ST. LUKE’S CHARGE 10000964 MYELOPEROXIDASE AB Insurance and Self Pay Discounts 301 83516 $135.00

Aurora ST. LUKE’S
CHARGE
10000964
MYELOPEROXIDASE AB
Rev 301
CPT 83516
NDC NA

Fee $135.00

Self-Pay $42.59

Insurance

Minimum $67.50
Maximum $114.75
Aetna W $31.68
Aetna PPO $112.59
Anthem Blue Priority $25.24
Anthem Blue Preferred $25.24
Anthem PPO $114.75
Aurora Caregiver $25.95
Centivo $33.55
Cigna GPPO $75.93
Cigna PPO $114.20
Common Ground ETF Network $32.29
Common Ground Exchange Envision $32.29
Common Ground Group Envision $32.29
Everpointe Elite $29.29
Health EOS Plus $82.35
Health EOS PPO $108.00
HealthPartners ETF $36.00
HealthPartners Robin Focused $45.31
HealthPartners Broad $101.25
HPS $40.81
HST $40.69
Humana HPN $32.97
Humana HMO $32.97
Humana PPO $114.20
Molina Exchange $35.90
Quartz One $33.62
Quartz Group $37.36
Trilogy $45.46
UHC Individual Exchange $26.40
UHC Charter $26.40
UHC Nexus $26.40
UHC HMO $28.38
UHC PPO $114.21
WPS Aurora Featured Network $40.46
WPS Arise $42.59
WPS Statewide $42.59