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Examples of
Services Covered
Sample HMO
Co-Payment
Sample POS
Co-Payment
Atlantis Outpatient
Center Co-Payment *
Blood Work $15 $20 No co-payment
Sonogram $15 $20 No co-payment
Physical Therapy $15 $20 No co-payment
EKG $15 $20 No co-payment
   Minor Local Surgery    Lesser of 20% or $200    Lesser of 20% or $200    No co-payment
Second Opinions $15 $20 No co-payment
IV/ IM Therapy $15 $20 No co-payment
Endoscopies $15 $20 No co-payment
Pre-Surgical Testing $15 $20 No co-payment
Office Visits $15 $20 No co-payment
X-Rays $15 $20 No co-payment
Echocardiogram $15 $20 No co-payment
Vascular Studies $15 $20 No co-payment
Holter Monitor $15 $20 No co-payment
Spirometer $15 $20 No co-payment

*Atlantis Outpatient Centers are owned and operated by physicians. Atlantis Health Plan has licensed the naming rights and logo of Atlantis Health Plan to the physician entity that owns and operates Atlantis Outpatient Centers.