Table cy_2022_two_plan_model_rates

Table: cy_2022_two_plan_model_rates

rating_period calendar_year model county health_plan category_of_aid lower_bound midpoint upper_bound

1/22-12/22 2022 Two Plan Alameda Alameda Alliance for Health Child $98.52 $103.13 $108.01

1/22-12/22 2022 Two Plan Alameda Alameda Alliance for Health Adult $254.79 $264.31 $274.31

1/22-12/22 2022 Two Plan Alameda Alameda Alliance for Health ACA Optional Expansion $329.50 $341.22 $353.51

1/22-12/22 2022 Two Plan Alameda Alameda Alliance for Health SPD $856.88 $884.47 $913.28

1/22-12/22 2022 Two Plan Alameda Alameda Alliance for Health SPD/Full-Dual $181.53 $188.36 $195.56

1/22-12/22 2022 Two Plan Alameda Alameda Alliance for Health Maternity $9,156.23 $9,437.63 $9,729.71

1/22-12/22 2022 Two Plan Alameda Alameda Alliance for Health Behavioral Health Treatment 0-6 $3,367.77 $3,480.05 $3,596.80

1/22-12/22 2022 Two Plan Alameda Alameda Alliance for Health Behavioral Health Treatment 7-20 $2,383.91 $2,463.39 $2,546.03

1/22-12/22 2022 Two Plan Alameda Anthem Blue Cross Child $88.91 $93.14 $97.61

1/22-12/22 2022 Two Plan Alameda Anthem Blue Cross Adult $223.78 $232.11 $240.86

1/22-12/22 2022 Two Plan Alameda Anthem Blue Cross ACA Optional Expansion $272.83 $282.54 $292.72

1/22-12/22 2022 Two Plan Alameda Anthem Blue Cross SPD $786.96 $812.27 $838.70

1/22-12/22 2022 Two Plan Alameda Anthem Blue Cross SPD/Full-Dual $201.41 $208.59 $216.14

1/22-12/22 2022 Two Plan Alameda Anthem Blue Cross Maternity $9,156.23 $9,437.63 $9,729.71

1/22-12/22 2022 Two Plan Alameda Anthem Blue Cross Behavioral Health Treatment 0-6 $3,876.90 $4,006.15 $4,140.55

1/22-12/22 2022 Two Plan Alameda Anthem Blue Cross Behavioral Health Treatment 7-20 $2,779.24 $2,871.89 $2,968.24

1/22-12/22 2022 Two Plan Contra Costa Contra Costa HP Child $86.85 $91.11 $95.63

1/22-12/22 2022 Two Plan Contra Costa Contra Costa HP Adult $287.71 $298.28 $309.38

1/22-12/22 2022 Two Plan Contra Costa Contra Costa HP ACA Optional Expansion $367.89 $380.87 $394.48

1/22-12/22 2022 Two Plan Contra Costa Contra Costa HP SPD $962.33 $993.22 $1,025.46

1/22-12/22 2022 Two Plan Contra Costa Contra Costa HP SPD/Full-Dual $141.44 $147.20 $153.29

1/22-12/22 2022 Two Plan Contra Costa Contra Costa HP Maternity $10,708.16 $11,037.20 $11,378.74

1/22-12/22 2022 Two Plan Contra Costa Contra Costa HP Behavioral Health Treatment 0-6 $3,455.53 $3,570.74 $3,690.53

1/22-12/22 2022 Two Plan Contra Costa Contra Costa HP Behavioral Health Treatment 7-20 $2,702.19 $2,792.28 $2,885.95

1/22-12/22 2022 Two Plan Contra Costa Anthem Blue Cross Child $82.48 $86.45 $90.67

1/22-12/22 2022 Two Plan Contra Costa Anthem Blue Cross Adult $226.47 $234.72 $243.38

1/22-12/22 2022 Two Plan Contra Costa Anthem Blue Cross ACA Optional Expansion $263.19 $272.45 $282.16

1/22-12/22 2022 Two Plan Contra Costa Anthem Blue Cross SPD $692.14 $714.42 $737.68

1/22-12/22 2022 Two Plan Contra Costa Anthem Blue Cross SPD/Full-Dual $168.12 $174.17 $180.52

1/22-12/22 2022 Two Plan Contra Costa Anthem Blue Cross Maternity $10,708.16 $11,037.20 $11,378.74

