CT lumbar spine without contrast
| 2020 CPT/HCPCS | 72131 |
| Negotiated Private Fee | $350.00 |
| Prossam | $260.00 |
| Champva | $143.17 |
| First Medical | $275.00 |
| First Medical Vital | $110.80 |
| Plan de Salud Menonita | $300.00 |
| Menonita Vital | $133.46 |
| Humana Gold plus/ Gold choice | Ambulatory Payment classification (APC) |
| Humana | $275.00 |
| Mapfre | $300.00 |
| Mcs Classicare | $210.00 |
| MCS Life | $225.00 |
| Medicare | Ambulatory Payment classification (APC) |
| MMM | $154.19 |
| MMM Vital | $116.78 |
| Panamerican Life | $300.00 |
| PMC | $154.19 |
| Tricare | $139.56 |
| Triple S Salud | $275.00 |
| Triple S Vital | $115.50 |
| Triple S Advantage | Ambulatory Payment classification (APC) |
| Negotiated Minimum Charge | $110.80 |
| Negotiated Maximus Charge | $300.00 |
| Discounted Cash Price | $280.00 |
© 2024 Liga Puertorriqueña Contra el Cáncer. Diseñado por Wigo Technologies.
Política de Privacidad | Acreditaciones | Price Transparency
