ST. LUKE’S CHARGE 10000682 NM BONE MARROW IMAGING/MULTI Insurance and Self Pay Discounts 341 78103 $1,950.00

Aurora ST. LUKE’S
CHARGE
10000682
NM BONE MARROW IMAGING/MULTI
Rev 341
CPT 78103
NDC NA

Fee $1,950.00

Self-Pay $1,098.04

Insurance

Minimum $975.00
Maximum $1,655.72
Aetna W $859.23
Aetna PPO $1,623.78
Anthem Blue Priority $953.12
Anthem Blue Preferred $953.12
Anthem PPO $1,655.72
Aurora Caregiver $958.94
Centivo $1,148.46
Cigna GPPO $1,092.70
Cigna PPO $1,648.28
Common Ground ETF Network $934.00
Common Ground Exchange Envision $934.00
Common Ground Group Envision $934.00
Everpointe Elite $815.30
Health EOS Plus $1,188.68
Health EOS PPO $1,558.22
HealthPartners ETF $963.98
HealthPartners Robin Focused $1,148.76
HealthPartners Broad $1,461.49
HPS $1,057.37
HST $887.30
Humana HPN $988.56
Humana HMO $988.56
Humana PPO $1,647.52
Molina Exchange $710.92
Quartz One $846.98
Quartz Group $1,001.92
Trilogy $1,162.14
UHC Individual Exchange $518.80
UHC Charter $524.84
UHC Nexus $524.84
UHC HMO $593.89
UHC PPO $1,647.69
WPS Aurora Featured Network $1,043.14
WPS Arise $1,098.04
WPS Statewide $1,098.04