madera CalViva Health SPD Dual 142.44 147.29 152.38

1/21-12/21 2021 Two-Plan Riverside Inland Empire Health Plan Adult 297.33 305.78 314.64

1/21-12/21 2021 Two-Plan Riverside Inland Empire Health Plan Adult Expansion 385.07 395.37 406.15

1/21-12/21 2021 Two-Plan Riverside Inland Empire Health Plan Behavioral Health Treatment 0-6 2,642.42 2,716.71 2,793.69

1/21-12/21 2021 Two-Plan Riverside Inland Empire Health Plan Behavioral Health Treatment 7-20 1,868.34 1,920.87 1,975.30

1/21-12/21 2021 Two-Plan Riverside Inland Empire Health Plan Child 83.52 86.86 90.40

1/21-12/21 2021 Two-Plan Riverside Inland Empire Health Plan Hep C 340B 1,722.85 1,722.85 1,759.31

1/21-12/21 2021 Two-Plan Riverside Inland Empire Health Plan Hep C Non-340B 2,184.11 2,184.11 2,285.16

1/21-12/21 2021 Two-Plan Riverside Inland Empire Health Plan Maternity 6,775.06 6,982.68 7,198.15

1/21-12/21 2021 Two-Plan Riverside Inland Empire Health Plan SPD 963.79 986.96 1,011.14

1/21-12/21 2021 Two-Plan Riverside Inland Empire Health Plan SPD Dual 138.59 143.56 148.79

1/21-12/21 2021 Two-Plan Riverside Inland Empire Health Plan Health Homes Non-Dual 190.29 196.62 203.52

1/21-12/21 2021 Two-Plan Riverside Inland Empire Health Plan Health Homes Dual 61.89 63.82 65.91

1/21-12/21 2021 Two-Plan Riverside Molina Healthcare Adult 192.22 197.83 203.71

1/21-12/21 2021 Two-Plan Riverside Molina Healthcare Adult Expansion 262.57 269.79 277.36

1/21-12/21 2021 Two-Plan Riverside Molina Healthcare Behavioral Health Treatment 0-6 2,745.93 2,823.13 2,903.13

1/21-12/21 2021 Two-Plan Riverside Molina Healthcare Behavioral Health Treatment 7-20 2,039.09 2,096.43 2,155.83

1/21-12/21 2021 Two-Plan Riverside Molina Healthcare Child 72.32 75.21 78.27

1/21-12/21 2021 Two-Plan Riverside Molina Healthcare Health Homes Non-Dual 236.83 244.83 253.54

1/21-12/21 2021 Two-Plan Riverside Molina Healthcare Health Homes Dual 76.39 78.79 81.39

1/21-12/21 2021 Two-Plan Riverside Molina Healthcare Hep C 340B 1,722.85 1,722.85 1,759.31

1/21-12/21 2021 Two-Plan Riverside Molina Healthcare Hep C Non-340B 2,184.11 2,184.11 2,285.16

1/21-12/21 2021 Two-Plan Riverside Molina Healthcare Maternity 6,775.06 6,982.68 7,198.15

1/21-12/21 2021 Two-Plan Riverside Molina Healthcare SPD 658.52 674.71 691.60

1/21-12/21 2021 Two-Plan Riverside Molina Healthcare SPD Dual 116.03 119.92 124.01

1/21-12/21 2021 Two-Plan San Bernardino Inland Empire Health Plan Adult 298.83 307.27 316.12

1/21-12/21 2021 Two-Plan San Bernardino Inland Empire Health Plan Adult Expansion 374.74 384.91 395.56

1/21-12/21 2021 Two-Plan San Bernardino Inland Empire Health Plan Behavioral Health Treatment 0-6 2,660.99 2,735.81 2,813.32

1/21-12/21 2021 Two-Plan San Bernardino Inland Empire Health Plan Behavioral Health Treatment 7-20 1,889.48 1,942.60 1,997.65

1/21-12/21 2021 Two-Plan San Bernardino Inland Empire Health Plan Child 85.06 88.51 92.15

1/21-12/21 2021 Two-Plan San Bernardino Inland Empire Health Plan Hep C 340B 1,722.85 1,722.85 1,759.31

1/21-12/21 2021 Two-Plan San Bernardino Inland Empire Health Plan Hep C Non-340B 2,184.11 2,184.11 2,285.16

1/21-12/21 2021 Two-Plan San Bernardino Inland Empire Health Plan Maternity 6,853.90 7,063.94 7,281.92

