In Network
Out of Network
In Network
Out of Network
In Network
Out of Network
| Total Cost | Low Deductible | Medium Deductible | High Deductible |
|---|---|---|---|
| $100.00 | $1,900.00 | $1,300.00 | ($500.00) |
| $200.00 | $2,000.00 | $1,400.00 | ($400.00) |
| $300.00 | $2,100.00 | $1,500.00 | ($300.00) |
| $400.00 | $2,200.00 | $1,600.00 | ($200.00) |
| $500.00 | $2,300.00 | $1,700.00 | ($100.00) |
| $600.00 | $2,320.00 | $1,800.00 | $0.00 |
| $700.00 | $2,340.00 | $1,900.00 | $100.00 |
| $800.00 | $2,360.00 | $2,000.00 | $200.00 |
| $900.00 | $2,380.00 | $2,100.00 | $300.00 |
| $1,000.00 | $2,400.00 | $2,200.00 | $400.00 |
| $1,100.00 | $2,420.00 | $2,220.00 | $500.00 |
| $1,200.00 | $2,440.00 | $2,240.00 | $600.00 |
| $1,300.00 | $2,460.00 | $2,260.00 | $700.00 |
| $1,400.00 | $2,480.00 | $2,280.00 | $800.00 |
| $1,500.00 | $2,500.00 | $2,300.00 | $900.00 |
| $1,600.00 | $2,520.00 | $2,320.00 | $1,000.00 |
| $1,700.00 | $2,540.00 | $2,340.00 | $1,100.00 |
| $1,800.00 | $2,560.00 | $2,360.00 | $1,200.00 |
| $1,900.00 | $2,580.00 | $2,380.00 | $1,300.00 |
| $2,000.00 | $2,600.00 | $2,400.00 | $1,400.00 |
| $2,100.00 | $2,620.00 | $2,420.00 | $1,500.00 |
| $2,200.00 | $2,640.00 | $2,440.00 | $1,600.00 |
| $2,300.00 | $2,660.00 | $2,460.00 | $1,700.00 |
| $2,400.00 | $2,680.00 | $2,480.00 | $1,800.00 |
| $2,500.00 | $2,700.00 | $2,500.00 | $1,900.00 |
| $2,600.00 | $2,720.00 | $2,520.00 | $2,000.00 |
| $2,700.00 | $2,740.00 | $2,540.00 | $2,100.00 |
| $2,800.00 | $2,760.00 | $2,560.00 | $2,200.00 |
| $2,900.00 | $2,780.00 | $2,580.00 | $2,300.00 |
| $3,000.00 | $2,800.00 | $2,600.00 | $2,400.00 |
| $3,100.00 | $2,820.00 | $2,620.00 | $2,400.00 |
| $3,200.00 | $2,840.00 | $2,640.00 | $2,400.00 |
| $3,300.00 | $2,860.00 | $2,660.00 | $2,400.00 |
| $3,400.00 | $2,880.00 | $2,680.00 | $2,400.00 |
| $3,500.00 | $2,900.00 | $2,700.00 | $2,400.00 |
| $3,600.00 | $2,920.00 | $2,720.00 | $2,400.00 |
| $3,700.00 | $2,940.00 | $2,740.00 | $2,400.00 |
| $3,800.00 | $2,960.00 | $2,760.00 | $2,400.00 |
| $3,900.00 | $2,980.00 | $2,780.00 | $2,400.00 |
| $4,000.00 | $3,000.00 | $2,800.00 | $2,400.00 |
| $4,100.00 | $3,020.00 | $2,820.00 | $2,400.00 |
| $4,200.00 | $3,040.00 | $2,840.00 | $2,400.00 |
| $4,300.00 | $3,060.00 | $2,860.00 | $2,400.00 |
| $4,400.00 | $3,080.00 | $2,880.00 | $2,400.00 |
| $4,500.00 | $3,100.00 | $2,900.00 | $2,400.00 |
| $4,600.00 | $3,120.00 | $2,920.00 | $2,400.00 |
| $4,700.00 | $3,140.00 | $2,940.00 | $2,400.00 |
| $4,800.00 | $3,160.00 | $2,960.00 | $2,400.00 |
| $4,900.00 | $3,180.00 | $2,980.00 | $2,400.00 |
| $5,000.00 | $3,200.00 | $3,000.00 | $2,400.00 |
| $5,100.00 | $3,220.00 | $3,020.00 | $2,400.00 |
| $5,200.00 | $3,240.00 | $3,040.00 | $2,400.00 |
| $5,300.00 | $3,260.00 | $3,060.00 | $2,400.00 |
| $5,400.00 | $3,280.00 | $3,080.00 | $2,400.00 |
| $5,500.00 | $3,300.00 | $3,100.00 | $2,400.00 |
| $5,600.00 | $3,320.00 | $3,120.00 | $2,400.00 |
| $5,700.00 | $3,340.00 | $3,140.00 | $2,400.00 |
| $5,800.00 | $3,360.00 | $3,160.00 | $2,400.00 |
| $5,900.00 | $3,380.00 | $3,180.00 | $2,400.00 |
| $6,000.00 | $3,400.00 | $3,200.00 | $2,400.00 |
| $6,100.00 | $3,420.00 | $3,220.00 | $2,400.00 |
| $6,200.00 | $3,440.00 | $3,240.00 | $2,400.00 |
| $6,300.00 | $3,460.00 | $3,260.00 | $2,400.00 |
| $6,400.00 | $3,480.00 | $3,280.00 | $2,400.00 |
| $6,500.00 | $3,500.00 | $3,300.00 | $2,400.00 |
| $6,600.00 | $3,520.00 | $3,320.00 | $2,400.00 |
| $6,700.00 | $3,540.00 | $3,340.00 | $2,400.00 |
| $6,800.00 | $3,560.00 | $3,360.00 | $2,400.00 |
| $6,900.00 | $3,580.00 | $3,380.00 | $2,400.00 |
| $7,000.00 | $3,600.00 | $3,400.00 | $2,400.00 |
| $7,100.00 | $3,620.00 | $3,420.00 | $2,400.00 |
| $7,200.00 | $3,640.00 | $3,440.00 | $2,400.00 |
| $7,300.00 | $3,660.00 | $3,460.00 | $2,400.00 |
| $7,400.00 | $3,680.00 | $3,480.00 | $2,400.00 |
| $7,500.00 | $3,700.00 | $3,500.00 | $2,400.00 |
| $7,600.00 | $3,720.00 | $3,520.00 | $2,400.00 |
| $7,700.00 | $3,740.00 | $3,540.00 | $2,400.00 |
| $7,800.00 | $3,760.00 | $3,560.00 | $2,400.00 |
| $7,900.00 | $3,780.00 | $3,580.00 | $2,400.00 |
| $8,000.00 | $3,800.00 | $3,600.00 | $2,400.00 |
| $8,100.00 | $3,800.00 | $3,620.00 | $2,400.00 |
| $8,200.00 | $3,800.00 | $3,640.00 | $2,400.00 |
| $8,300.00 | $3,800.00 | $3,660.00 | $2,400.00 |
| $8,400.00 | $3,800.00 | $3,680.00 | $2,400.00 |
| $8,500.00 | $3,800.00 | $3,700.00 | $2,400.00 |
| $8,600.00 | $3,800.00 | $3,720.00 | $2,400.00 |
| $8,700.00 | $3,800.00 | $3,740.00 | $2,400.00 |
| $8,800.00 | $3,800.00 | $3,760.00 | $2,400.00 |
| $8,900.00 | $3,800.00 | $3,780.00 | $2,400.00 |
| $9,000.00 | $3,800.00 | $3,800.00 | $2,400.00 |
| $9,100.00 | $3,800.00 | $3,820.00 | $2,400.00 |
| $9,200.00 | $3,800.00 | $3,840.00 | $2,400.00 |
| $9,300.00 | $3,800.00 | $3,860.00 | $2,400.00 |
| $9,400.00 | $3,800.00 | $3,880.00 | $2,400.00 |
| $9,500.00 | $3,800.00 | $3,900.00 | $2,400.00 |
| $9,600.00 | $3,800.00 | $3,920.00 | $2,400.00 |
| $9,700.00 | $3,800.00 | $3,940.00 | $2,400.00 |
| $9,800.00 | $3,800.00 | $3,960.00 | $2,400.00 |
| $9,900.00 | $3,800.00 | $3,980.00 | $2,400.00 |
| $10,000.00 | $3,800.00 | $4,000.00 | $2,400.00 |
| $10,100.00 | $3,800.00 | $4,020.00 | $2,400.00 |
| $10,200.00 | $3,800.00 | $4,040.00 | $2,400.00 |
| $10,300.00 | $3,800.00 | $4,060.00 | $2,400.00 |
| $10,400.00 | $3,800.00 | $4,080.00 | $2,400.00 |
| $10,500.00 | $3,800.00 | $4,100.00 | $2,400.00 |
| $10,600.00 | $3,800.00 | $4,120.00 | $2,400.00 |
| $10,700.00 | $3,800.00 | $4,140.00 | $2,400.00 |
| $10,800.00 | $3,800.00 | $4,160.00 | $2,400.00 |
| $10,900.00 | $3,800.00 | $4,180.00 | $2,400.00 |
| $11,000.00 | $3,800.00 | $4,200.00 | $2,400.00 |
| $11,100.00 | $3,800.00 | $4,220.00 | $2,400.00 |
| $11,200.00 | $3,800.00 | $4,240.00 | $2,400.00 |
| $11,300.00 | $3,800.00 | $4,260.00 | $2,400.00 |
| $11,400.00 | $3,800.00 | $4,280.00 | $2,400.00 |
| $11,500.00 | $3,800.00 | $4,300.00 | $2,400.00 |
| $11,600.00 | $3,800.00 | $4,320.00 | $2,400.00 |
| $11,700.00 | $3,800.00 | $4,340.00 | $2,400.00 |
| $11,800.00 | $3,800.00 | $4,360.00 | $2,400.00 |
| $11,900.00 | $3,800.00 | $4,380.00 | $2,400.00 |
| $12,000.00 | $3,800.00 | $4,400.00 | $2,400.00 |
| $12,100.00 | $3,800.00 | $4,420.00 | $2,400.00 |
| $12,200.00 | $3,800.00 | $4,440.00 | $2,400.00 |
| $12,300.00 | $3,800.00 | $4,460.00 | $2,400.00 |
| $12,400.00 | $3,800.00 | $4,480.00 | $2,400.00 |
| $12,500.00 | $3,800.00 | $4,500.00 | $2,400.00 |
| $12,600.00 | $3,800.00 | $4,520.00 | $2,400.00 |
| $12,700.00 | $3,800.00 | $4,540.00 | $2,400.00 |
| $12,800.00 | $3,800.00 | $4,560.00 | $2,400.00 |
| $12,900.00 | $3,800.00 | $4,580.00 | $2,400.00 |
| $13,000.00 | $3,800.00 | $4,600.00 | $2,400.00 |
| $13,100.00 | $3,800.00 | $4,620.00 | $2,400.00 |
| $13,200.00 | $3,800.00 | $4,640.00 | $2,400.00 |
| $13,300.00 | $3,800.00 | $4,660.00 | $2,400.00 |
| $13,400.00 | $3,800.00 | $4,680.00 | $2,400.00 |
