DETAIL FOR SERVICES: | Study | Radiologist reading (interpretation) |
2020 CPT/HCPCS Primary Code | 77046 | Not provided by Hospital (may be billed separately) |
Negotiated Private Fee | $650.00 | Not provided by Hospital (may be billed separately) |
Prossam | $125.00 | Not provided by Hospital (may be billed separately) |
Champva | $233.49 | Not provided by Hospital (may be billed separately) |
First Medical | $312.50 | Not provided by Hospital (may be billed separately) |
First Medical Vital | $126.00 | Not provided by Hospital (may be billed separately) |
Plan de Salud Menonita | $276.25 | Not provided by Hospital (may be billed separately) |
Menonita Vital | $276.25 | Not provided by Hospital (may be billed separately) |
Humana Gold Plus / Gold Choice | Ambulatory Payment classification (APC) | Not provided by Hospital (may be billed separately) |
Humana | $325.00 | Not provided by Hospital (may be billed separately) |
Mapfre | $325.00 | Not provided by Hospital (may be billed separately) |
Mcsclassicare | $127.17 | Not provided by Hospital (may be billed separately) |
MCS Life | $127.17 | Not provided by Hospital (may be billed separately) |
Medicare | $239.78 | Not provided by Hospital (may be billed separately) |
MMM | $233.49 | Not provided by Hospital (may be billed separately) |
MMM Vital | $126.00 | Not provided by Hospital (may be billed separately) |
Panamerican Life | $387.50 | Not provided by Hospital (may be billed separately) |
PMC | $233.49 | Not provided by Hospital (may be billed separately) |
Tricare | $233.59 | Not provided by Hospital (may be billed separately) |
Triple S Salud | $325.00 | Not provided by Hospital (may be billed separately) |
Triple S Vital | $332.71 | Not provided by Hospital (may be billed separately) |
Triple S Advantage | Ambulatory Payment classification (APC) | Not provided by Hospital (may be billed separately) |
Negotiated Minimum Charge | $125.00 | Not provided by Hospital (may be billed separately) |
Negotiated Maximum Charge | $387.50 | Not provided by Hospital (may be billed separately) |
Discounted Cash Price | $520.00 | Not provided by Hospital (may be billed separately) |
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