ST. LUKE’S IP DRG* 987 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC Insurance and Self Pay Discounts NA $161,619.06

Aurora ST. LUKE’S
IP DRG*
987
NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC
Rev NA
CPT NA
NDC NA

Fee $161,619.06

Self-Pay $98,216.48

Insurance

Minimum $80,809.53
Maximum $137,376.21
Aetna W $73,920.67
Aetna PPO $134,786.68
Anthem Blue Priority $72,290.24
Anthem Blue Preferred $72,290.24
Anthem PPO $137,376.21
Aurora Caregiver $80,414.16
Centivo $81,341.57
Cigna GPPO $89,352.31
Cigna PPO $136,716.80
Common Ground ETF Network $83,513.22
Common Ground Exchange Envision $83,513.22
Common Ground Group Envision $83,513.22
Everpointe Elite $74,417.47
Health EOS Plus $98,587.63
Health EOS PPO $129,295.25
HealthPartners ETF $74,455.12
HealthPartners Robin Focused $103,147.11
HealthPartners Broad $121,214.29
HPS $96,944.08
HST $97,766.64
Humana HPN $78,369.92
Humana HMO $78,369.92
Humana PPO $136,716.80
Molina Exchange $75,425.21
Quartz One $71,457.28
Quartz Group $78,849.78
Trilogy $93,029.04
UHC Individual Exchange $111,633.12
UHC Charter $112,931.84
UHC Nexus $112,931.84
UHC HMO $120,796.47
UHC PPO $136,729.72
WPS Aurora Featured Network $93,305.66
WPS Arise $98,216.48
WPS Statewide $98,216.48