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≤$2000
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$40/$3000 Deductible Plan NM
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HMO
HMO
Lab
$10
Office Visit
$40
Deductible
$3000
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$40/$4000 Deductible Plan NM w/H.S.A.
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PPO
HSA
Lab
$10
Office Visit
$40
Deductible
$4000
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$0/$5000 WM Deductible Plan w/H.S.A.
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PPO
HSA
Lab
$0
Office Visit
$0
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$5000
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$25/$1000 Deductible Plan
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HSA
Lab
$10
Office Visit
$25
Deductible
$1000
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$50/$5000 NM Deductible Plan
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HMO
HMO
Lab
$10
Office Visit
$50
Deductible
$5000
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0
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$0/$1500 Deductible Plan w/H.S.A.
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PPO
HSA
Lab
$0
Office Visit
$0
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$1500
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$0/$2700 Deductible Plan w/H.S.A.
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PPO
HSA
Lab
$0
Office Visit
$0
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$2700
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$30/$2700 Deductible Plan w/H.S.A.
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PPO
HSA
Lab
$10
Office Visit
$30
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$2700
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$40 Copayment Plan
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HMO
Lab
$10
Office Visit
$40
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$0
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$40/$2000 Deductible Plan
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HMO
HMO
Lab
$10
Office Visit
$40
Deductible
$2000
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$50 Copayment Plan
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HMO
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$10
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$50
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$25 Copayment Plan
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HMO
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$10
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$25
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$20/$500 Deductible Plan
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HMO
HMO
Lab
$10
Office Visit
$20
Deductible
$500
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$30/$1500 Deductible Plan
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HMO
HMO
Lab
$10
Office Visit
$30
Deductible
$1500
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