| $13,500.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $13,600.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $13,700.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $13,800.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $13,900.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $14,000.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $14,100.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $14,200.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $14,300.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $14,400.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $14,500.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $14,600.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $14,700.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $14,800.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $14,900.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $15,000.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $15,100.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $15,200.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $15,300.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $15,400.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $15,500.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $15,600.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $15,700.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $15,800.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $15,900.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $16,000.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $16,100.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $16,200.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $16,300.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $16,400.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $16,500.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $16,600.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $16,700.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $16,800.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $16,900.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $17,000.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $17,100.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $17,200.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $17,300.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $17,400.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $17,500.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $17,600.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $17,700.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $17,800.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $17,900.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $18,000.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $18,100.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $18,200.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $18,300.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $18,400.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $18,500.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $18,600.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $18,700.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $18,800.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $18,900.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $19,000.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $19,100.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $19,200.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $19,300.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $19,400.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $19,500.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $19,600.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $19,700.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $19,800.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $19,900.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $20,000.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $20,100.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $20,200.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $20,300.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $20,400.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $20,500.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $20,600.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $20,700.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $20,800.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $20,900.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $21,000.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $21,100.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $21,200.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $21,300.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $21,400.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $21,500.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $21,600.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $21,700.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $21,800.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $21,900.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $22,000.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $22,100.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $22,200.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $22,300.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $22,400.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $22,500.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $22,600.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $22,700.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $22,800.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $22,900.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $23,000.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $23,100.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $23,200.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $23,300.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $23,400.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $23,500.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $23,600.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $23,700.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $23,800.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $23,900.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $24,000.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $24,100.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $24,200.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $24,300.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $24,400.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $24,500.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $24,600.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $24,700.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $24,800.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $24,900.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $25,000.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $25,100.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $25,200.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $25,300.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $25,400.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $25,500.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $25,600.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $25,700.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $25,800.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $25,900.