ST. LUKE’S CHARGE 10001249 BETA 2 GLYCOPROTEIN I AB Insurance and Self Pay Discounts 302 86146 $130.00

Aurora ST. LUKE’S
CHARGE
10001249
BETA 2 GLYCOPROTEIN I AB
Rev 302
CPT 86146
NDC NA

Fee $130.00

Self-Pay $50.11

Insurance

Minimum $65.00
Maximum $110.50
Aetna W $37.78
Aetna PPO $108.42
Anthem Blue Priority $30.51
Anthem Blue Preferred $30.51
Anthem PPO $110.50
Aurora Caregiver $31.39
Centivo $39.15
Cigna GPPO $74.96
Cigna PPO $109.97
Common Ground ETF Network $38.48
Common Ground Exchange Envision $38.48
Common Ground Group Envision $38.48
Everpointe Elite $34.53
Health EOS Plus $79.30
Health EOS PPO $104.00
HealthPartners ETF $42.29
HealthPartners Robin Focused $53.29
HealthPartners Broad $97.50
HPS $46.75
HST $48.36
Humana HPN $38.78
Humana HMO $38.78
Humana PPO $109.97
Molina Exchange $42.55
Quartz One $41.14
Quartz Group $46.00
Trilogy $53.26
UHC Individual Exchange $29.39
UHC Charter $29.39
UHC Nexus $29.39
UHC HMO $31.51
UHC PPO $109.98
WPS Aurora Featured Network $47.60
WPS Arise $50.11
WPS Statewide $50.11