Everyday Bronze
Ambetter Health |
Expanded Bronze | HMO |
$726.16 |
$8,450 |
$10,150 |
Standard Expanded Bronze
Ambetter Health |
Expanded Bronze | HMO |
$728.39 |
$7,500 |
$10,000 |
Everyday Bronze + Vision + Adult Dental
Ambetter Health |
Expanded Bronze | HMO |
$745.81 |
$8,450 |
$10,150 |
Standard Expanded Bronze + Vision + Adult Dental
Ambetter Health |
Expanded Bronze | HMO |
$748.09 |
$7,500 |
$10,000 |
Molina Bronze Standard
Molina Healthcare |
Expanded Bronze | HMO |
$788.83 |
$7,500 |
$10,000 |
myBlue Bronze 26M01-23 (Rewards)
Florida Blue HMO (a BlueCross BlueShield FL company) |
Bronze | HMO |
$805.45 |
$10,125 |
$10,150 |
Molina Bronze Enhanced 3500
Molina Healthcare |
Expanded Bronze | HMO |
$808.19 |
$3,500 |
$9,950 |
Molina Bronze Enhanced 3500 Pluswith Adult Vision
Molina Healthcare |
Expanded Bronze | HMO |
$813.82 |
$3,500 |
$9,950 |
Elite Bronze
Ambetter Health |
Expanded Bronze | HMO |
$829.45 |
$0 |
$10,500 |
Molina Bronze Enhanced 3500 Plus with Adult Dental and Vision
Molina Healthcare |
Expanded Bronze | HMO |
$833.68 |
$3,500 |
$9,950 |
Elite Bronze + Vision + Adult Dental
Ambetter Health |
Expanded Bronze | HMO |
$851.89 |
$0 |
$10,500 |
Molina Bronze Premier with $0 Medical Deductible
Molina Healthcare |
Expanded Bronze | HMO |
$883.93 |
$0 |
$10,350 |
Molina Bronze Premier with $0 Medical Deductible Pluswith Adult Vision
Molina Healthcare |
Expanded Bronze | HMO |
$889.58 |
$0 |
$10,350 |
Molina Bronze Premier with $0 Medical Deductible Plus with Adult Dental and Vision
Molina Healthcare |
Expanded Bronze | HMO |
$909.38 |
$0 |
$10,350 |
myBlue Bronze 2219 ($75 PCP Visits / Rewards)
Florida Blue HMO (a BlueCross BlueShield FL company) |
Expanded Bronze | HMO |
$917.58 |
$2,625 |
$10,150 |
myBlue Bronze 2312S ($50 PCP Visits / Rewards)
Florida Blue HMO (a BlueCross BlueShield FL company) |
Expanded Bronze | HMO |
$918.91 |
$7,500 |
$10,000 |
Clarity Silver
Ambetter Health |
Silver | HMO |
$922.16 |
$8,000 |
$8,400 |
myBlue Bronze 1601 (3 PCP Visits for $0 then $25 / $75 Specialist Visits / Rewards)
Florida Blue HMO (a BlueCross BlueShield FL company) |
Expanded Bronze | HMO |
$929.20 |
$6,000 |
$10,150 |
Standard Gold
Ambetter Health |
Gold | HMO |
$962.60 |
$2,000 |
$8,200 |
BlueSelect Bronze 24L01-01 (Rewards)
Florida Blue (BlueCross BlueShield FL) |
Bronze | EPO |
$968.46 |
$6,150 |
$10,150 |
Everyday Gold
Ambetter Health |
Gold | HMO |
$983.44 |
$800 |
$7,250 |
Standard Silver
Ambetter Health |
Silver | HMO |
$983.61 |
$6,000 |
$8,900 |
BlueCare Bronze 24K01-05 (Rewards)
Florida Blue HMO (a BlueCross BlueShield FL company) |
Bronze | POS |
$988.27 |
$6,150 |
$10,150 |
Standard Gold + Vision + Adult Dental
Ambetter Health |
Gold | HMO |
$988.64 |
$2,000 |
$8,200 |
myBlue Bronze 2129 ($35 PCP Visits / $75 Specialist Visits / Rewards)
Florida Blue HMO (a BlueCross BlueShield FL company) |