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $26,000.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $26,100.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $26,200.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $26,300.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $26,400.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $26,500.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $26,600.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $26,700.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $26,800.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $26,900.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $27,000.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $27,100.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $27,200.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $27,300.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $27,400.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $27,500.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $27,600.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $27,700.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $27,800.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $27,900.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $28,000.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $28,100.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $28,200.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $28,300.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $28,400.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $28,500.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $28,600.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $28,700.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $28,800.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $28,900.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $29,000.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $29,100.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $29,200.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $29,300.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $29,400.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $29,500.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $29,600.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $29,700.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $29,800.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $29,900.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $30,000.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $30,100.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $30,200.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $30,300.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $30,400.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $30,500.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $30,600.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $30,700.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $30,800.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $30,900.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $31,000.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $31,100.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $31,200.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $31,300.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $31,400.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $31,500.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $31,600.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $31,700.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $31,800.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $31,900.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $32,000.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $32,100.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $32,200.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $32,300.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $32,400.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $32,500.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $32,600.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $32,700.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $32,800.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $32,900.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $33,000.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $33,100.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $33,200.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $33,300.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $33,400.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $33,500.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $33,600.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $33,700.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $33,800.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $33,900.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $34,000.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $34,100.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $34,200.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $34,300.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $34,400.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $34,500.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $34,600.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $34,700.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $34,800.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $34,900.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $35,000.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $35,100.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $35,200.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $35,300.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $35,400.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $35,500.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $35,600.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $35,700.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $35,800.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $35,900.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $36,000.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $36,100.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $36,200.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $36,300.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $36,400.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $36,500.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $36,600.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $36,700.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $36,800.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $36,900.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $37,000.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $37,100.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $37,200.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $37,300.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $37,400.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $37,500.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $37,600.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $37,700.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $37,800.