ST. LUKE’S CHARGE 10000924 GGT Insurance and Self Pay Discounts 301 82977 $145.00

Aurora ST. LUKE’S
CHARGE
10000924
GGT
Rev 301
CPT 82977
NDC NA

Fee $145.00

Self-Pay $60.21

Insurance

Minimum $72.50
Maximum $114.18
Aetna W $51.64
Aetna PPO $110.36
Anthem Blue Priority $48.90
Anthem Blue Preferred $48.90
Anthem PPO $111.32
Aurora Caregiver $47.49
Centivo $51.69
Cigna GPPO $84.84
Cigna PPO $114.18
Common Ground ETF Network $51.04
Common Ground Exchange Envision $51.04
Common Ground Group Envision $51.04
Everpointe Elite $49.45
Health EOS Plus $82.99
Health EOS PPO $104.06
HealthPartners ETF $54.11
HealthPartners Robin Focused $65.88
HealthPartners Broad $101.92
HPS $58.03
HST $58.23
Humana HPN $51.41
Humana HMO $51.41
Humana PPO $109.08
Molina Exchange $53.52
Quartz One $50.43
Quartz Group $55.86
Trilogy $63.70
UHC Individual Exchange $49.22
UHC Charter $49.22
UHC Nexus $49.22
UHC HMO $51.85
UHC PPO $109.16
WPS Aurora Featured Network $57.20
WPS Arise $60.21
WPS Statewide $60.21