1/21-12/21 2021 Two-Plan San Bernardino Inland Empire Health Plan SPD 1,007.83 1,032.27 1,057.77

1/21-12/21 2021 Two-Plan San Bernardino Inland Empire Health Plan SPD Dual 138.06 143.04 148.27

1/21-12/21 2021 Two-Plan San Bernardino Inland Empire Health Plan Health Homes Non-Dual 190.93 197.27 204.18

1/21-12/21 2021 Two-Plan San Bernardino Inland Empire Health Plan Health Homes Dual 62.63 64.57 66.68

1/21-12/21 2021 Two-Plan San Bernardino Molina Healthcare Adult 195.40 201.07 207.02

1/21-12/21 2021 Two-Plan San Bernardino Molina Healthcare Adult Expansion 258.43 265.64 273.18

1/21-12/21 2021 Two-Plan San Bernardino Molina Healthcare Behavioral Health Treatment 0-6 2,499.45 2,569.73 2,642.54

1/21-12/21 2021 Two-Plan San Bernardino Molina Healthcare Behavioral Health Treatment 7-20 1,757.92 1,807.35 1,858.56

1/21-12/21 2021 Two-Plan San Bernardino Molina Healthcare Child 70.91 73.78 76.83

1/21-12/21 2021 Two-Plan San Bernardino Molina Healthcare Health Homes Non-Dual 233.55 241.47 250.09

1/21-12/21 2021 Two-Plan San Bernardino Molina Healthcare Health Homes Dual 76.41 78.81 81.41

1/21-12/21 2021 Two-Plan San Bernardino Molina Healthcare Hep C 340B 1,722.85 1,722.85 1,759.31

1/21-12/21 2021 Two-Plan San Bernardino Molina Healthcare Hep C Non-340B 2,184.11 2,184.11 2,285.16

1/21-12/21 2021 Two-Plan San Bernardino Molina Healthcare Maternity 6,853.90 7,063.94 7,281.92

1/21-12/21 2021 Two-Plan San Bernardino Molina Healthcare SPD 709.53 727.17 745.57

1/21-12/21 2021 Two-Plan San Bernardino Molina Healthcare SPD Dual 113.22 117.05 121.08

1/21-12/21 2021 Two-Plan San Francisco Anthem Blue Cross Adult 297.35 306.53 316.17

1/21-12/21 2021 Two-Plan San Francisco Anthem Blue Cross Adult Expansion 347.85 357.94 368.53

1/21-12/21 2021 Two-Plan San Francisco Anthem Blue Cross Behavioral Health Treatment 0-6 3,156.06 3,244.80 3,336.74

1/21-12/21 2021 Two-Plan San Francisco Anthem Blue Cross Behavioral Health Treatment 7-20 2,299.39 2,364.04 2,431.03

1/21-12/21 2021 Two-Plan San Francisco Anthem Blue Cross Child 97.91 102.20 106.75

1/21-12/21 2021 Two-Plan San Francisco Anthem Blue Cross Health Homes Non-Dual 189.06 195.29 202.07

1/21-12/21 2021 Two-Plan San Francisco Anthem Blue Cross Health Homes Dual 61.57 63.46 65.51

1/21-12/21 2021 Two-Plan San Francisco Anthem Blue Cross Hep C 340B 1,722.85 1,722.85 1,759.31

1/21-12/21 2021 Two-Plan San Francisco Anthem Blue Cross Hep C Non-340B 2,184.11 2,184.11 2,285.16

1/21-12/21 2021 Two-Plan San Francisco Anthem Blue Cross Maternity 8,401.59 8,659.04 8,926.22

1/21-12/21 2021 Two-Plan San Francisco Anthem Blue Cross SPD 959.50 984.69 1,010.99

1/21-12/21 2021 Two-Plan San Francisco Anthem Blue Cross SPD Dual 394.09 407.79 422.15

1/21-12/21 2021 Two-Plan San Francisco San Francisco Health Plan Adult 289.13 297.81 306.92

1/21-12/21 2021 Two-Plan San Francisco San Francisco Health Plan Adult Expansion 380.71 391.65 403.13

1/21-12/21 2021 Two-Plan San Francisco San Francisco Health Plan Behavioral Health Treatment 0-6 3,008.71 3,093.31 3,180.96

1/21-12/21 2021 Two-Plan San Francisco San Francisco Health Plan Behavioral Health Treatment 7-20 2,254.70 2,318.09 2,383.78