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $37,900.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $38,000.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $38,100.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $38,200.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $38,300.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $38,400.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $38,500.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $38,600.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $38,700.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $38,800.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $38,900.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $39,000.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $39,100.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $39,200.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $39,300.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $39,400.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $39,500.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $39,600.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $39,700.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $39,800.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $39,900.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $40,000.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $40,100.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $40,200.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $40,300.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $40,400.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $40,500.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $40,600.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $40,700.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $40,800.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $40,900.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $41,000.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $41,100.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $41,200.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $41,300.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $41,400.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $41,500.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $41,600.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $41,700.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $41,800.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $41,900.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $42,000.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $42,100.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $42,200.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $42,300.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $42,400.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $42,500.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $42,600.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $42,700.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $42,800.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $42,900.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $43,000.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $43,100.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $43,200.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $43,300.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $43,400.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $43,500.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $43,600.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $43,700.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $43,800.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $43,900.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $44,000.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $44,100.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $44,200.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $44,300.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $44,400.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $44,500.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $44,600.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $44,700.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $44,800.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $44,900.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $45,000.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $45,100.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $45,200.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $45,300.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $45,400.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $45,500.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $45,600.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $45,700.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $45,800.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $45,900.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $46,000.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $46,100.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $46,200.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $46,300.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $46,400.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $46,500.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $46,600.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $46,700.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $46,800.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $46,900.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $47,000.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $47,100.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $47,200.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $47,300.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $47,400.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $47,500.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $47,600.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $47,700.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $47,800.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $47,900.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $48,000.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $48,100.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $48,200.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $48,300.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $48,400.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $48,500.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $48,600.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $48,700.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $48,800.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $48,900.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $49,000.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $49,100.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $49,200.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $49,300.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $49,400.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $49,500.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $49,600.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $49,700.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $49,800.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $49,900.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| $50,000.00 | $3,800.00 | $4,700.00 | $2,400.00 |
