2020 CPT/HCPCS | 76700 |
Negotiated Private Fee | $110.00 |
Prossam | $90.00 |
Champva | $125.30 |
First Medical | $70.00 |
First Medical Vital | $88.17 |
Plan de Salud Menonita | $100.00 |
Menonita Vital | $88.40 |
Humana Gold plus/ Gold choice | Ambulatory Payment classification (APC) |
Humana | $90.00 |
Mapfre | $100.00 |
Mcs Classicare | $90.00 |
MCS Life | $90.00 |
Medicare | Ambulatory Payment classification (APC) |
MMM | $101.99 |
MMM Vital | $88.40 |
Panamerican Life | $90.00 |
PMC | $101.99 |
Tricare | $122.87 |
Triple S Salud | $100.00 |
Triple S Vital | $46.29 |
Triple S Advantage | Ambulatory Payment classification (APC) |
Negotiated Minimum Charge | $46.29 |
Negotiated Maximus Charge | $125.30 |
Discounted Cash Price | $88.00 |
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