1/21-12/21 2021 Two-Plan San Francisco San Francisco Health Plan Child 111.88 116.56 121.51

1/21-12/21 2021 Two-Plan San Francisco San Francisco Health Plan Health Homes Non-Dual 195.37 202.38 210.04

1/21-12/21 2021 Two-Plan San Francisco San Francisco Health Plan Health Homes Dual 54.10 56.02 58.11

1/21-12/21 2021 Two-Plan San Francisco San Francisco Health Plan Hep C 340B 1,722.85 1,722.85 1,759.31

1/21-12/21 2021 Two-Plan San Francisco San Francisco Health Plan Hep C Non-340B 2,184.11 2,184.11 2,285.16

1/21-12/21 2021 Two-Plan San Francisco San Francisco Health Plan Maternity 8,401.59 8,659.04 8,926.22

1/21-12/21 2021 Two-Plan San Francisco San Francisco Health Plan SPD 910.79 934.46 959.17

1/21-12/21 2021 Two-Plan San Francisco San Francisco Health Plan SPD Dual 156.96 162.99 169.34

1/21-12/21 2021 Two-Plan San Joaquin Health Net of California Adult 223.56 230.23 237.24

1/21-12/21 2021 Two-Plan San Joaquin Health Net of California Adult Expansion 275.28 283.01 291.11

1/21-12/21 2021 Two-Plan San Joaquin Health Net of California Behavioral Health Treatment 0-6 3,169.97 3,259.10 3,351.45

1/21-12/21 2021 Two-Plan San Joaquin Health Net of California Behavioral Health Treatment 7-20 2,379.78 2,446.69 2,516.02

1/21-12/21 2021 Two-Plan San Joaquin Health Net of California Child 67.00 69.79 72.75

1/21-12/21 2021 Two-Plan San Joaquin Health Net of California Hep C 340B 1,722.85 1,722.85 1,759.31

1/21-12/21 2021 Two-Plan San Joaquin Health Net of California Hep C Non-340B 2,184.11 2,184.11 2,285.16

1/21-12/21 2021 Two-Plan San Joaquin Health Net of California Maternity 7,236.65 7,458.45 7,688.63

1/21-12/21 2021 Two-Plan San Joaquin Health Net of California SPD 832.80 853.81 875.73

1/21-12/21 2021 Two-Plan San Joaquin Health Net of California SPD Dual 141.96 147.10 152.52

1/21-12/21 2021 Two-Plan San Joaquin Health Plan of San Joaquin Adult 278.42 286.52 295.01

1/21-12/21 2021 Two-Plan San Joaquin Health Plan of San Joaquin Adult Expansion 325.93 334.85 344.21

1/21-12/21 2021 Two-Plan San Joaquin Health Plan of San Joaquin Behavioral Health Treatment 0-6 3,030.58 3,115.79 3,204.08

1/21-12/21 2021 Two-Plan San Joaquin Health Plan of San Joaquin Behavioral Health Treatment 7-20 1,969.87 2,025.26 2,082.64

1/21-12/21 2021 Two-Plan San Joaquin Health Plan of San Joaquin Child 79.43 82.62 86.01

1/21-12/21 2021 Two-Plan San Joaquin Health Plan of San Joaquin Hep C 340B 1,722.85 1,722.85 1,759.31

1/21-12/21 2021 Two-Plan San Joaquin Health Plan of San Joaquin Hep C Non-340B 2,184.11 2,184.11 2,285.16

1/21-12/21 2021 Two-Plan San Joaquin Health Plan of San Joaquin Maternity 7,236.65 7,458.45 7,688.63

1/21-12/21 2021 Two-Plan San Joaquin Health Plan of San Joaquin SPD 865.31 886.47 908.54

1/21-12/21 2021 Two-Plan San Joaquin Health Plan of San Joaquin SPD Dual 117.81 122.08 126.57

1/21-12/21 2021 Two-Plan Santa Clara Anthem Blue Cross Adult 234.67 241.74 249.16

1/21-12/21 2021 Two-Plan Santa Clara Anthem Blue Cross Adult Expansion 259.66 267.00 274.69

1/21-12/21 2021 Two-Plan Santa Clara Anthem Blue Cross Behavioral Health Treatment 0-6 3,238.14 3,329.18 3,423.51

1/21-12/21 2021 Two-Plan Santa Clara Anthem Blue Cross Behavioral Health Treatment 7-20 2,280.75 2,344.87 2,411.32

