ST. LUKE’S OP PROC* 92978 ENDOLUMINL IVUS OCT C 1ST Insurance and Self Pay Discounts NA $92,628.52

Aurora ST. LUKE’S
OP PROC*
92978
ENDOLUMINL IVUS OCT C 1ST
Rev NA
CPT NA
NDC NA

Fee $92,628.52

Self-Pay $33,223.68

Insurance

Minimum $46,314.26
Maximum $78,734.24
Aetna W $40,092.54
Aetna PPO $77,250.11
Anthem Blue Priority $25,110.06
Anthem Blue Preferred $25,110.06
Anthem PPO $78,734.24
Aurora Caregiver $29,416.34
Centivo $30,233.18
Cigna GPPO $19,316.34
Cigna PPO $78,356.31
Common Ground ETF Network $22,960.01
Common Ground Exchange Envision $22,960.01
Common Ground Group Envision $22,960.01
Everpointe Elite $24,168.85
Health EOS Plus $55,577.11
Health EOS PPO $74,102.81
HealthPartners ETF $34,123.68
HealthPartners Robin Focused $45,564.41
HealthPartners Broad $69,471.39
HPS $29,661.48
HST $30,830.98
Humana HPN $30,042.09
Humana HMO $30,042.09
Humana PPO $78,356.31
Molina Exchange $26,307.57
Quartz One $25,305.64
Quartz Group $28,115.59
Trilogy $35,050.04
UHC Individual Exchange $26,867.15
UHC Charter $27,179.72
UHC Nexus $27,179.72
UHC HMO $29,453.16
UHC PPO $78,363.72
WPS Aurora Featured Network $31,562.50
WPS Arise $33,223.68
WPS Statewide $33,223.68