2020 CPT/HCPCS | 73552 |
Negotiated Private Fee | $60.00 |
Prossam | $25.00 |
Champva | $36.16 |
First Medical | $21.00 |
First Medical Vital | $25.31 |
Plan de Salud Menonita | $29.00 |
Menonita Vital | $24.65 |
Humana Gold plus/ Gold choice | Ambulatory Payment classification (APC) |
Humana | $26.00 |
Mapfre | $24.00 |
Mcs Classicare | $24.58 |
MCS Life | $24.58 |
Medicare | Ambulatory Payment classification (APC) |
MMM | $24.57 |
MMM Vital | $24.65 |
Panamerican Life | Not Covered |
PMC | $24.57 |
Tricare | $36.57 |
Triple S Salud | $29.00 |
Triple S Vital | $13.32 |
Triple S Advantage | Ambulatory Payment classification (APC) |
Negotiated Minimum Charge | $13.32 |
Negotiated Maximus Charge | $36.57 |
Discounted Cash Price | $48.00 |
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