ST. LUKE’S CHARGE 10000308 CT ANGIO HEAD Insurance and Self Pay Discounts 350 70496 $3,720.00

Aurora ST. LUKE’S
CHARGE
10000308
CT ANGIO HEAD
Rev 350
CPT 70496
NDC NA

Fee $3,720.00

Self-Pay $1,338.90

Insurance

Minimum $1,860.00
Maximum $3,154.52
Aetna W $1,050.59
Aetna PPO $3,079.05
Anthem Blue Priority $1,158.99
Anthem Blue Preferred $1,158.99
Anthem PPO $3,154.52
Aurora Caregiver $1,197.07
Centivo $1,191.51
Cigna GPPO $1,839.69
Cigna PPO $3,141.51
Common Ground ETF Network $1,139.67
Common Ground Exchange Envision $1,139.67
Common Ground Group Envision $1,139.67
Everpointe Elite $1,104.49
Health EOS Plus $2,265.78
Health EOS PPO $2,968.52
HealthPartners ETF $1,105.72
HealthPartners Robin Focused $1,374.31
HealthPartners Broad $2,785.73
HPS $1,365.50
HST $1,383.15
Humana HPN $1,268.78
Humana HMO $1,268.78
Humana PPO $3,122.10
Molina Exchange $1,137.21
Quartz One $1,117.44
Quartz Group $1,240.33
Trilogy $1,414.48
UHC Individual Exchange $1,158.63
UHC Charter $1,172.11
UHC Nexus $1,172.11
UHC HMO $1,276.12
UHC PPO $3,138.65
WPS Aurora Featured Network $1,271.96
WPS Arise $1,338.90
WPS Statewide $1,338.90