Silver Performance PPO 4500/20/35 + Silver + PPO – PPO
Network type: PPO
Coverage tier: Silver
Primary care visit: $35 copay
Specialist visit: $65 copay
Urgent care visit: $100 copay
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Silver PPO 6000/20/30 + Silver + PPO – PPO
Network type: PPO
Coverage tier: Silver
Primary care visit: $30 copay
Specialist visit: $60 copay
Urgent care visit: $100 copay