XR abdomen 2 views
| 2020 CPT/HCPCS | 74019 |
| Negotiated Private Fee | $60.00 |
| Prossam | $23.00 |
| Champva | $37.90 |
| First Medical | Not covered |
| First Medical Vital | $26.54 |
| Plan de Salud Menonita | $32.00 |
| Menonita Vital | $25.66 |
| Humana Gold plus/ Gold choice | Ambulatory Payment classification (APC) |
| Humana | $26.00 |
| Mapfre | $34.00 |
| Mcs Classicare | $22.31 |
| MCS Life | $22.31 |
| Medicare | Ambulatory Payment classification (APC) |
| MMM | $31.20 |
| MMM Vital | $25.66 |
| Panamerican Life | Not Covered |
| PMC | $31.20 |
| Tricare | $38.30 |
| Triple S Salud | $32.00 |
| Triple S Vital | $13.47 |
| Triple S Advantage | Ambulatory Payment classification (APC) |
| Negotiated Minimum Charge | $13.47 |
| Negotiated Maximus Charge | $38.30 |
| Discounted Cash Price | $48.00 |
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