1/22-12/22 2022 Two Plan Contra Costa Anthem Blue Cross Behavioral Health Treatment 0-6 $3,623.46 $3,744.26 $3,869.87

1/22-12/22 2022 Two Plan Contra Costa Anthem Blue Cross Behavioral Health Treatment 7-20 $2,440.64 $2,522.00 $2,606.61

1/22-12/22 2022 Two Plan Fresno Anthem Blue Cross Child $63.29 $66.28 $69.44

1/22-12/22 2022 Two Plan Fresno Anthem Blue Cross Adult $185.47 $192.22 $199.30

1/22-12/22 2022 Two Plan Fresno Anthem Blue Cross ACA Optional Expansion $228.18 $236.18 $244.55

1/22-12/22 2022 Two Plan Fresno Anthem Blue Cross SPD $589.77 $608.74 $628.53

1/22-12/22 2022 Two Plan Fresno Anthem Blue Cross SPD/Full-Dual $150.14 $155.63 $161.40

1/22-12/22 2022 Two Plan Fresno Anthem Blue Cross Maternity $8,466.01 $8,726.20 $8,996.26

1/22-12/22 2022 Two Plan Fresno Anthem Blue Cross Behavioral Health Treatment 0-6 $3,988.25 $4,121.20 $4,259.47

1/22-12/22 2022 Two Plan Fresno Anthem Blue Cross Behavioral Health Treatment 7-20 $2,689.80 $2,779.47 $2,872.72

1/22-12/22 2022 Two Plan Fresno CalViva Health Child $66.85 $69.99 $73.31

1/22-12/22 2022 Two Plan Fresno CalViva Health Adult $208.18 $215.78 $223.76

1/22-12/22 2022 Two Plan Fresno CalViva Health ACA Optional Expansion $264.06 $273.32 $283.02

1/22-12/22 2022 Two Plan Fresno CalViva Health SPD $734.99 $758.55 $783.14

1/22-12/22 2022 Two Plan Fresno CalViva Health SPD/Full-Dual $165.02 $170.91 $177.11

1/22-12/22 2022 Two Plan Fresno CalViva Health Maternity $8,468.22 $8,728.48 $8,998.61

1/22-12/22 2022 Two Plan Fresno CalViva Health Behavioral Health Treatment 0-6 $3,872.08 $4,001.17 $4,135.40

1/22-12/22 2022 Two Plan Fresno CalViva Health Behavioral Health Treatment 7-20 $2,659.81 $2,748.49 $2,840.69

1/22-12/22 2022 Two Plan Kern Kern Health Systems Child $74.63 $78.16 $81.89

1/22-12/22 2022 Two Plan Kern Kern Health Systems Adult $249.40 $258.41 $267.86

1/22-12/22 2022 Two Plan Kern Kern Health Systems ACA Optional Expansion $298.75 $309.19 $320.12

1/22-12/22 2022 Two Plan Kern Kern Health Systems SPD $800.22 $825.61 $852.10

1/22-12/22 2022 Two Plan Kern Kern Health Systems SPD/Full-Dual $177.42 $183.85 $190.60

1/22-12/22 2022 Two Plan Kern Kern Health Systems Maternity $7,498.79 $7,729.23 $7,968.43

1/22-12/22 2022 Two Plan Kern Kern Health Systems Behavioral Health Treatment 0-6 $4,400.90 $4,547.62 $4,700.18

1/22-12/22 2022 Two Plan Kern Kern Health Systems Behavioral Health Treatment 7-20 $3,164.86 $3,270.38 $3,380.09

1/22-12/22 2022 Two Plan Kern Health Net of California Child $66.65 $69.86 $73.26

1/22-12/22 2022 Two Plan Kern Health Net of California Adult $211.84 $219.56 $227.66

1/22-12/22 2022 Two Plan Kern Health Net of California ACA Optional Expansion $263.98 $273.17 $282.80

1/22-12/22 2022 Two Plan Kern Health Net of California SPD $711.46 $733.96 $757.43

1/22-12/22 2022 Two Plan Kern Health Net of California SPD/Full-Dual $158.85 $164.62 $170.68

1/22-12/22 2022 Two Plan Kern Health Net of California Maternity $7,498.79 $7,729.23 $7,968.43

1/22-12/22 2022 Two Plan Kern Health Net of California Behavioral Health Treatment 0-6 $3,356.74 $3,468.65 $3,585.01

