XR thoracic spine minimum of 4 views
| 2020 CPT/HCPCS | 72074 |
| Negotiated Private Fee | $75.00 |
| Prossam | $33.00 |
| Champva | $45.64 |
| First Medical | $39.00 |
| First Medical Vital | $31.95 |
| Plan de Salud Menonita | $35.00 |
| Menonita Vital | $30.75 |
| Humana Gold plus/ Gold choice | Ambulatory Payment classification (APC) |
| Humana | $37.00 |
| Mapfre | $36.00 |
| Mcs Classicare | $39.58 |
| MCS Life | $48.00 |
| Medicare | Ambulatory Payment classification (APC) |
| MMM | $33.02 |
| MMM Vital | $30.75 |
| Panamerican Life | $48.00 |
| PMC | $33.02 |
| Tricare | $46.31 |
| Triple S Salud | $39.00 |
| Triple S Vital | $17.91 |
| Triple S Advantage | Ambulatory Payment classification (APC) |
| Negotiated Minimum Charge | $17.91 |
| Negotiated Maximus Charge | $46.31 |
| Discounted Cash Price | $60.00 |
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