BAY AREA CHARGE 10002800 BETAMETHASONE SOD PHOS & ACET 6 (3-3) MG/ML IJ SUSP Insurance and Self Pay Discounts 250 J0702 0517-0720-01 $15.40

Aurora BAY AREA
CHARGE
10002800
BETAMETHASONE SOD PHOS & ACET 6 (3-3) MG/ML IJ SUSP
Rev 250
CPT J0702
NDC 0517-0720-01

Fee $15.40

Self-Pay $12.38
Minimum $7.70
Maximum $14.01

Insurance
Aetna W $11.17
Aetna PPO $12.84
Anthem Blue Priority $9.75
Anthem Blue Preferred $9.75
Anthem PPO $9.35
Aurora Caregiver $10.47
Centivo $11.24
Cigna GPPO $13.19
Cigna PPO $13.19
Common Ground ETF Network $10.97
Common Ground Exchange Envision $10.97
Common Ground Group Envision $10.97
Everpointe Elite $10.67
Health EOS Plus $14.01
Health EOS PPO $14.01
HealthPartners ETF $10.23
HealthPartners Robin Focused $11.64
HealthPartners Broad $11.56
HPS $11.64
HST $11.57
Humana HPN $11.70
Humana HMO $11.70
Humana PPO $13.03
Molina Exchange $12.67
Quartz One $10.69
Quartz Group $11.58
Trilogy $12.26
UHC Individual Exchange $12.36
UHC Charter $12.36
UHC Nexus $12.36
UHC HMO $12.65
UHC PPO $13.03
WPS Aurora Featured Network $11.76
WPS Arise $12.38
WPS Statewide $12.38