1/22-12/22 2022 Two Plan Kern Health Net of California Behavioral Health Treatment 7-20 $2,376.90 $2,456.14 $2,538.54

1/22-12/22 2022 Two Plan Kings CalViva Health Child $66.85 $69.99 $73.31

1/22-12/22 2022 Two Plan Kings CalViva Health Adult $208.18 $215.78 $223.76

1/22-12/22 2022 Two Plan Kings CalViva Health ACA Optional Expansion $264.06 $273.32 $283.02

1/22-12/22 2022 Two Plan Kings CalViva Health SPD $734.99 $758.55 $783.14

1/22-12/22 2022 Two Plan Kings CalViva Health SPD/Full-Dual $165.02 $170.91 $177.11

1/22-12/22 2022 Two Plan Kings CalViva Health Maternity $8,468.22 $8,728.48 $8,998.61

1/22-12/22 2022 Two Plan Kings CalViva Health Behavioral Health Treatment 0-6 $3,872.08 $4,001.17 $4,135.40

1/22-12/22 2022 Two Plan Kings CalViva Health Behavioral Health Treatment 7-20 $2,659.81 $2,748.49 $2,840.69

1/22-12/22 2022 Two Plan Kings Anthem Blue Cross Child $63.29 $66.28 $69.44

1/22-12/22 2022 Two Plan Kings Anthem Blue Cross Adult $185.47 $192.22 $199.30

1/22-12/22 2022 Two Plan Kings Anthem Blue Cross ACA Optional Expansion $228.18 $236.18 $244.55

1/22-12/22 2022 Two Plan Kings Anthem Blue Cross SPD $589.77 $608.74 $628.53

1/22-12/22 2022 Two Plan Kings Anthem Blue Cross SPD/Full-Dual $150.14 $155.63 $161.40

1/22-12/22 2022 Two Plan Kings Anthem Blue Cross Maternity $8,466.01 $8,726.20 $8,996.26

1/22-12/22 2022 Two Plan Kings Anthem Blue Cross Behavioral Health Treatment 0-6 $3,988.25 $4,121.20 $4,259.47

1/22-12/22 2022 Two Plan Kings Anthem Blue Cross Behavioral Health Treatment 7-20 $2,689.80 $2,779.47 $2,872.72

1/22-12/22 2022 Two Plan Los Angeles LA Care HP Child $75.50 $78.99 $82.69

1/22-12/22 2022 Two Plan Los Angeles LA Care HP Adult $180.44 $187.23 $194.36

1/22-12/22 2022 Two Plan Los Angeles LA Care HP ACA Optional Expansion $263.48 $272.76 $282.49

1/22-12/22 2022 Two Plan Los Angeles LA Care HP SPD $670.55 $691.05 $712.43

1/22-12/22 2022 Two Plan Los Angeles LA Care HP SPD/Full-Dual $125.87 $130.70 $135.80

1/22-12/22 2022 Two Plan Los Angeles LA Care HP Maternity $7,719.01 $7,956.28 $8,202.56

1/22-12/22 2022 Two Plan Los Angeles LA Care HP Behavioral Health Treatment 0-6 $3,068.68 $3,170.99 $3,277.37

1/22-12/22 2022 Two Plan Los Angeles LA Care HP Behavioral Health Treatment 7-20 $2,405.75 $2,485.95 $2,569.35

1/22-12/22 2022 Two Plan Los Angeles Health Net of California Child $70.02 $73.27 $76.71

1/22-12/22 2022 Two Plan Los Angeles Health Net of California Adult $169.27 $175.61 $182.28

1/22-12/22 2022 Two Plan Los Angeles Health Net of California ACA Optional Expansion $255.22 $264.18 $273.56

1/22-12/22 2022 Two Plan Los Angeles Health Net of California SPD $555.85 $573.23 $591.36

1/22-12/22 2022 Two Plan Los Angeles Health Net of California SPD/Full-Dual $162.29 $167.97 $173.93

1/22-12/22 2022 Two Plan Los Angeles Health Net of California Maternity $7,719.01 $7,956.28 $8,202.56

1/22-12/22 2022 Two Plan Los Angeles Health Net of California Behavioral Health Treatment 0-6 $3,095.85 $3,199.06 $3,306.38

1/22-12/22 2022 Two Plan Los Angeles Health Net of California Behavioral Health Treatment 7-20 $2,423.87 $2,504.68 $2,588.70

