ST. LUKE’S CHARGE 10002800 CEFAZOLIN 25MG/ML SOLUTION Insurance and Self Pay Discounts 250 J0690 0781-3451-97 $60.34

Aurora ST. LUKE’S
CHARGE
10002800
CEFAZOLIN 25MG/ML SOLUTION
Rev 250
CPT J0690
NDC 0781-3451-97

Fee $60.34

Self-Pay $32.13

Insurance

Minimum $30.17
Maximum $50.90
Aetna W $24.38
Aetna PPO $49.90
Anthem Blue Priority $26.63
Anthem Blue Preferred $26.63
Anthem PPO $50.90
Aurora Caregiver $28.65
Centivo $28.62
Cigna GPPO $35.53
Cigna PPO $50.76
Common Ground ETF Network $26.64
Common Ground Exchange Envision $26.64
Common Ground Group Envision $26.64
Everpointe Elite $26.19
Health EOS Plus $36.62
Health EOS PPO $47.88
HealthPartners ETF $26.48
HealthPartners Robin Focused $32.87
HealthPartners Broad $45.03
HPS $32.58
HST $33.27
Humana HPN $30.95
Humana HMO $30.95
Humana PPO $50.59
Molina Exchange $27.70
Quartz One $25.95
Quartz Group $28.75
Trilogy $34.38
UHC Individual Exchange $28.73
UHC Charter $28.73
UHC Nexus $28.73
UHC HMO $31.20
UHC PPO $50.61
WPS Aurora Featured Network $30.52
WPS Arise $32.13
WPS Statewide $32.13