XR temporomandibular joint, open and closed mouth; unilateral
| 2020 CPT/HCPCS | 70328 |
| Negotiated Private Fee | $40.00 |
| Prossam | $14.00 |
| Champva | $35.46 |
| First Medical | $16.00 |
| First Medical Vital | $24.82 |
| Plan de Salud Menonita | $20.00 |
| Menonita Vital | $23.89 |
| Humana Gold plus/ Gold choice | Ambulatory Payment classification (APC) |
| Humana | $21.00 |
| Mapfre | $22.00 |
| Mcs Classicare | $23.32 |
| MCS Life | $28.80 |
| Medicare | Ambulatory Payment classification (APC) |
| MMM | $24.05 |
| MMM Vital | $23.89 |
| Panamerican Life | $32.00 |
| PMC | $24.05 |
| Tricare | $36.21 |
| Triple S Salud | $27.00 |
| Triple S Vital | $12.55 |
| Triple S Advantage | Ambulatory Payment classification (APC) |
| Negotiated Minimum Charge | $14.00 |
| Negotiated Maximus Charge | $35.46 |
| Discounted Cash Price | $32.00 |
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