ST. LUKE’S CHARGE 10000870 CREATININE CLEARANCE Insurance and Self Pay Discounts 301 82575 $155.00

Aurora ST. LUKE’S
CHARGE
10000870
CREATININE CLEARANCE
Rev 301
CPT 82575
NDC NA

Fee $155.00

Self-Pay $47.93

Insurance

Minimum $77.50
Maximum $131.75
Aetna W $38.65
Aetna PPO $129.27
Anthem Blue Priority $31.71
Anthem Blue Preferred $31.71
Anthem PPO $131.75
Aurora Caregiver $29.50
Centivo $36.36
Cigna GPPO $97.53
Cigna PPO $131.12
Common Ground ETF Network $37.63
Common Ground Exchange Envision $37.63
Common Ground Group Envision $37.63
Everpointe Elite $32.08
Health EOS Plus $94.55
Health EOS PPO $124.00
HealthPartners ETF $36.20
HealthPartners Robin Focused $45.08
HealthPartners Broad $116.25
HPS $42.99
HST $46.83
Humana HPN $34.81
Humana HMO $34.81
Humana PPO $131.12
Molina Exchange $41.39
Quartz One $42.37
Quartz Group $48.64
Trilogy $51.76
UHC Individual Exchange $29.25
UHC Charter $29.25
UHC Nexus $29.25
UHC HMO $31.34
UHC PPO $131.13
WPS Aurora Featured Network $45.53
WPS Arise $47.93
WPS Statewide $47.93