| Total Cost | Low Deductible | Medium Deductible | High Deductible |
|---|---|---|---|
| $100.00 | $1,900.00 | $1,300.00 | ($500.00) |
| $200.00 | $2,000.00 | $1,400.00 | ($400.00) |
| $300.00 | $2,100.00 | $1,500.00 | ($300.00) |
| $400.00 | $2,200.00 | $1,600.00 | ($200.00) |
| $500.00 | $2,300.00 | $1,700.00 | ($100.00) |
| $600.00 | $2,400.00 | $1,800.00 | $0.00 |
| $700.00 | $2,500.00 | $1,900.00 | $100.00 |
| $800.00 | $2,600.00 | $2,000.00 | $200.00 |
| $900.00 | $2,700.00 | $2,100.00 | $300.00 |
| $1,000.00 | $2,800.00 | $2,200.00 | $400.00 |
| $1,100.00 | $2,825.00 | $2,300.00 | $500.00 |
| $1,200.00 | $2,850.00 | $2,400.00 | $600.00 |
| $1,300.00 | $2,875.00 | $2,500.00 | $700.00 |
| $1,400.00 | $2,900.00 | $2,600.00 | $800.00 |
| $1,500.00 | $2,925.00 | $2,700.00 | $900.00 |
| $1,600.00 | $2,950.00 | $2,800.00 | $1,000.00 |
| $1,700.00 | $2,975.00 | $2,900.00 | $1,100.00 |
| $1,800.00 | $3,000.00 | $3,000.00 | $1,200.00 |
| $1,900.00 | $3,025.00 | $3,100.00 | $1,300.00 |
| $2,000.00 | $3,050.00 | $3,200.00 | $1,400.00 |
| $2,100.00 | $3,075.00 | $3,300.00 | $1,500.00 |
| $2,200.00 | $3,100.00 | $3,400.00 | $1,600.00 |
| $2,300.00 | $3,125.00 | $3,500.00 | $1,700.00 |
| $2,400.00 | $3,150.00 | $3,600.00 | $1,800.00 |
| $2,500.00 | $3,175.00 | $3,700.00 | $1,900.00 |
| $2,600.00 | $3,200.00 | $3,725.00 | $2,000.00 |
| $2,700.00 | $3,225.00 | $3,750.00 | $2,100.00 |
| $2,800.00 | $3,250.00 | $3,775.00 | $2,200.00 |
| $2,900.00 | $3,275.00 | $3,800.00 | $2,300.00 |
| $3,000.00 | $3,300.00 | $3,825.00 | $2,400.00 |
| $3,100.00 | $3,325.00 | $3,850.00 | $2,500.00 |
| $3,200.00 | $3,350.00 | $3,875.00 | $2,600.00 |
| $3,300.00 | $3,375.00 | $3,900.00 | $2,700.00 |
| $3,400.00 | $3,400.00 | $3,925.00 | $2,800.00 |
| $3,500.00 | $3,425.00 | $3,950.00 | $2,900.00 |
| $3,600.00 | $3,450.00 | $3,975.00 | $3,000.00 |
| $3,700.00 | $3,475.00 | $4,000.00 | $3,100.00 |
| $3,800.00 | $3,500.00 | $4,025.00 | $3,200.00 |
| $3,900.00 | $3,525.00 | $4,050.00 | $3,300.00 |
| $4,000.00 | $3,550.00 | $4,075.00 | $3,400.00 |
| $4,100.00 | $3,575.00 | $4,100.00 | $3,440.00 |
| $4,200.00 | $3,600.00 | $4,125.00 | $3,480.00 |
| $4,300.00 | $3,625.00 | $4,150.00 | $3,520.00 |
| $4,400.00 | $3,650.00 | $4,175.00 | $3,560.00 |
| $4,500.00 | $3,675.00 | $4,200.00 | $3,600.00 |
| $4,600.00 | $3,700.00 | $4,225.00 | $3,640.00 |
| $4,700.00 | $3,725.00 | $4,250.00 | $3,680.00 |
| $4,800.00 | $3,750.00 | $4,275.00 | $3,720.00 |
| $4,900.00 | $3,775.00 | $4,300.00 | $3,760.00 |
| $5,000.00 | $3,800.00 | $4,325.00 | $3,800.00 |
| $5,100.00 | $3,825.00 | $4,350.00 | $3,840.00 |
| $5,200.00 | $3,850.00 | $4,375.00 | $3,880.00 |
| $5,300.00 | $3,875.00 | $4,400.00 | $3,920.00 |
| $5,400.00 | $3,900.00 | $4,425.00 | $3,960.00 |
| $5,500.00 | $3,925.00 | $4,450.00 | $4,000.00 |
| $5,600.00 | $3,950.00 | $4,475.00 | $4,040.00 |
| $5,700.00 | $3,975.00 | $4,500.00 | $4,080.00 |
| $5,800.00 | $4,000.00 | $4,525.00 | $4,120.00 |
| $5,900.00 | $4,025.00 | $4,550.00 | $4,160.00 |
| $6,000.00 | $4,050.00 | $4,575.00 | $4,200.00 |
| $6,100.00 | $4,075.00 | $4,600.00 | $4,240.00 |
| $6,200.00 | $4,100.00 | $4,625.00 | $4,280.00 |
| $6,300.00 | $4,125.00 | $4,650.00 | $4,320.00 |
| $6,400.00 | $4,150.00 | $4,675.00 | $4,360.00 |
| $6,500.00 | $4,175.00 | $4,700.00 | $4,400.00 |
| $6,600.00 | $4,200.00 | $4,725.00 | $4,440.00 |
| $6,700.00 | $4,225.00 | $4,750.00 | $4,480.00 |
| $6,800.00 | $4,250.00 | $4,775.00 | $4,520.00 |
| $6,900.00 | $4,275.00 | $4,800.00 | $4,560.00 |
| $7,000.00 | $4,300.00 | $4,825.00 | $4,600.00 |
| $7,100.00 | $4,325.00 | $4,850.00 | $4,640.00 |
| $7,200.00 | $4,350.00 | $4,875.00 | $4,680.00 |
| $7,300.00 | $4,375.00 | $4,900.00 | $4,720.00 |
| $7,400.00 | $4,400.00 | $4,925.00 | $4,760.00 |
| $7,500.00 | $4,425.00 | $4,950.00 | $4,800.00 |
| $7,600.00 | $4,450.00 | $4,975.00 | $4,840.00 |
| $7,700.00 | $4,475.00 | $5,000.00 | $4,880.00 |
| $7,800.00 | $4,500.00 | $5,025.00 | $4,920.00 |
| $7,900.00 | $4,525.00 | $5,050.00 | $4,960.00 |
| $8,000.00 | $4,550.00 | $5,075.00 | $5,000.00 |
| $8,100.00 | $4,575.00 | $5,100.00 | $5,040.00 |
| $8,200.00 | $4,600.00 | $5,125.00 | $5,080.00 |
| $8,300.00 | $4,625.00 | $5,150.00 | $5,120.00 |
| $8,400.00 | $4,650.00 | $5,175.00 | $5,160.00 |
| $8,500.00 | $4,675.00 | $5,200.00 | $5,200.00 |
| $8,600.00 | $4,700.00 | $5,225.00 | $5,240.00 |
| $8,700.00 | $4,725.00 | $5,250.00 | $5,280.00 |
| $8,800.00 | $4,750.00 | $5,275.00 | $5,320.00 |
| $8,900.00 | $4,775.00 | $5,300.00 | $5,360.00 |
| $9,000.00 | $4,800.00 | $5,325.00 | $5,400.00 |
| $9,100.00 | $4,800.00 | $5,350.00 | $5,440.00 |
| $9,200.00 | $4,800.00 | $5,375.00 | $5,480.00 |
| $9,300.00 | $4,800.00 | $5,400.00 | $5,520.00 |
| $9,400.00 | $4,800.00 | $5,425.00 | $5,560.00 |
| $9,500.00 | $4,800.00 | $5,450.00 | $5,600.00 |
| $9,600.00 | $4,800.00 | $5,475.00 | $5,640.00 |
| $9,700.00 | $4,800.00 | $5,500.00 | $5,680.00 |
| $9,800.00 | $4,800.00 | $5,525.00 | $5,720.00 |
| $9,900.00 | $4,800.00 | $5,550.00 | $5,760.00 |
| $10,000.00 | $4,800.00 | $5,575.00 | $5,800.00 |
| $10,100.00 | $4,800.00 | $5,600.00 | $5,840.00 |
| $10,200.00 | $4,800.00 | $5,625.00 | $5,880.00 |
| $10,300.00 | $4,800.00 | $5,650.00 | $5,920.00 |
| $10,400.00 | $4,800.00 | $5,675.00 | $5,960.00 |
| $10,500.00 | $4,800.00 | $5,700.00 | $6,000.00 |
| $10,600.00 | $4,800.00 | $5,725.00 | $6,040.00 |
| $10,700.00 | $4,800.00 | $5,750.00 | $6,080.00 |
| $10,800.00 | $4,800.00 | $5,775.00 | $6,120.00 |
| $10,900.00 | $4,800.00 | $5,800.00 | $6,160.00 |
| $11,000.00 | $4,800.00 | $5,825.00 | $6,200.00 |
| $11,100.00 | $4,800.00 | $5,850.00 | $6,240.00 |
| $11,200.00 | $4,800.00 | $5,875.00 | $6,280.00 |
| $11,300.00 | $4,800.00 | $5,900.00 | $6,320.00 |
| $11,400.00 | $4,800.00 | $5,925.00 | $6,360.00 |
| $11,500.00 | $4,800.00 | $5,950.00 | $6,400.00 |
| $11,600.00 | $4,800.00 | $5,975.00 | $6,440.00 |
| $11,700.00 | $4,800.00 | $6,000.00 | $6,480.00 |
| $11,800.00 | $4,800.00 | $6,025.00 | $6,520.00 |
| $11,900.00 | $4,800.00 | $6,050.00 | $6,560.00 |
| $12,000.00 | $4,800.00 | $6,075.00 | $6,600.00 |
| $12,100.00 | $4,800.00 | $6,100.00 | $6,640.00 |
| $12,200.00 | $4,800.00 | $6,125.00 | $6,680.00 |
| $12,300.00 | $4,800.00 | $6,150.00 | $6,720.00 |
| $12,400.00 | $4,800.00 | $6,175.00 | $6,760.00 |
| $12,500.00 | $4,800.00 | $6,200.00 | $6,800.00 |
| $12,600.00 | $4,800.00 | $6,225.00 | $6,840.00 |
| $12,700.00 | $4,800.00 | $6,250.00 | $6,880.00 |
| $12,800.00 | $4,800.00 | $6,275.00 | $6,920.00 |
| $12,900.00 | $4,800.00 | $6,300.00 | $6,960.00 |
| $13,000.00 | $4,800.00 | $6,325.00 | $7,000.00 |
| $13,100.00 | $4,800.00 | $6,350.00 | $7,040.00 |
| $13,200.00 | $4,800.00 | $6,375.00 | $7,080.00 |
| $13,300.00 | $4,800.00 | $6,400.00 | $7,120.00 |
| $13,400.00 | $4,800.00 | $6,425.00 | $7,160.00 |
| $13,500.00 | $4,800.00 | $6,450.00 | $7,200.00 |
| $13,600.00 | $4,800.00 | $6,475.00 | $7,240.00 |
| $13,700.00 | $4,800.00 | $6,500.00 | $7,280.00 |
