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MRI scan of brain, with contrast

2020 CPT/HCPCS 70552
Negotiated Private Fee $720.00
Prossam $500.00
Champva $308.93
First Medical $625.00
First Medical Vital $220.87
Plan de Salud Menonita $647.00
Menonita Vital $262.91
Humana Gold plus/ Gold choice Ambulatory Payment classification (APC)
Humana $720.00
Mapfre $650.00
Mcs Classicare $387.50
MCS Life $387.50
Medicare Ambulatory Payment classification (APC)
MMM $348.63
MMM Vital $230.05
Panamerican Life $725.00
PMC $348.63
Tricare $295.23
Triple S Salud $650.00
Triple S Vital $262.50
Triple S Advantage Ambulatory Payment classification (APC)
Negotiated Minimum Charge $220.87
Negotiated Maximus Charge $725.00
Discounted Cash Price $576.00

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