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CT cervical spine before and after contrast

2020 CPT/HCPCS 72127
Negotiated Private Fee $450.00
Prossam $260.00
Champva $220.13
First Medical $275.00
First Medical Vital $164.72
Plan de Salud Menonita $300.00
Menonita Vital $221.27
Humana Gold plus/ Gold choice Ambulatory Payment classification (APC)
Humana $285.00
Mapfre $325.00
Mcs Classicare $300.00
MCS Life $294.00
Medicare Ambulatory Payment classification (APC)
MMM $228.57
MMM Vital $193.61
Panamerican Life $400.00
PMC $228.57
Tricare $215.15
Triple S Salud $275.00
Triple S Vital $115.50
Triple S Advantage Ambulatory Payment classification (APC)
Negotiated Minimum Charge $115.50
Negotiated Maximus Charge $400.00
Discounted Cash Price $360.00

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