1/21-12/21 2021 Two-Plan Santa Clara Anthem Blue Cross Child 78.50 81.81 85.32

1/21-12/21 2021 Two-Plan Santa Clara Anthem Blue Cross Health Homes Non-Dual 409.06 414.66 435.71

1/21-12/21 2021 Two-Plan Santa Clara Anthem Blue Cross Health Homes Dual 114.37 119.14 124.39

1/21-12/21 2021 Two-Plan Santa Clara Anthem Blue Cross Hep C 340B 1,722.85 1,722.85 1,759.31

1/21-12/21 2021 Two-Plan Santa Clara Anthem Blue Cross Hep C Non-340B 2,184.11 2,184.11 2,285.16

1/21-12/21 2021 Two-Plan Santa Clara Anthem Blue Cross Maternity 8,473.00 8,732.62 9,002.05

1/21-12/21 2021 Two-Plan Santa Clara Anthem Blue Cross SPD 645.59 662.29 679.74

1/21-12/21 2021 Two-Plan Santa Clara Anthem Blue Cross SPD Dual 131.43 136.06 140.93

1/21-12/21 2021 Two-Plan Santa Clara Santa Clara Family Health Plan Adult 276.37 284.62 293.27

1/21-12/21 2021 Two-Plan Santa Clara Santa Clara Family Health Plan Adult Expansion 320.62 329.60 339.01

1/21-12/21 2021 Two-Plan Santa Clara Santa Clara Family Health Plan Behavioral Health Treatment 0-6 3,318.08 3,411.38 3,508.04

1/21-12/21 2021 Two-Plan Santa Clara Santa Clara Family Health Plan Behavioral Health Treatment 7-20 2,734.56 2,811.45 2,891.11

1/21-12/21 2021 Two-Plan Santa Clara Santa Clara Family Health Plan Child 92.12 95.94 99.98

1/21-12/21 2021 Two-Plan Santa Clara Santa Clara Family Health Plan Hep C 340B 1,722.85 1,722.85 1,759.31

1/21-12/21 2021 Two-Plan Santa Clara Santa Clara Family Health Plan Hep C Non-340B 2,184.11 2,184.11 2,285.16

1/21-12/21 2021 Two-Plan Santa Clara Santa Clara Family Health Plan Maternity 8,473.00 8,732.62 9,002.05

1/21-12/21 2021 Two-Plan Santa Clara Santa Clara Family Health Plan SPD 744.29 763.56 783.67

1/21-12/21 2021 Two-Plan Santa Clara Santa Clara Family Health Plan SPD Dual 136.52 141.54 146.82

1/21-12/21 2021 Two-Plan Santa Clara Santa Clara Family Health Plan Health Homes Non-Dual 407.62 413.29 433.92

1/21-12/21 2021 Two-Plan Santa Clara Santa Clara Family Health Plan Health Homes Dual 108.78 113.30 118.25

1/21-12/21 2021 Two-Plan Stanislaus Health Net of California Adult 264.45 272.31 280.55

1/21-12/21 2021 Two-Plan Stanislaus Health Net of California Adult Expansion 314.72 323.74 333.19

1/21-12/21 2021 Two-Plan Stanislaus Health Net of California Behavioral Health Treatment 0-6 3,679.39 3,782.84 3,890.03

1/21-12/21 2021 Two-Plan Stanislaus Health Net of California Behavioral Health Treatment 7-20 2,199.01 2,260.84 2,324.90

1/21-12/21 2021 Two-Plan Stanislaus Health Net of California Child 71.49 74.54 77.77

1/21-12/21 2021 Two-Plan Stanislaus Health Net of California Hep C 340B 1,722.85 1,722.85 1,759.31

1/21-12/21 2021 Two-Plan Stanislaus Health Net of California Hep C Non-340B 2,184.11 2,184.11 2,285.16

1/21-12/21 2021 Two-Plan Stanislaus Health Net of California Maternity 8,539.56 8,801.27 9,072.87

1/21-12/21 2021 Two-Plan Stanislaus Health Net of California SPD 910.21 932.64 956.04

1/21-12/21 2021 Two-Plan Stanislaus Health Net of California SPD Dual 152.63 157.97 163.57

1/21-12/21 2021 Two-Plan Stanislaus Health Plan of San Joaquin Adult 309.85 319.10 328.79

