ST. LUKE’S CHARGE 10000887 ESTRIOL Insurance and Self Pay Discounts 301 82677 $110.00

Aurora ST. LUKE’S
CHARGE
10000887
ESTRIOL
Rev 301
CPT 82677
NDC NA

Fee $110.00

Self-Pay $51.61

Insurance

Minimum $55.00
Maximum $92.13
Aetna W $40.58
Aetna PPO $90.02
Anthem Blue Priority $39.67
Anthem Blue Preferred $39.67
Anthem PPO $92.13
Aurora Caregiver $40.70
Centivo $43.59
Cigna GPPO $65.08
Cigna PPO $92.04
Common Ground ETF Network $42.67
Common Ground Exchange Envision $42.67
Common Ground Group Envision $42.67
Everpointe Elite $39.39
Health EOS Plus $66.45
Health EOS PPO $86.60
HealthPartners ETF $41.89
HealthPartners Robin Focused $51.27
HealthPartners Broad $81.68
HPS $50.15
HST $51.92
Humana HPN $44.00
Humana HMO $44.00
Humana PPO $91.35
Molina Exchange $44.07
Quartz One $43.41
Quartz Group $48.82
Trilogy $55.05
UHC Individual Exchange $41.20
UHC Charter $41.20
UHC Nexus $41.20
UHC HMO $44.30
UHC PPO $91.47
WPS Aurora Featured Network $49.03
WPS Arise $51.61
WPS Statewide $51.61