CT Upper Extremity before and after contrast
| 2020 CPT/HCPCS | 73202 |
| Negotiated Private Fee | $450.00 |
| Prossam | $260.00 |
| Champva | $239.83 |
| First Medical | $275.00 |
| First Medical Vital | $172.37 |
| Plan de Salud Menonita | $300.00 |
| Menonita Vital | $227.66 |
| Humana Gold plus/ Gold choice | Ambulatory Payment classification (APC) |
| Humana | $280.00 |
| Mapfre | $325.00 |
| Mcs Classicare | $310.00 |
| MCS Life | $315.00 |
| Medicare | Ambulatory Payment classification (APC) |
| MMM | $236.78 |
| MMM Vital | $199.21td> |
| Panamerican Life | $400.00 |
| PMC | $236.78 |
| Tricare | $243.43 |
| Triple S Salud | $300.00 |
| Triple S Vital | $240.00 |
| Triple S Advantage | Ambulatory Payment classification (APC) |
| Negotiated Minimum Charge | $172.37 |
| Negotiated Maximus Charge | $400.00 |
| Discounted Cash Price | $360.00 |
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