ST. LUKE’S CHARGE 10001672 BORDETELLA PERTUSSIS PCR Insurance and Self Pay Discounts 306 87798 $305.00

Aurora ST. LUKE’S
CHARGE
10001672
BORDETELLA PERTUSSIS PCR
Rev 306
CPT 87798
NDC NA

Fee $305.00

Self-Pay $239.01

Insurance

Minimum $152.50
Maximum $259.25
Aetna W $184.27
Aetna PPO $254.36
Anthem Blue Priority $187.33
Anthem Blue Preferred $187.33
Anthem PPO $259.25
Aurora Caregiver $192.41
Centivo $193.78
Cigna GPPO $185.83
Cigna PPO $258.01
Common Ground ETF Network $169.15
Common Ground Exchange Envision $169.15
Common Ground Group Envision $169.15
Everpointe Elite $168.59
Health EOS Plus $186.05
Health EOS PPO $244.00
HealthPartners ETF $180.18
HealthPartners Robin Focused $223.80
HealthPartners Broad $228.75
HPS $203.57
HST $217.68
Humana HPN $203.87
Humana HMO $203.87
Humana PPO $258.01
Molina Exchange $202.04
Quartz One $195.56
Quartz Group $223.50
Trilogy $239.12
UHC Individual Exchange $138.72
UHC Charter $138.72
UHC Nexus $138.72
UHC HMO $149.59
UHC PPO $258.03
WPS Aurora Featured Network $227.06
WPS Arise $239.01
WPS Statewide $239.01