ST. LUKE’S CHARGE 10000793 ANGIOTENSIN CONVERTING ENZYME Insurance and Self Pay Discounts 301 82164 $175.00

Aurora ST. LUKE’S
CHARGE
10000793
ANGIOTENSIN CONVERTING ENZYME
Rev 301
CPT 82164
NDC NA

Fee $175.00

Self-Pay $65.82

Insurance

Minimum $87.50
Maximum $148.75
Aetna W $51.16
Aetna PPO $145.95
Anthem Blue Priority $46.49
Anthem Blue Preferred $46.49
Anthem PPO $148.75
Aurora Caregiver $48.92
Centivo $54.64
Cigna GPPO $90.95
Cigna PPO $148.04
Common Ground ETF Network $53.07
Common Ground Exchange Envision $53.07
Common Ground Group Envision $53.07
Everpointe Elite $48.78
Health EOS Plus $106.75
Health EOS PPO $140.00
HealthPartners ETF $57.12
HealthPartners Robin Focused $71.46
HealthPartners Broad $131.25
HPS $65.44
HST $66.72
Humana HPN $54.94
Humana HMO $54.94
Humana PPO $148.04
Molina Exchange $55.89
Quartz One $52.97
Quartz Group $59.07
Trilogy $69.05
UHC Individual Exchange $47.90
UHC Charter $47.90
UHC Nexus $47.90
UHC HMO $51.72
UHC PPO $148.05
WPS Aurora Featured Network $62.53
WPS Arise $65.82
WPS Statewide $65.82