ST. LUKE’S CHARGE 10002770 PLATELETS, EACH UNIT Insurance and Self Pay Discounts 390 P9019 $230.00

Aurora ST. LUKE’S
CHARGE
10002770
PLATELETS, EACH UNIT
Rev 390
CPT P9019
NDC NA

Fee $230.00

Self-Pay $122.68

Insurance

Minimum $115.00
Maximum $184.97
Aetna W $108.66
Aetna PPO $174.34
Anthem Blue Priority $116.93
Anthem Blue Preferred $116.93
Anthem PPO $182.00
Aurora Caregiver $117.79
Centivo $119.83
Cigna GPPO $144.59
Cigna PPO $184.97
Common Ground ETF Network $125.12
Common Ground Exchange Envision $125.12
Common Ground Group Envision $125.12
Everpointe Elite $107.89
Health EOS Plus $134.13
Health EOS PPO $170.50
HealthPartners ETF $108.49
HealthPartners Robin Focused $130.75
HealthPartners Broad $164.78
HPS $139.17
HST $136.75
Humana HPN $117.37
Humana HMO $117.37
Humana PPO $179.22
Molina Exchange $111.37
Quartz One $111.18
Quartz Group $126.79
Trilogy $139.85
UHC Individual Exchange $118.98
UHC Charter $120.36
UHC Nexus $120.36
UHC HMO $128.06
UHC PPO $179.32
WPS Aurora Featured Network $116.55
WPS Arise $122.68
WPS Statewide $122.68