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2020 CPT/HCPCS Primary Code 85002
Negotiated Private Fee $13.00
Prossam $6.00
Champva $4.82
First Medical $3.00
First Medical Vital $3.37
Plan de Salud Menonita $2.00
Menonita Vital $3.35
Humana Gold plus/ Gold choice $4.82
Humana $5.00
Mapfre $12.00
Mcs Classicare $4.82
MCS Life $3.00
Medicare $4.82
MMM $4.99
MMM Vital $3.90
Panamerican Life $3.00
PMC $4.99
Tricare $4.82
Triple S Salud $5.04
Triple S Vital $5.24
Triple S Advantage $11.14
Negotiated Minimum Charge $2.00
Negotiated Maximus Charge $12.00
Discounted Cash Price $10.40

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