1/22-12/22 2022 Two Plan Madera CalViva Health Child $66.85 $69.99 $73.31

1/22-12/22 2022 Two Plan Madera CalViva Health Adult $208.18 $215.78 $223.76

1/22-12/22 2022 Two Plan Madera CalViva Health ACA Optional Expansion $264.06 $273.32 $283.02

1/22-12/22 2022 Two Plan Madera CalViva Health SPD $734.99 $758.55 $783.14

1/22-12/22 2022 Two Plan Madera CalViva Health SPD/Full-Dual $165.02 $170.91 $177.11

1/22-12/22 2022 Two Plan Madera CalViva Health Maternity $8,468.22 $8,728.48 $8,998.61

1/22-12/22 2022 Two Plan Madera CalViva Health Behavioral Health Treatment 0-6 $3,872.08 $4,001.17 $4,135.40

1/22-12/22 2022 Two Plan Madera CalViva Health Behavioral Health Treatment 7-20 $2,659.81 $2,748.49 $2,840.69

1/22-12/22 2022 Two Plan Madera Anthem Blue Cross Child $63.29 $66.28 $69.44

1/22-12/22 2022 Two Plan Madera Anthem Blue Cross Adult $185.47 $192.22 $199.30

1/22-12/22 2022 Two Plan Madera Anthem Blue Cross ACA Optional Expansion $228.18 $236.18 $244.55

1/22-12/22 2022 Two Plan Madera Anthem Blue Cross SPD $589.77 $608.74 $628.53

1/22-12/22 2022 Two Plan Madera Anthem Blue Cross SPD/Full-Dual $150.14 $155.63 $161.40

1/22-12/22 2022 Two Plan Madera Anthem Blue Cross Maternity $8,466.01 $8,726.20 $8,996.26

1/22-12/22 2022 Two Plan Madera Anthem Blue Cross Behavioral Health Treatment 0-6 $3,988.25 $4,121.20 $4,259.47

1/22-12/22 2022 Two Plan Madera Anthem Blue Cross Behavioral Health Treatment 7-20 $2,689.80 $2,779.47 $2,872.72

1/22-12/22 2022 Two Plan Riverside Inland Empire HP Child $84.77 $88.63 $92.71

1/22-12/22 2022 Two Plan Riverside Inland Empire HP Adult $249.47 $258.48 $267.94

1/22-12/22 2022 Two Plan Riverside Inland Empire HP ACA Optional Expansion $304.22 $314.82 $325.93

1/22-12/22 2022 Two Plan Riverside Inland Empire HP SPD $815.90 $841.80 $868.82

1/22-12/22 2022 Two Plan Riverside Inland Empire HP SPD/Full-Dual $155.17 $160.98 $167.10

1/22-12/22 2022 Two Plan Riverside Inland Empire HP Maternity $7,579.88 $7,812.84 $8,054.64

1/22-12/22 2022 Two Plan Riverside Inland Empire HP Behavioral Health Treatment 0-6 $2,707.66 $2,797.92 $2,891.78

1/22-12/22 2022 Two Plan Riverside Inland Empire HP Behavioral Health Treatment 7-20 $1,928.76 $1,993.06 $2,059.92

1/22-12/22 2022 Two Plan Riverside Molina Healthcare Child $74.06 $77.41 $80.95

1/22-12/22 2022 Two Plan Riverside Molina Healthcare Adult $169.60 $175.78 $182.25

1/22-12/22 2022 Two Plan Riverside Molina Healthcare ACA Optional Expansion $217.25 $224.83 $232.78

1/22-12/22 2022 Two Plan Riverside Molina Healthcare SPD $570.25 $588.36 $607.25

1/22-12/22 2022 Two Plan Riverside Molina Healthcare SPD/Full-Dual $111.40 $115.45 $119.72

1/22-12/22 2022 Two Plan Riverside Molina Healthcare Maternity $7,578.32 $7,811.23 $8,052.98

1/22-12/22 2022 Two Plan Riverside Molina Healthcare Behavioral Health Treatment 0-6 $2,725.91 $2,816.79 $2,911.29

1/22-12/22 2022 Two Plan Riverside Molina Healthcare Behavioral Health Treatment 7-20 $2,010.06 $2,077.07 $2,146.75

1/22-12/22 2022 Two Plan San Bernardino Inland Empire HP Child $84.77 $88.63 $92.71