Expanded Bronze | HMO |
$992.25 |
$0 |
$10,150 |
Focused Silver
Ambetter Health |
Silver | HMO |
$995.47 |
$6,300 |
$8,400 |
myBlue Bronze 2129V ($35 PCP Visits / $75 Specialist Visits / Adult Vision / Rewards)
Florida Blue HMO (a BlueCross BlueShield FL company) |
Expanded Bronze | HMO |
$998.39 |
$0 |
$10,150 |
Molina Silver Saver with Four Free PCP Visits
Molina Healthcare |
Silver | HMO |
$998.45 |
$7,000 |
$10,150 |
AvMed Entrust Expanded Bronze Standard (2026)
AvMed |
Expanded Bronze | HMO |
$1,004.03 |
$7,500 |
$10,000 |
BlueSelect Bronze 2342S ($50 PCP Visits / Rewards)
Florida Blue (BlueCross BlueShield FL) |
Expanded Bronze | EPO |
$1,005.02 |
$7,500 |
$10,000 |
Molina Silver Core
Molina Healthcare |
Silver | HMO |
$1,006.10 |
$6,000 |
$8,990 |
Everyday Gold + Vision + Adult Dental
Ambetter Health |
Gold | HMO |
$1,010.05 |
$800 |
$7,250 |
Standard Silver + Vision + Adult Dental
Ambetter Health |
Silver | HMO |
$1,010.22 |
$6,000 |
$8,900 |
myBlue Bronze 2129E ($35 PCP Visits / $75 Specialist Visits / Adult Dental & Vision / Rewards)
Florida Blue HMO (a BlueCross BlueShield FL company) |
Expanded Bronze | HMO |
$1,011 |
$0 |
$10,150 |
Molina Silver Core Pluswith Adult Vision
Molina Healthcare |
Silver | HMO |
$1,011.72 |
$6,000 |
$8,990 |
Enhanced Diabetes Care Silver with $0 Drug Options
Ambetter Health |
Silver | HMO |
$1,011.95 |
$5,000 |
$8,650 |
BlueSelect Bronze (HSA) 1735 (Rewards / $4 Condition Care Rx)
Florida Blue (BlueCross BlueShield FL) |
Expanded Bronze | EPO |
$1,013.63 |
$6,650 |
$7,400 |
Complete Gold
Ambetter Health |
Gold | HMO |
$1,016.31 |
$1,450 |
$7,500 |
AvMed Entrust Bronze 650 (2026)
AvMed |
Expanded Bronze | HMO |
$1,018.43 |
$10,150 |
$10,150 |
BlueSelect Bronze 1449 (3 PCP Visits for $0 then $55 / $70 Specialist Visits / Rewards)
Florida Blue (BlueCross BlueShield FL) |
Expanded Bronze | EPO |
$1,020.79 |
$6,500 |
$10,000 |
Focused Silver + Vision + Adult Dental
Ambetter Health |
Silver | HMO |
$1,022.40 |
$6,300 |
$8,400 |
Molina Silver Core Plus with Adult Dental and Vision
Molina Healthcare |
Silver | HMO |
$1,031.51 |
$6,000 |
$8,990 |
AvMed Entrust Bronze 600 (2026)
AvMed |
Expanded Bronze | HMO |
$1,033.79 |
$6,500 |
$9,500 |
Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental
Ambetter Health |
Silver | HMO |
$1,039.33 |
$5,000 |
$8,650 |
Molina Silver Standard
Molina Healthcare |
Silver | HMO |
$1,040.38 |
$6,000 |
$8,900 |
BlueCare Bronze (HSA) 24K01-09 (Rewards / $4 Condition Care Rx)
Florida Blue HMO (a BlueCross BlueShield FL company) |
Expanded Bronze | POS |
$1,043.54 |
$6,650 |
$7,400 |
BlueCare Bronze 24K01-31S ($50 PCP Visits / Rewards)
Florida Blue HMO (a BlueCross BlueShield FL company) |
Expanded Bronze | POS |
$1,043.72 |
$7,500 |
$10,000 |
Complete Gold + Vision + Adult Dental
Ambetter Health |
Gold | HMO |
$1,043.80 |
$1,450 |
$7,500 |
