XR temporomandibular joint, open and closed mouth; bilateral
| 2020 CPT/HCPCS | 70330 |
| Negotiated Private Fee | $80.00 |
| Prossam | $23.00 |
| Champva | $54.78 |
| First Medical | $26.00 |
| First Medical Vital | $38.35 |
| Plan de Salud Menonita | $40.00 |
| Menonita Vital | $36.86 |
| Humana Gold plus/ Gold choice | Ambulatory Payment classification (APC) |
| Humana | $33.00 |
| Mapfre | $38.00 |
| Mcs Classicare | $38.00 |
| MCS Life | $38.00 |
| Medicare | Ambulatory Payment classification (APC) |
| MMM | $36.24 |
| MMM Vital | $36.86 |
| Panamerican Life | $40.00 |
| PMC | $36.24 |
| Tricare | $55.73 |
| Triple S Salud | $40.00 |
| Triple S Vital | $19.35 |
| Triple S Advantage | Ambulatory Payment classification (APC) |
| Negotiated Minimum Charge | $23.00 |
| Negotiated Maximus Charge | $54.78 |
| Discounted Cash Price | $64.00 |
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