ST. LUKE’S CHARGE 10002590 MISC PROCEDURE ENT Insurance and Self Pay Discounts 440 92700 $160.00

Aurora ST. LUKE’S
CHARGE
10002590
MISC PROCEDURE ENT
Rev 440
CPT 92700
NDC NA

Fee $160.00

Self-Pay $78.49

Insurance

Minimum $80.00
Maximum $135.41
Aetna W $62.46
Aetna PPO $132.53
Anthem Blue Priority $66.65
Anthem Blue Preferred $66.65
Anthem PPO $135.41
Aurora Caregiver $70.94
Centivo $72.18
Cigna GPPO $81.09
Cigna PPO $134.93
Common Ground ETF Network $73.68
Common Ground Exchange Envision $73.68
Common Ground Group Envision $73.68
Everpointe Elite $65.16
Health EOS Plus $97.33
Health EOS PPO $127.41
HealthPartners ETF $66.21
HealthPartners Robin Focused $80.79
HealthPartners Broad $119.67
HPS $84.79
HST $80.96
Humana HPN $73.40
Humana HMO $73.40
Humana PPO $134.59
Molina Exchange $65.99
Quartz One $65.69
Quartz Group $73.65
Trilogy $82.80
UHC Individual Exchange $74.71
UHC Charter $75.58
UHC Nexus $75.58
UHC HMO $81.93
UHC PPO $134.70
WPS Aurora Featured Network $74.57
WPS Arise $78.49
WPS Statewide $78.49