1/21-12/21 2021 Two-Plan Stanislaus Health Plan of San Joaquin Adult Expansion 380.96 391.76 403.07

1/21-12/21 2021 Two-Plan Stanislaus Health Plan of San Joaquin Behavioral Health Treatment 0-6 4,285.47 4,405.97 4,530.81

1/21-12/21 2021 Two-Plan Stanislaus Health Plan of San Joaquin Behavioral Health Treatment 7-20 2,266.37 2,330.10 2,396.12

1/21-12/21 2021 Two-Plan Stanislaus Health Plan of San Joaquin Child 80.11 83.52 87.13

1/21-12/21 2021 Two-Plan Stanislaus Health Plan of San Joaquin Hep C 340B 1,722.85 1,722.85 1,759.31

1/21-12/21 2021 Two-Plan Stanislaus Health Plan of San Joaquin Hep C Non-340B 2,184.11 2,184.11 2,285.16

1/21-12/21 2021 Two-Plan Stanislaus Health Plan of San Joaquin Maternity 8,539.56 8,801.27 9,072.87

1/21-12/21 2021 Two-Plan Stanislaus Health Plan of San Joaquin SPD 1,117.14 1,144.63 1,173.30

1/21-12/21 2021 Two-Plan Stanislaus Health Plan of San Joaquin SPD Dual 139.02 144.23 149.71

1/21-12/21 2021 Two-Plan Tulare Anthem Blue Cross Adult 208.74 214.83 221.21

1/21-12/21 2021 Two-Plan Tulare Anthem Blue Cross Adult Expansion 267.45 274.95 282.79

1/21-12/21 2021 Two-Plan Tulare Anthem Blue Cross Behavioral Health Treatment 0-6 3,643.57 3,746.01 3,852.15

1/21-12/21 2021 Two-Plan Tulare Anthem Blue Cross Behavioral Health Treatment 7-20 2,459.35 2,528.50 2,600.14

1/21-12/21 2021 Two-Plan Tulare Anthem Blue Cross Child 58.01 60.40 62.93

1/21-12/21 2021 Two-Plan Tulare Anthem Blue Cross Health Homes Non-Dual 300.81 304.94 320.96

1/21-12/21 2021 Two-Plan Tulare Anthem Blue Cross Health Homes Dual 66.55 69.02 71.72

1/21-12/21 2021 Two-Plan Tulare Anthem Blue Cross Hep C 340B 1,722.85 1,722.85 1,759.31

1/21-12/21 2021 Two-Plan Tulare Anthem Blue Cross Hep C Non-340B 2,184.11 2,184.11 2,285.16

1/21-12/21 2021 Two-Plan Tulare Anthem Blue Cross Maternity 7,166.98 7,386.60 7,614.52

1/21-12/21 2021 Two-Plan Tulare Anthem Blue Cross SPD 662.17 678.19 694.90

1/21-12/21 2021 Two-Plan Tulare Anthem Blue Cross SPD Dual 121.93 126.20 130.69

1/21-12/21 2021 Two-Plan Tulare Health Net of California Adult 216.13 222.37 228.92

1/21-12/21 2021 Two-Plan Tulare Health Net of California Adult Expansion 295.25 303.47 312.08

1/21-12/21 2021 Two-Plan Tulare Health Net of California Behavioral Health Treatment 0-6 2,769.84 2,847.72 2,928.41

1/21-12/21 2021 Two-Plan Tulare Health Net of California Behavioral Health Treatment 7-20 2,164.69 2,225.56 2,288.62

1/21-12/21 2021 Two-Plan Tulare Health Net of California Child 58.66 61.09 63.66

1/21-12/21 2021 Two-Plan Tulare Health Net of California Health Homes Non-Dual 322.31 326.94 342.51

1/21-12/21 2021 Two-Plan Tulare Health Net of California Health Homes Dual 72.60 75.14 77.91

1/21-12/21 2021 Two-Plan Tulare Health Net of California Hep C 340B 1,722.85 1,722.85 1,759.31

1/21-12/21 2021 Two-Plan Tulare Health Net of California Hep C Non-340B 2,184.11 2,184.11 2,285.16

1/21-12/21 2021 Two-Plan Tulare Health Net of California Maternity 7,166.98 7,386.60 7,614.52

1/21-12/21 2021 Two-Plan Tulare Health Net of California SPD 723.15 740.38 758.35

1/21-12/21 2021 Two-Plan Tulare Health Net of California SPD Dual 134.92 139.60 144.52