1/22-12/22 2022 Two Plan San Bernardino Inland Empire HP Adult $249.47 $258.48 $267.94

1/22-12/22 2022 Two Plan San Bernardino Inland Empire HP ACA Optional Expansion $304.22 $314.82 $325.93

1/22-12/22 2022 Two Plan San Bernardino Inland Empire HP SPD $815.90 $841.80 $868.82

1/22-12/22 2022 Two Plan San Bernardino Inland Empire HP SPD/Full-Dual $155.17 $160.98 $167.10

1/22-12/22 2022 Two Plan San Bernardino Inland Empire HP Maternity $7,579.88 $7,812.84 $8,054.64

1/22-12/22 2022 Two Plan San Bernardino Inland Empire HP Behavioral Health Treatment 0-6 $2,707.66 $2,797.92 $2,891.78

1/22-12/22 2022 Two Plan San Bernardino Inland Empire HP Behavioral Health Treatment 7-20 $1,928.76 $1,993.06 $2,059.92

1/22-12/22 2022 Two Plan San Bernardino Molina Healthcare Child $74.06 $77.41 $80.95

1/22-12/22 2022 Two Plan San Bernardino Molina Healthcare Adult $169.60 $175.78 $182.25

1/22-12/22 2022 Two Plan San Bernardino Molina Healthcare ACA Optional Expansion $217.25 $224.83 $232.78

1/22-12/22 2022 Two Plan San Bernardino Molina Healthcare SPD $570.25 $588.36 $607.25

1/22-12/22 2022 Two Plan San Bernardino Molina Healthcare SPD/Full-Dual $111.40 $115.45 $119.72

1/22-12/22 2022 Two Plan San Bernardino Molina Healthcare Maternity $7,578.32 $7,811.23 $8,052.98

1/22-12/22 2022 Two Plan San Bernardino Molina Healthcare Behavioral Health Treatment 0-6 $2,725.91 $2,816.79 $2,911.29

1/22-12/22 2022 Two Plan San Bernardino Molina Healthcare Behavioral Health Treatment 7-20 $2,010.06 $2,077.07 $2,146.75

1/22-12/22 2022 Two Plan San Francisco San Francisco Health Plan Child $106.20 $111.22 $116.53

1/22-12/22 2022 Two Plan San Francisco San Francisco Health Plan Adult $240.87 $250.12 $259.84

1/22-12/22 2022 Two Plan San Francisco San Francisco Health Plan ACA Optional Expansion $362.86 $375.80 $389.36

1/22-12/22 2022 Two Plan San Francisco San Francisco Health Plan SPD $869.07 $897.54 $927.26

1/22-12/22 2022 Two Plan San Francisco San Francisco Health Plan SPD/Full-Dual $164.54 $171.17 $178.17

1/22-12/22 2022 Two Plan San Francisco San Francisco Health Plan Maternity $8,520.44 $8,782.32 $9,054.15

1/22-12/22 2022 Two Plan San Francisco San Francisco Health Plan Behavioral Health Treatment 0-6 $3,083.12 $3,185.90 $3,292.78

1/22-12/22 2022 Two Plan San Francisco San Francisco Health Plan Behavioral Health Treatment 7-20 $2,297.02 $2,373.59 $2,453.22

1/22-12/22 2022 Two Plan San Francisco Anthem Blue Cross Child $92.69 $97.30 $102.19

1/22-12/22 2022 Two Plan San Francisco Anthem Blue Cross Adult $249.69 $259.20 $269.20

1/22-12/22 2022 Two Plan San Francisco Anthem Blue Cross ACA Optional Expansion $311.40 $322.64 $334.43

1/22-12/22 2022 Two Plan San Francisco Anthem Blue Cross SPD $869.13 $897.58 $927.30

1/22-12/22 2022 Two Plan San Francisco Anthem Blue Cross SPD/Full-Dual $413.46 $427.99 $443.22

1/22-12/22 2022 Two Plan San Francisco Anthem Blue Cross Maternity $8,520.44 $8,782.32 $9,054.15

1/22-12/22 2022 Two Plan San Francisco Anthem Blue Cross Behavioral Health Treatment 0-6 $3,230.62 $3,338.32 $3,450.31

1/22-12/22 2022 Two Plan San Francisco Anthem Blue Cross Behavioral Health Treatment 7-20 $2,343.62 $2,421.76 $2,503.00

1/22-12/22 2022 Two Plan San Joaquin HP of San Joaquin Child $74.64 $78.21 $81.99

