ST. LUKE’S IP DRG* 252 OTHER VASCULAR PROCEDURES WITH MCC Insurance and Self Pay Discounts NA $193,063.13

Aurora ST. LUKE’S
IP DRG*
252
OTHER VASCULAR PROCEDURES WITH MCC
Rev NA
CPT NA
NDC NA

Fee $193,063.13

Self-Pay $111,051.85

Insurance

Minimum $96,531.57
Maximum $164,103.66
Aetna W $86,595.36
Aetna PPO $161,010.33
Anthem Blue Priority $89,403.64
Anthem Blue Preferred $89,403.64
Anthem PPO $164,103.66
Aurora Caregiver $96,237.50
Centivo $95,909.51
Cigna GPPO $111,464.67
Cigna PPO $163,315.96
Common Ground ETF Network $99,370.38
Common Ground Exchange Envision $99,370.38
Common Ground Group Envision $99,370.38
Everpointe Elite $85,771.83
Health EOS Plus $117,768.51
Health EOS PPO $154,450.50
HealthPartners ETF $88,136.57
HealthPartners Robin Focused $118,865.11
HealthPartners Broad $144,797.35
HPS $114,842.10
HST $113,817.13
Humana HPN $95,684.09
Humana HMO $95,684.09
Humana PPO $163,315.96
Molina Exchange $86,927.00
Quartz One $86,344.55
Quartz Group $97,310.35
Trilogy $109,916.79
UHC Individual Exchange $121,125.39
UHC Charter $122,534.54
UHC Nexus $122,534.54
UHC HMO $131,913.78
UHC PPO $163,331.40
WPS Aurora Featured Network $105,499.26
WPS Arise $111,051.85
WPS Statewide $111,051.85