| $13,800.00 | $4,800.00 | $6,525.00 | $7,320.00 |
| $13,900.00 | $4,800.00 | $6,550.00 | $7,360.00 |
| $14,000.00 | $4,800.00 | $6,575.00 | $7,400.00 |
| $14,100.00 | $4,800.00 | $6,600.00 | $7,400.00 |
| $14,200.00 | $4,800.00 | $6,625.00 | $7,400.00 |
| $14,300.00 | $4,800.00 | $6,650.00 | $7,400.00 |
| $14,400.00 | $4,800.00 | $6,675.00 | $7,400.00 |
| $14,500.00 | $4,800.00 | $6,700.00 | $7,400.00 |
| $14,600.00 | $4,800.00 | $6,725.00 | $7,400.00 |
| $14,700.00 | $4,800.00 | $6,750.00 | $7,400.00 |
| $14,800.00 | $4,800.00 | $6,775.00 | $7,400.00 |
| $14,900.00 | $4,800.00 | $6,800.00 | $7,400.00 |
| $15,000.00 | $4,800.00 | $6,825.00 | $7,400.00 |
| $15,100.00 | $4,800.00 | $6,850.00 | $7,400.00 |
| $15,200.00 | $4,800.00 | $6,875.00 | $7,400.00 |
| $15,300.00 | $4,800.00 | $6,900.00 | $7,400.00 |
| $15,400.00 | $4,800.00 | $6,925.00 | $7,400.00 |
| $15,500.00 | $4,800.00 | $6,950.00 | $7,400.00 |
| $15,600.00 | $4,800.00 | $6,975.00 | $7,400.00 |
| $15,700.00 | $4,800.00 | $7,000.00 | $7,400.00 |
| $15,800.00 | $4,800.00 | $7,025.00 | $7,400.00 |
| $15,900.00 | $4,800.00 | $7,050.00 | $7,400.00 |
| $16,000.00 | $4,800.00 | $7,075.00 | $7,400.00 |
| $16,100.00 | $4,800.00 | $7,100.00 | $7,400.00 |
| $16,200.00 | $4,800.00 | $7,125.00 | $7,400.00 |
| $16,300.00 | $4,800.00 | $7,150.00 | $7,400.00 |
| $16,400.00 | $4,800.00 | $7,175.00 | $7,400.00 |
| $16,500.00 | $4,800.00 | $7,200.00 | $7,400.00 |
| $16,600.00 | $4,800.00 | $7,225.00 | $7,400.00 |
| $16,700.00 | $4,800.00 | $7,250.00 | $7,400.00 |
| $16,800.00 | $4,800.00 | $7,275.00 | $7,400.00 |
| $16,900.00 | $4,800.00 | $7,300.00 | $7,400.00 |
| $17,000.00 | $4,800.00 | $7,325.00 | $7,400.00 |
| $17,100.00 | $4,800.00 | $7,350.00 | $7,400.00 |
| $17,200.00 | $4,800.00 | $7,375.00 | $7,400.00 |
| $17,300.00 | $4,800.00 | $7,400.00 | $7,400.00 |
| $17,400.00 | $4,800.00 | $7,425.00 | $7,400.00 |
| $17,500.00 | $4,800.00 | $7,450.00 | $7,400.00 |
| $17,600.00 | $4,800.00 | $7,475.00 | $7,400.00 |
| $17,700.00 | $4,800.00 | $7,500.00 | $7,400.00 |
| $17,800.00 | $4,800.00 | $7,525.00 | $7,400.00 |
| $17,900.00 | $4,800.00 | $7,550.00 | $7,400.00 |
| $18,000.00 | $4,800.00 | $7,575.00 | $7,400.00 |
| $18,100.00 | $4,800.00 | $7,600.00 | $7,400.00 |
| $18,200.00 | $4,800.00 | $7,625.00 | $7,400.00 |
| $18,300.00 | $4,800.00 | $7,650.00 | $7,400.00 |
| $18,400.00 | $4,800.00 | $7,675.00 | $7,400.00 |
| $18,500.00 | $4,800.00 | $7,700.00 | $7,400.00 |
| $18,600.00 | $4,800.00 | $7,725.00 | $7,400.00 |
| $18,700.00 | $4,800.00 | $7,750.00 | $7,400.00 |
| $18,800.00 | $4,800.00 | $7,775.00 | $7,400.00 |
| $18,900.00 | $4,800.00 | $7,800.00 | $7,400.00 |
| $19,000.00 | $4,800.00 | $7,825.00 | $7,400.00 |
| $19,100.00 | $4,800.00 | $7,850.00 | $7,400.00 |
| $19,200.00 | $4,800.00 | $7,875.00 | $7,400.00 |
| $19,300.00 | $4,800.00 | $7,900.00 | $7,400.00 |
| $19,400.00 | $4,800.00 | $7,925.00 | $7,400.00 |
| $19,500.00 | $4,800.00 | $7,950.00 | $7,400.00 |
| $19,600.00 | $4,800.00 | $7,975.00 | $7,400.00 |
| $19,700.00 | $4,800.00 | $8,000.00 | $7,400.00 |
| $19,800.00 | $4,800.00 | $8,025.00 | $7,400.00 |
| $19,900.00 | $4,800.00 | $8,050.00 | $7,400.00 |
| $20,000.00 | $4,800.00 | $8,075.00 | $7,400.00 |
| $20,100.00 | $4,800.00 | $8,100.00 | $7,400.00 |
| $20,200.00 | $4,800.00 | $8,125.00 | $7,400.00 |
| $20,300.00 | $4,800.00 | $8,150.00 | $7,400.00 |
| $20,400.00 | $4,800.00 | $8,175.00 | $7,400.00 |
| $20,500.00 | $4,800.00 | $8,200.00 | $7,400.00 |
| $20,600.00 | $4,800.00 | $8,225.00 | $7,400.00 |
| $20,700.00 | $4,800.00 | $8,250.00 | $7,400.00 |
| $20,800.00 | $4,800.00 | $8,275.00 | $7,400.00 |
| $20,900.00 | $4,800.00 | $8,300.00 | $7,400.00 |
| $21,000.00 | $4,800.00 | $8,325.00 | $7,400.00 |
| $21,100.00 | $4,800.00 | $8,350.00 | $7,400.00 |
| $21,200.00 | $4,800.00 | $8,375.00 | $7,400.00 |
| $21,300.00 | $4,800.00 | $8,400.00 | $7,400.00 |
| $21,400.00 | $4,800.00 | $8,425.00 | $7,400.00 |
| $21,500.00 | $4,800.00 | $8,450.00 | $7,400.00 |
| $21,600.00 | $4,800.00 | $8,475.00 | $7,400.00 |
| $21,700.00 | $4,800.00 | $8,500.00 | $7,400.00 |
| $21,800.00 | $4,800.00 | $8,525.00 | $7,400.00 |
| $21,900.00 | $4,800.00 | $8,550.00 | $7,400.00 |
| $22,000.00 | $4,800.00 | $8,575.00 | $7,400.00 |
| $22,100.00 | $4,800.00 | $8,600.00 | $7,400.00 |
| $22,200.00 | $4,800.00 | $8,625.00 | $7,400.00 |
| $22,300.00 | $4,800.00 | $8,650.00 | $7,400.00 |
| $22,400.00 | $4,800.00 | $8,675.00 | $7,400.00 |
| $22,500.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $22,600.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $22,700.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $22,800.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $22,900.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $23,000.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $23,100.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $23,200.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $23,300.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $23,400.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $23,500.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $23,600.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $23,700.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $23,800.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $23,900.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $24,000.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $24,100.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $24,200.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $24,300.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $24,400.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $24,500.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $24,600.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $24,700.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $24,800.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $24,900.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $25,000.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $25,100.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $25,200.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $25,300.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $25,400.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $25,500.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $25,600.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $25,700.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $25,800.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $25,900.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $26,000.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $26,100.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $26,200.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $26,300.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $26,400.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $26,500.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $26,600.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $26,700.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $26,800.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $26,900.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $27,000.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $27,100.