ST. LUKE’S OP PROC* 12032 INTMD RPR S/A/T/EXT 2.6-7.5 Insurance and Self Pay Discounts NA $5,376.24

Aurora ST. LUKE’S
OP PROC*
12032
INTMD RPR S/A/T/EXT 2.6-7.5
Rev NA
CPT NA
NDC NA

Fee $5,376.24

Self-Pay $2,054.66

Insurance

Minimum $2,688.12
Maximum $4,569.80
Aetna W $1,936.05
Aetna PPO $4,483.66
Anthem Blue Priority $1,150.58
Anthem Blue Preferred $1,150.58
Anthem PPO $4,569.80
Aurora Caregiver $1,403.92
Centivo $1,878.67
Cigna GPPO $2,113.39
Cigna PPO $4,547.86
Common Ground ETF Network $1,506.06
Common Ground Exchange Envision $1,506.06
Common Ground Group Envision $1,506.06
Everpointe Elite $1,291.81
Health EOS Plus $3,225.75
Health EOS PPO $4,300.99
HealthPartners ETF $1,980.57
HealthPartners Robin Focused $2,644.59
HealthPartners Broad $4,032.18
HPS $2,307.70
HST $1,992.05
Humana HPN $2,043.70
Humana HMO $2,043.70
Humana PPO $4,547.86
Molina Exchange $1,781.99
Quartz One $1,567.41
Quartz Group $1,714.28
Trilogy $2,112.61
UHC Individual Exchange $1,620.94
UHC Charter $1,639.80
UHC Nexus $1,639.80
UHC HMO $1,760.22
UHC PPO $4,548.29
WPS Aurora Featured Network $1,951.93
WPS Arise $2,054.66
WPS Statewide $2,054.66