XR ribs unilateral 2 views
| 2020 CPT/HCPCS | 71100 |
| Negotiated Private Fee | $45.00 |
| Prossam | $23.00 |
| Champva | $37.56 |
| First Medical | $28.00 |
| First Medical Vital | $30.22 |
| Plan de Salud Menonita | $31.00 |
| Menonita Vital | $25.41 |
| Humana Gold plus/ Gold choice | Ambulatory Payment classification (APC) |
| Humana | $27.00 |
| Mapfre | $28.00 |
| Mcs Classicare | $28.00 |
| MCS Life | $28.00 |
| Medicare | Ambulatory Payment classification (APC) |
| MMM | $24.71 |
| MMM Vital | $25.41 |
| Panamerican Life | $34.00 |
| PMC | $24.71 |
| Tricare | $43.86 |
| Triple S Salud | $35.00 |
| Triple S Vital | $16.89 |
| Triple S Advantage | Ambulatory Payment classification (APC) |
| Negotiated Minimum Charge | $16.89 |
| Negotiated Maximus Charge | $43.86 |
| Discounted Cash Price | $36.00 |
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