ST. LUKE’S CHARGE 10007164 LEGIONELLA SPECIES BY PCR Insurance and Self Pay Discounts 306 87798 $175.00

Aurora ST. LUKE’S
CHARGE
10007164
LEGIONELLA SPECIES BY PCR
Rev 306
CPT 87798
NDC NA

Fee $175.00

Self-Pay $175.00

Insurance

Minimum $87.50
Maximum $175.00
Aetna W $175.00
Aetna PPO $145.95
Anthem Blue Priority $175.00
Anthem Blue Preferred $175.00
Anthem PPO $148.75
Aurora Caregiver $175.00
Centivo $175.00
Cigna GPPO $175.00
Cigna PPO $148.04
Common Ground ETF Network $169.15
Common Ground Exchange Envision $169.15
Common Ground Group Envision $169.15
Everpointe Elite $168.59
Health EOS Plus $106.75
Health EOS PPO $140.00
HealthPartners ETF $175.00
HealthPartners Robin Focused $175.00
HealthPartners Broad $131.25
HPS $175.00
HST $175.00
Humana HPN $175.00
Humana HMO $175.00
Humana PPO $148.04
Molina Exchange $175.00
Quartz One $175.00
Quartz Group $175.00
Trilogy $175.00
UHC Individual Exchange $138.72
UHC Charter $138.72
UHC Nexus $138.72
UHC HMO $149.59
UHC PPO $148.05
WPS Aurora Featured Network $166.25
WPS Arise $175.00
WPS Statewide $175.00