Molina Gold Enhanced 895
Molina Healthcare |
Gold | HMO |
$1,056.22 |
$895 |
$8,700 |
myBlue Silver 26M06-03 ($5 PCP Visits / $5 Labs / Rewards)
Florida Blue HMO (a BlueCross BlueShield FL company) |
Silver | HMO |
$1,056.40 |
$9,500 |
$10,150 |
Molina Gold Core 1640
Molina Healthcare |
Gold | HMO |
$1,056.99 |
$1,640 |
$8,100 |
Molina Gold Enhanced 895 Pluswith Adult Vision
Molina Healthcare |
Gold | HMO |
$1,061.84 |
$895 |
$8,700 |
Molina Gold Core 1640 Pluswith Adult Vision
Molina Healthcare |
Gold | HMO |
$1,062.67 |
$1,640 |
$8,100 |
myBlue Silver 26M06-03V ($5 PCP Visits / $5 Labs / Adult Vision / Rewards)
Florida Blue HMO (a BlueCross BlueShield FL company) |
Silver | HMO |
$1,062.76 |
$9,500 |
$10,150 |
BlueSelect Bronze 2139 ($50 PCP Visits / Rewards)
Florida Blue (BlueCross BlueShield FL) |
Expanded Bronze | EPO |
$1,064.51 |
$0 |
$9,900 |
BlueCare Bronze 24K01-03 (3 PCP Visits for $0 then $55 / $70 Specialist Visits / Rewards)
Florida Blue HMO (a BlueCross BlueShield FL company) |
Expanded Bronze | POS |
$1,067.49 |
$6,500 |
$10,000 |
BlueSelect Bronze 2139V ($50 PCP Visits / Adult Vision / Rewards)
Florida Blue (BlueCross BlueShield FL) |
Expanded Bronze | EPO |
$1,070.15 |
$0 |
$9,900 |
myBlue Silver 25M06-02 ($0 Labs / $50 PCP Visits / Rewards)
Florida Blue HMO (a BlueCross BlueShield FL company) |
Silver | HMO |
$1,072.78 |
$7,000 |
$9,150 |
myBlue Silver 26M06-03E ($5 PCP Visits / $5 Labs / Adult Dental & Vision / Rewards)
Florida Blue HMO (a BlueCross BlueShield FL company) |
Silver | HMO |
$1,075.44 |
$9,500 |
$10,150 |
myBlue Silver 25M06-02V ($0 Labs / $50 PCP Visits / Adult Vision / Rewards)
Florida Blue HMO (a BlueCross BlueShield FL company) |
Silver | HMO |
$1,078.90 |
$7,000 |
$9,150 |
BlueSelect Bronze 2139E ($50 PCP Visits / Adult Dental & Vision / Rewards)
Florida Blue (BlueCross BlueShield FL) |
Expanded Bronze | EPO |
$1,081.42 |
$0 |
$9,900 |
Molina Gold Enhanced 895 Plus with Adult Dental and Vision
Molina Healthcare |
Gold | HMO |
$1,081.62 |
$895 |
$8,700 |
Molina Gold Core 1640 Plus with Adult Dental and Vision
Molina Healthcare |
Gold | HMO |
$1,082.44 |
$1,640 |
$8,100 |
myBlue Silver 25M06-02E ($0 Labs / $50 PCP Visits / Adult Dental & Vision / Rewards)
Florida Blue HMO (a BlueCross BlueShield FL company) |
Silver | HMO |
$1,091.55 |
$7,000 |
$9,150 |
myBlue Silver 24M06-76 ($50 PCP Visits / $15 Labs / Rewards)
Florida Blue HMO (a BlueCross BlueShield FL company) |
Silver | HMO |
$1,096.41 |
$6,500 |
$9,200 |
myBlue Silver 24M06-76V ($50 PCP Visits / $15 Labs / Adult Vision / Rewards)
Florida Blue HMO (a BlueCross BlueShield FL company) |
Silver | HMO |
$1,102.53 |
$6,500 |
$9,200 |
Molina Gold Standard
Molina Healthcare |
Gold | HMO |
$1,105.74 |
$2,000 |
$8,200 |
myBlue Silver 2237 ($60 PCP Visits / Rewards)
Florida Blue HMO (a BlueCross BlueShield FL company) |
Silver | HMO |