1/22-12/22 2022 Two Plan San Joaquin HP of San Joaquin Adult $244.54 $253.42 $262.73

1/22-12/22 2022 Two Plan San Joaquin HP of San Joaquin ACA Optional Expansion $315.36 $326.37 $337.90

1/22-12/22 2022 Two Plan San Joaquin HP of San Joaquin SPD $820.24 $846.32 $873.53

1/22-12/22 2022 Two Plan San Joaquin HP of San Joaquin SPD/Full-Dual $119.37 $124.19 $129.28

1/22-12/22 2022 Two Plan San Joaquin HP of San Joaquin Maternity $8,024.51 $8,271.15 $8,527.15

1/22-12/22 2022 Two Plan San Joaquin HP of San Joaquin Behavioral Health Treatment 0-6 $3,536.88 $3,654.79 $3,777.41

1/22-12/22 2022 Two Plan San Joaquin HP of San Joaquin Behavioral Health Treatment 7-20 $2,108.37 $2,178.66 $2,251.75

1/22-12/22 2022 Two Plan San Joaquin Health Net of California Child $66.09 $69.34 $72.80

1/22-12/22 2022 Two Plan San Joaquin Health Net of California Adult $211.39 $219.13 $227.26

1/22-12/22 2022 Two Plan San Joaquin Health Net of California ACA Optional Expansion $287.61 $297.62 $308.11

1/22-12/22 2022 Two Plan San Joaquin Health Net of California SPD $753.09 $777.05 $802.06

1/22-12/22 2022 Two Plan San Joaquin Health Net of California SPD/Full-Dual $144.39 $149.68 $155.25

1/22-12/22 2022 Two Plan San Joaquin Health Net of California Maternity $8,497.34 $8,758.50 $9,029.59

1/22-12/22 2022 Two Plan San Joaquin Health Net of California Behavioral Health Treatment 0-6 $3,273.69 $3,382.83 $3,496.31

1/22-12/22 2022 Two Plan San Joaquin Health Net of California Behavioral Health Treatment 7-20 $2,258.57 $2,333.86 $2,412.16

1/22-12/22 2022 Two Plan Santa Clara Santa Clara Family HP Child $84.19 $88.05 $92.14

1/22-12/22 2022 Two Plan Santa Clara Santa Clara Family HP Adult $225.18 $233.46 $242.15

1/22-12/22 2022 Two Plan Santa Clara Santa Clara Family HP ACA Optional Expansion $268.17 $277.69 $287.66

1/22-12/22 2022 Two Plan Santa Clara Santa Clara Family HP SPD $605.03 $624.62 $645.08

1/22-12/22 2022 Two Plan Santa Clara Santa Clara Family HP SPD/Full-Dual $159.42 $165.21 $171.31

1/22-12/22 2022 Two Plan Santa Clara Santa Clara Family HP Maternity $9,024.18 $9,301.49 $9,589.33

1/22-12/22 2022 Two Plan Santa Clara Santa Clara Family HP Behavioral Health Treatment 0-6 $3,389.48 $3,502.48 $3,619.98

1/22-12/22 2022 Two Plan Santa Clara Santa Clara Family HP Behavioral Health Treatment 7-20 $2,788.65 $2,881.62 $2,978.29

1/22-12/22 2022 Two Plan Santa Clara Anthem Blue Cross Child $73.78 $77.22 $80.87

1/22-12/22 2022 Two Plan Santa Clara Anthem Blue Cross Adult $187.84 $194.76 $202.03

1/22-12/22 2022 Two Plan Santa Clara Anthem Blue Cross ACA Optional Expansion $223.21 $231.14 $239.45

1/22-12/22 2022 Two Plan Santa Clara Anthem Blue Cross SPD $541.89 $559.32 $577.53

1/22-12/22 2022 Two Plan Santa Clara Anthem Blue Cross SPD/Full-Dual $141.44 $146.50 $151.83

1/22-12/22 2022 Two Plan Santa Clara Anthem Blue Cross Maternity $9,024.18 $9,301.49 $9,589.33

1/22-12/22 2022 Two Plan Santa Clara Anthem Blue Cross Behavioral Health Treatment 0-6 $3,298.35 $3,408.31 $3,522.65

1/22-12/22 2022 Two Plan Santa Clara Anthem Blue Cross Behavioral Health Treatment 7-20 $2,324.62 $2,402.12 $2,482.71