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $27,200.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $27,300.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $27,400.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $27,500.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $27,600.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $27,700.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $27,800.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $27,900.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $28,000.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $28,100.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $28,200.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $28,300.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $28,400.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $28,500.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $28,600.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $28,700.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $28,800.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $28,900.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $29,000.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $29,100.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $29,200.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $29,300.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $29,400.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $29,500.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $29,600.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $29,700.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $29,800.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $29,900.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $30,000.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $30,100.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $30,200.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $30,300.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $30,400.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $30,500.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $30,600.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $30,700.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $30,800.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $30,900.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $31,000.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $31,100.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $31,200.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $31,300.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $31,400.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $31,500.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $31,600.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $31,700.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $31,800.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $31,900.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $32,000.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $32,100.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $32,200.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $32,300.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $32,400.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $32,500.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $32,600.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $32,700.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $32,800.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $32,900.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $33,000.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $33,100.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $33,200.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $33,300.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $33,400.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $33,500.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $33,600.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $33,700.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $33,800.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $33,900.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $34,000.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $34,100.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $34,200.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $34,300.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $34,400.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $34,500.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $34,600.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $34,700.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $34,800.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $34,900.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $35,000.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $35,100.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $35,200.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $35,300.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $35,400.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $35,500.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $35,600.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $35,700.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $35,800.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $35,900.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $36,000.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $36,100.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $36,200.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $36,300.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $36,400.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $36,500.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $36,600.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $36,700.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $36,800.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $36,900.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $37,000.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $37,100.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $37,200.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $37,300.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $37,400.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $37,500.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $37,600.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $37,700.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $37,800.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $37,900.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $38,000.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $38,100.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $38,200.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $38,300.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $38,400.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $38,500.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $38,600.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $38,700.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $38,800.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $38,900.