$1,108.16 |
$3,150 |
$8,675 |
myBlue Silver 2237V ($60 PCP Visits / Adult Vision / Rewards)
Florida Blue HMO (a BlueCross BlueShield FL company) |
Silver | HMO |
$1,114.27 |
$3,150 |
$8,675 |
myBlue Silver 24M06-76E ($50 PCP Visits / $15 Labs / Adult Dental & Vision / Rewards)
Florida Blue HMO (a BlueCross BlueShield FL company) |
Silver | HMO |
$1,115.16 |
$6,500 |
$9,200 |
myBlue Silver 2237E ($60 PCP Visits / Adult Dental & Vision / Rewards)
Florida Blue HMO (a BlueCross BlueShield FL company) |
Silver | HMO |
$1,126.89 |
$3,150 |
$8,675 |
myBlue Silver 2313S ($40 PCP Visits / $80 Specialist Visits / Rewards)
Florida Blue HMO (a BlueCross BlueShield FL company) |
Silver | HMO |
$1,127.38 |
$6,000 |
$8,900 |
BlueCare Bronze 24K01-25 ($50 PCP Visits / $75 Specialist Visits / Rewards)
Florida Blue HMO (a BlueCross BlueShield FL company) |
Expanded Bronze | POS |
$1,128.14 |
$0 |
$9,900 |
AvMed Entrust Silver Standard (2026)
AvMed |
Silver | HMO |
$1,257.74 |
$6,000 |
$8,900 |
AvMed Entrust Silver 550 (2026)
AvMed |
Silver | HMO |
$1,278.63 |
$6,250 |
$8,000 |
AvMed Entrust Silver 550 Dental+Vision (2026)
AvMed |
Silver | HMO |
$1,283.97 |
$6,250 |
$8,000 |
BlueOptions Bronze 24J01-06 (Rewards)
Florida Blue (BlueCross BlueShield FL) |
Bronze | PPO |
$1,287.10 |
$6,150 |
$10,150 |
BlueSelect Silver 1443 ($10 Labs / Rewards)
Florida Blue (BlueCross BlueShield FL) |
Silver | EPO |
$1,298.01 |
$4,000 |
$8,100 |
BlueSelect Silver 1443V ($10 Labs / Adult Vision / Rewards)
Florida Blue (BlueCross BlueShield FL) |
Silver | EPO |
$1,303.74 |
$4,000 |
$8,100 |
BlueSelect Silver 1443E ($10 Labs / Adult Dental & Vision / Rewards)
Florida Blue (BlueCross BlueShield FL) |
Silver | EPO |
$1,315.16 |
$4,000 |
$8,100 |
AvMed Entrust Silver 350 (2026)
AvMed |
Silver | HMO |
$1,315.65 |
$3,500 |
$9,250 |
BlueSelect Silver 2343S ($40 PCP Visits / $80 Specialist Visits / Rewards)
Florida Blue (BlueCross BlueShield FL) |
Silver | EPO |
$1,319.53 |
$6,000 |
$8,900 |
AvMed Entrust Silver 350 Dental+Vision (2026)
AvMed |
Silver | HMO |
$1,321.13 |
$3,500 |
$9,250 |
BlueSelect Silver 1456 ($50 PCP Visits / Rewards)
Florida Blue (BlueCross BlueShield FL) |
Silver | EPO |
$1,334.43 |
$3,125 |
$8,100 |
BlueOptions Bronze 24J01-18S ($50 PCP Visits / Rewards)
Florida Blue (BlueCross BlueShield FL) |
Expanded Bronze | PPO |
$1,335.46 |
$7,500 |
$10,000 |
myBlue Gold 2314S ($30 PCP Visits / $60 Specialist Visits / Rewards)
Florida Blue HMO (a BlueCross BlueShield FL company) |
Gold | HMO |
$1,336.95 |
$2,000 |
$8,200 |
BlueOptions Bronze (HSA) 24J01-10 (Rewards / $4 Condition Care Rx)
Florida Blue (BlueCross BlueShield FL) |
Expanded Bronze | PPO |
$1,347.29 |
$6,650 |
$7,400 |
BlueOptions Bronze 24J01-04 (3 PCP Visits for $0 then $55 / $70 Specialist Visits / Rewards)
Florida Blue (BlueCross BlueShield FL) |
Expanded Bronze | PPO |
$1,357 |
$6,500 |
