ST. LUKE’S IP DRG* 737 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC Insurance and Self Pay Discounts NA $133,821.92

Aurora ST. LUKE’S
IP DRG*
737
UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC
Rev NA
CPT NA
NDC NA

Fee $133,821.92

Self-Pay $51,751.61

Insurance

Minimum $66,910.96
Maximum $113,748.64
Aetna W $38,355.95
Aetna PPO $111,604.48
Anthem Blue Priority $42,673.21
Anthem Blue Preferred $42,673.21
Anthem PPO $113,748.64
Aurora Caregiver $46,520.04
Centivo $44,941.11
Cigna GPPO $61,753.89
Cigna PPO $113,202.65
Common Ground ETF Network $43,133.15
Common Ground Exchange Envision $43,133.15
Common Ground Group Envision $43,133.15
Everpointe Elite $41,269.91
Health EOS Plus $81,631.38
Health EOS PPO $107,057.54
HealthPartners ETF $39,757.16
HealthPartners Robin Focused $52,497.09
HealthPartners Broad $100,366.44
HPS $53,134.87
HST $56,697.91
Humana HPN $48,063.84
Humana HMO $48,063.84
Humana PPO $113,202.65
Molina Exchange $42,097.13
Quartz One $40,380.40
Quartz Group $44,901.24
Trilogy $52,179.96
UHC Individual Exchange $45,293.98
UHC Charter $45,820.92
UHC Nexus $45,820.92
UHC HMO $51,068.40
UHC PPO $113,213.35
WPS Aurora Featured Network $49,164.03
WPS Arise $51,751.61
WPS Statewide $51,751.61