ST. LUKE’S CHARGE 10000535 SHUNTOGRAM NONVASCULAR S&I Insurance and Self Pay Discounts 320 75809 $580.00

Aurora ST. LUKE’S
CHARGE
10000535
SHUNTOGRAM NONVASCULAR S&I
Rev 320
CPT 75809
NDC NA

Fee $580.00

Self-Pay $248.15

Insurance

Minimum $290.00
Maximum $487.20
Aetna W $191.24
Aetna PPO $476.79
Anthem Blue Priority $202.91
Anthem Blue Preferred $202.91
Anthem PPO $487.20
Aurora Caregiver $212.53
Centivo $230.41
Cigna GPPO $331.06
Cigna PPO $486.51
Common Ground ETF Network $210.99
Common Ground Exchange Envision $210.99
Common Ground Group Envision $210.99
Everpointe Elite $201.38
Health EOS Plus $351.15
Health EOS PPO $458.20
HealthPartners ETF $212.19
HealthPartners Robin Focused $266.05
HealthPartners Broad $431.69
HPS $271.50
HST $251.80
Humana HPN $255.90
Humana HMO $255.90
Humana PPO $483.81
Molina Exchange $220.28
Quartz One $200.14
Quartz Group $223.27
Trilogy $279.99
UHC Individual Exchange $233.37
UHC Charter $236.09
UHC Nexus $236.09
UHC HMO $255.49
UHC PPO $484.12
WPS Aurora Featured Network $235.74
WPS Arise $248.15
WPS Statewide $248.15