| White | Green | Blue 80 | Blue 90 | |
|---|---|---|---|---|
| Maximum | $250,000 | Unlimited | Unlimited | Unlimited |
| Co-insurance (Network) | 100% | 80% | 80% | 90% |
| Deductible | $100 | $500 | $500 | $100 |
| Yearly rates (17~24) | $342 | $687 | $995 | $1,591 |
| Yearly rates (25~29) | $487 | $909 | $1,390 | $1,963 |
| Yearly rates (30~45) | $945 | $1,602 | $2,390 | $3,292 |
| Detail | Detail | Detail | Detail | |
| Buy | Buy | Buy | Buy |