ST. LUKE’S CHARGE 10002360 ANESTH GENERAL/FM 1ST 1/2 HR Insurance and Self Pay Discounts 370 NA $2,870.00

Aurora ST. LUKE’S
CHARGE
10002360
ANESTH GENERAL/FM 1ST 1/2 HR
Rev 370
CPT NA
NDC NA

Fee $2,870.00

Self-Pay $1,401.99

Insurance

Minimum $1,435.00
Maximum $2,420.35
Aetna W $1,038.37
Aetna PPO $2,371.79
Anthem Blue Priority $1,130.15
Anthem Blue Preferred $1,130.15
Anthem PPO $2,420.35
Aurora Caregiver $1,235.94
Centivo $1,257.51
Cigna GPPO $1,623.09
Cigna PPO $2,414.17
Common Ground ETF Network $1,140.59
Common Ground Exchange Envision $1,140.59
Common Ground Group Envision $1,140.59
Everpointe Elite $1,135.90
Health EOS Plus $1,741.94
Health EOS PPO $2,276.85
HealthPartners ETF $1,211.83
HealthPartners Robin Focused $1,528.66
HealthPartners Broad $2,141.56
HPS $1,416.78
HST $1,417.78
Humana HPN $1,354.87
Humana HMO $1,354.87
Humana PPO $2,406.01
Molina Exchange $1,206.44
Quartz One $1,122.39
Quartz Group $1,247.30
Trilogy $1,538.71
UHC Individual Exchange $1,197.48
UHC Charter $1,211.41
UHC Nexus $1,211.41
UHC HMO $1,320.99
UHC PPO $2,406.34
WPS Aurora Featured Network $1,331.89
WPS Arise $1,401.99
WPS Statewide $1,401.99