1/22-12/22 2022 Two Plan Stanislaus HP of San Joaquin Child $74.64 $78.21 $81.99

1/22-12/22 2022 Two Plan Stanislaus HP of San Joaquin Adult $244.54 $253.42 $262.73

1/22-12/22 2022 Two Plan Stanislaus HP of San Joaquin ACA Optional Expansion $315.36 $326.37 $337.90

1/22-12/22 2022 Two Plan Stanislaus HP of San Joaquin SPD $820.24 $846.32 $873.53

1/22-12/22 2022 Two Plan Stanislaus HP of San Joaquin SPD/Full-Dual $119.37 $124.19 $129.28

1/22-12/22 2022 Two Plan Stanislaus HP of San Joaquin Maternity $8,024.51 $8,271.15 $8,527.15

1/22-12/22 2022 Two Plan Stanislaus HP of San Joaquin Behavioral Health Treatment 0-6 $3,536.88 $3,654.79 $3,777.41

1/22-12/22 2022 Two Plan Stanislaus HP of San Joaquin Behavioral Health Treatment 7-20 $2,108.37 $2,178.66 $2,251.75

1/22-12/22 2022 Two Plan Stanislaus Health Net of California Child $66.09 $69.34 $72.80

1/22-12/22 2022 Two Plan Stanislaus Health Net of California Adult $211.39 $219.13 $227.26

1/22-12/22 2022 Two Plan Stanislaus Health Net of California ACA Optional Expansion $287.61 $297.62 $308.11

1/22-12/22 2022 Two Plan Stanislaus Health Net of California SPD $753.09 $777.05 $802.06

1/22-12/22 2022 Two Plan Stanislaus Health Net of California SPD/Full-Dual $144.39 $149.68 $155.25

1/22-12/22 2022 Two Plan Stanislaus Health Net of California Maternity $8,497.34 $8,758.50 $9,029.59

1/22-12/22 2022 Two Plan Stanislaus Health Net of California Behavioral Health Treatment 0-6 $3,273.69 $3,382.83 $3,496.31

1/22-12/22 2022 Two Plan Stanislaus Health Net of California Behavioral Health Treatment 7-20 $2,258.57 $2,333.86 $2,412.16

1/22-12/22 2022 Two Plan Tulare Anthem Blue Cross Child $54.03 $56.62 $59.37

1/22-12/22 2022 Two Plan Tulare Anthem Blue Cross Adult $173.59 $179.92 $186.56

1/22-12/22 2022 Two Plan Tulare Anthem Blue Cross ACA Optional Expansion $223.16 $230.95 $239.11

1/22-12/22 2022 Two Plan Tulare Anthem Blue Cross SPD $562.42 $580.46 $599.28

1/22-12/22 2022 Two Plan Tulare Anthem Blue Cross SPD/Full-Dual $122.81 $127.31 $132.04

1/22-12/22 2022 Two Plan Tulare Anthem Blue Cross Maternity $7,633.30 $7,867.90 $8,111.41

1/22-12/22 2022 Two Plan Tulare Anthem Blue Cross Behavioral Health Treatment 0-6 $3,719.61 $3,843.61 $3,972.56

1/22-12/22 2022 Two Plan Tulare Anthem Blue Cross Behavioral Health Treatment 7-20 $2,508.35 $2,591.97 $2,678.93

1/22-12/22 2022 Two Plan Tulare Health Net of California Child $53.29 $55.87 $58.59

1/22-12/22 2022 Two Plan Tulare Health Net of California Adult $180.40 $187.00 $193.92

1/22-12/22 2022 Two Plan Tulare Health Net of California ACA Optional Expansion $246.29 $254.86 $263.85

1/22-12/22 2022 Two Plan Tulare Health Net of California SPD $586.69 $605.44 $625.01

1/22-12/22 2022 Two Plan Tulare Health Net of California SPD/Full-Dual $142.50 $147.54 $152.83

1/22-12/22 2022 Two Plan Tulare Health Net of California Maternity $7,633.30 $7,867.90 $8,111.41

1/22-12/22 2022 Two Plan Tulare Health Net of California Behavioral Health Treatment 0-6 $2,826.05 $2,920.26 $3,018.23

1/22-12/22 2022 Two Plan Tulare Health Net of California Behavioral Health Treatment 7-20 $2,208.71 $2,282.35 $2,358.92