ST. LUKE’S CHARGE 10002172 INJECTION(S) TENDON SHEATH Insurance and Self Pay Discounts 360 20550 $1,100.00

Aurora ST. LUKE’S
CHARGE
10002172
INJECTION(S) TENDON SHEATH
Rev 360
CPT 20550
NDC NA

Fee $1,100.00

Self-Pay $498.21

Insurance

Minimum $550.00
Maximum $928.19
Aetna W $389.84
Aetna PPO $909.55
Anthem Blue Priority $402.71
Anthem Blue Preferred $402.71
Anthem PPO $928.19
Aurora Caregiver $443.18
Centivo $441.34
Cigna GPPO $560.84
Cigna PPO $925.67
Common Ground ETF Network $402.59
Common Ground Exchange Envision $402.59
Common Ground Group Envision $402.59
Everpointe Elite $402.86
Health EOS Plus $667.89
Health EOS PPO $873.19
HealthPartners ETF $450.38
HealthPartners Robin Focused $575.16
HealthPartners Broad $821.10
HPS $512.26
HST $502.14
Humana HPN $488.35
Humana HMO $488.35
Humana PPO $922.77
Molina Exchange $432.30
Quartz One $395.33
Quartz Group $439.17
Trilogy $553.54
UHC Individual Exchange $440.32
UHC Charter $445.44
UHC Nexus $445.44
UHC HMO $486.02
UHC PPO $922.89
WPS Aurora Featured Network $473.30
WPS Arise $498.21
WPS Statewide $498.21