Insurance Coverage
Health Screenings & Testing
Health Screening
$50
Cancer Screening
Discount
Mammography
Discount
Chest X-Ray
$50
Medical Care
Urgent Care
$200
Physician Office
$100
First Day Hospital
$1,250
Daily Hospital (365 Days)
$300
First Day ICU
$1,000
Hospital ICU
$400
Rehabilitation Unit
$200
Observation Room
$100
Surgical
Open Abdominal
$200
Tendon/Ligament/Rotator
$1,000
Torn Knee Cartilage
$500
Dislocation
Hip
$3,000
Knee
$1,800
Ankle
$1,500
Fracture
Skull
$4,000
Hip
$4,000
Pelvis
$2,000
Leg, Ankle, Wrist
$2,000
Burn
2nd Degree
$1,000
3rd Degree
$10,000
Laceration
2 inches
$100
2–6 inches
$400
6 or more
$800
Accidental Death
Accidental Death
$50,000