ST. LUKE’S CHARGE 10006868 MEPERIDINE QUANT Insurance and Self Pay Discounts 301 80362 $440.00

Aurora ST. LUKE’S
CHARGE
10006868
MEPERIDINE QUANT
Rev 301
CPT 80362
NDC NA

Fee $440.00

Self-Pay $216.24

Insurance

Minimum $220.00
Maximum $368.50
Aetna W $170.06
Aetna PPO $360.08
Anthem Blue Priority $166.23
Anthem Blue Preferred $166.23
Anthem PPO $368.50
Aurora Caregiver $170.53
Centivo $182.67
Cigna GPPO $272.73
Cigna PPO $368.16
Common Ground ETF Network $178.82
Common Ground Exchange Envision $178.82
Common Ground Group Envision $178.82
Everpointe Elite $165.07
Health EOS Plus $265.80
Health EOS PPO $346.37
HealthPartners ETF $175.54
HealthPartners Robin Focused $214.82
HealthPartners Broad $326.74
HPS $210.15
HST $217.58
Humana HPN $184.40
Humana HMO $184.40
Humana PPO $365.43
Molina Exchange $184.68
Quartz One $181.94
Quartz Group $204.60
Trilogy $230.68
UHC Individual Exchange $172.65
UHC Charter $172.65
UHC Nexus $172.65
UHC HMO $185.62
UHC PPO $365.87
WPS Aurora Featured Network $205.43
WPS Arise $216.24
WPS Statewide $216.24