$10,000 |
myBlue Gold 1605 ($0 Labs / Rewards)
Florida Blue HMO (a BlueCross BlueShield FL company) |
Gold | HMO |
$1,359.72 |
$940 |
$4,500 |
BlueCare Silver 24K01-02 ($10 Labs / Rewards)
Florida Blue HMO (a BlueCross BlueShield FL company) |
Silver | POS |
$1,360.38 |
$4,000 |
$8,100 |
AvMed Entrust Gold Standard (2026)
AvMed |
Gold | HMO |
$1,370.42 |
$2,000 |
$8,200 |
AvMed Entrust Gold 125 (2026)
AvMed |
Gold | HMO |
$1,396.69 |
$2,000 |
$5,850 |
AvMed Entrust Gold 125 Dental+Vision (2026)
AvMed |
Gold | HMO |
$1,402.45 |
$2,000 |
$5,850 |
BlueCare Silver 24K01-32S ($40 PCP Visits / $80 Specialist Visits / Rewards)
Florida Blue HMO (a BlueCross BlueShield FL company) |
Silver | POS |
$1,406.22 |
$6,000 |
$8,900 |
myBlue Gold 24M05-74 ($0 Deductible / $25 PCP Visits / $60 Specialist Visits / Rewards)
Florida Blue HMO (a BlueCross BlueShield FL company) |
Gold | HMO |
$1,408.03 |
$0 |
$6,550 |
BlueOptions Bronze 24J01-17 ($50 PCP Visits / Rewards)
Florida Blue (BlueCross BlueShield FL) |
Expanded Bronze | PPO |
$1,417.41 |
$0 |
$9,900 |
BlueCare Silver 24K01-06 ($50 PCP Visits / Rewards)
Florida Blue HMO (a BlueCross BlueShield FL company) |
Silver | POS |
$1,424.34 |
$3,125 |
$8,100 |
BlueSelect Gold 2344S ($30 PCP Visits / $60 Specialist Visits / Rewards)
Florida Blue (BlueCross BlueShield FL) |
Gold | EPO |
$1,459.72 |
$2,000 |
$8,200 |
BlueSelect Gold 1835 ($40 PCP Visits / $75 Specialist Visits / $15 Labs / Rewards)
Florida Blue (BlueCross BlueShield FL) |
Gold | EPO |
$1,494.27 |
$1,500 |
$6,450 |
BlueSelect Gold 1535 ($0 Deductible / $15 PCP Visits / $75 Specialist Visits / $20 Labs / Rewards)
Florida Blue (BlueCross BlueShield FL) |
Gold | EPO |
$1,533.67 |
$0 |
$6,250 |
BlueSelect Gold 1535V ($0 Deductible / $15 PCP Visits / $75 Specialist Visits / $20 Labs / Adult Vision / Rewards)
Florida Blue (BlueCross BlueShield FL) |
Gold | EPO |
$1,539.35 |
$0 |
$6,250 |
BlueCare Gold 24K01-33S ($30 PCP Visits / $60 Specialist Visits / Rewards)
Florida Blue HMO (a BlueCross BlueShield FL company) |
Gold | POS |
$1,554.77 |
$2,000 |
$8,200 |
BlueCare Gold 24K01-10 ($40 PCP Visits / $75 Specialist Visits / $15 Labs / Rewards)
Florida Blue HMO (a BlueCross BlueShield FL company) |
Gold | POS |
$1,593.06 |
$1,500 |
$6,450 |
BlueCare Gold 24K01-08 ($0 Deductible / $15 PCP Visits / $75 Specialist Visits / $20 Labs / Rewards)
Florida Blue HMO (a BlueCross BlueShield FL company) |
Gold | POS |
$1,648.98 |
$0 |
$6,250 |
myBlue Platinum 24M05-75 ($0 Deductible / $0 Labs / $15 PCP Visits / $25 Specialist Visits / Rewards)
Florida Blue HMO (a BlueCross BlueShield FL company) |
Platinum | HMO |
$1,821.90 |
$0 |
$2,250 |
AvMed Entrust Platinum 25 (2026)
AvMed |
Platinum | HMO |
$1,899.26 |
$0 |
$5,500 |
AvMed Entrust Platinum 25 Dental+Vision (2026)
AvMed |
Platinum | HMO |
$1,906.06 |
$0 |
$5,500 |