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $39,000.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $39,100.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $39,200.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $39,300.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $39,400.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $39,500.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $39,600.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $39,700.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $39,800.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $39,900.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $40,000.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $40,100.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $40,200.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $40,300.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $40,400.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $40,500.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $40,600.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $40,700.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $40,800.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $40,900.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $41,000.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $41,100.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $41,200.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $41,300.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $41,400.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $41,500.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $41,600.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $41,700.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $41,800.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $41,900.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $42,000.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $42,100.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $42,200.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $42,300.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $42,400.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $42,500.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $42,600.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $42,700.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $42,800.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $42,900.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $43,000.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $43,100.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $43,200.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $43,300.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $43,400.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $43,500.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $43,600.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $43,700.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $43,800.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $43,900.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $44,000.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $44,100.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $44,200.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $44,300.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $44,400.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $44,500.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $44,600.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $44,700.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $44,800.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $44,900.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $45,000.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $45,100.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $45,200.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $45,300.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $45,400.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $45,500.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $45,600.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $45,700.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $45,800.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $45,900.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $46,000.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $46,100.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $46,200.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $46,300.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $46,400.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $46,500.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $46,600.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $46,700.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $46,800.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $46,900.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $47,000.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $47,100.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $47,200.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $47,300.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $47,400.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $47,500.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $47,600.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $47,700.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $47,800.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $47,900.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $48,000.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $48,100.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $48,200.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $48,300.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $48,400.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $48,500.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $48,600.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $48,700.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $48,800.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $48,900.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $49,000.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $49,100.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $49,200.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $49,300.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $49,400.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $49,500.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $49,600.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $49,700.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $49,800.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $49,900.00 | $4,800.00 | $8,700.00 | $7,400.00 |
| $50,000.00 | $4,800.00 | $8,700.00 | $7,400.00 |
Disclaimer: This site is intended to show approximate cost of health care to an individual or family and may not work for all health plans. This site is merely an informational tool and should not be the basis for your health plan decisions. All parties associated with this site are not liable for any health care costs incurred due to your health plan selection.
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