myBlue Platinum 24M05-00S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Rewards)
Florida Blue HMO (a BlueCross BlueShield FL company) |
Platinum | HMO |
$1,908.52 |
$0 |
$5,200 |
BlueSelect Platinum 1451 ($0 Labs / $15 PCP Visits / $35 Specialist Visits / Rewards)
Florida Blue (BlueCross BlueShield FL) |
Platinum | EPO |
$1,912.13 |
$1,000 |
$4,000 |
BlueCare Platinum 24K01-04 ($0 Labs / $15 PCP Visits / $35 Specialist Visits / Rewards)
Florida Blue HMO (a BlueCross BlueShield FL company) |
Platinum | POS |
$1,945.63 |
$1,000 |
$4,000 |
AvMed Entrust Platinum Standard (2026)
AvMed |
Platinum | HMO |
$1,950.25 |
$0 |
$5,200 |
BlueSelect Platinum 1457 ($0 Deductible / $0 Labs / $15 PCP Visits / $25 Specialist Visits / Rewards)
Florida Blue (BlueCross BlueShield FL) |
Platinum | EPO |
$1,965.15 |
$0 |
$2,525 |
BlueCare Platinum 24K01-07 ($0 Deductible / $0 Labs / $15 PCP Visits / $25 Specialist Visits / Rewards)
Florida Blue HMO (a BlueCross BlueShield FL company) |
Platinum | POS |
$2,019.68 |
$0 |
$2,525 |
BlueSelect Platinum 2345S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Rewards)
Florida Blue (BlueCross BlueShield FL) |
Platinum | EPO |
$2,048.01 |
$0 |
$5,200 |
BlueOptions Silver 24J01-03 ($10 Labs / Rewards)
Florida Blue (BlueCross BlueShield FL) |
Silver | PPO |
$2,080.82 |
$4,000 |
$8,100 |
BlueCare Platinum 24K01-34S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Rewards)
Florida Blue HMO (a BlueCross BlueShield FL company) |
Platinum | POS |
$2,116.57 |
$0 |
$5,200 |
BlueOptions Gold 24J01-20S ($30 PCP Visits / $60 Specialist Visits / Rewards)
Florida Blue (BlueCross BlueShield FL) |
Gold | PPO |
$2,186.83 |
$2,000 |
$8,200 |
BlueOptions Silver 24J01-19S ($40 PCP Visits / $80 Specialist Visits / Rewards)
Florida Blue (BlueCross BlueShield FL) |
Silver | PPO |
$2,222.52 |
$6,000 |
$8,900 |
BlueOptions Gold 24J01-12 ($40 PCP Visits / $75 Specialist Visits / $15 Labs / Rewards)
Florida Blue (BlueCross BlueShield FL) |
Gold | PPO |
$2,238.79 |
$1,500 |
$6,450 |
BlueOptions Silver 24J01-07 ($50 PCP Visits / Rewards)
Florida Blue (BlueCross BlueShield FL) |
Silver | PPO |
$2,248.29 |
$3,125 |
$8,100 |
BlueOptions Gold 24J01-09 ($0 Deductible / $15 PCP Visits / $75 Specialist Visits / $20 Labs / Rewards)
Florida Blue (BlueCross BlueShield FL) |
Gold | PPO |
$2,299.62 |
$0 |
$6,250 |
BlueOptions Platinum 24J01-05 ($0 Labs / $15 PCP Visits / $35 Specialist Visits / Rewards)
Florida Blue (BlueCross BlueShield FL) |
Platinum | PPO |
$2,904.30 |
$1,000 |
$4,000 |
BlueOptions Platinum 24J01-08 ($0 Deductible / $0 Labs / $15 PCP Visits / $25 Specialist Visits / Rewards)
Florida Blue (BlueCross BlueShield FL) |
Platinum | PPO |
$2,987.94 |
$0 |
$2,525 |
BlueOptions Platinum 24J01-21S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Rewards)
Florida Blue (BlueCross BlueShield FL) |
Platinum | PPO |
$3,113.41 |
$0 |
$5,200 |