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Immunoassay for tumor antigen, quantitative; CA125

2020 CPT/HCPCS Primary Code 86304
Negotiated Private Fee $28.00
Prossam $43.00
Champva $20.81
First Medical $39.00
First Medical Vital $19.19
Plan de Salud Menonita $17.00
Menonita Vital $19.19
Humana Gold plus/ Gold choice $20.81
Humana $45.00
Mapfre $65.00
Mcs Classicare $20.81
MCS Life $27.42
Medicare $20.81
MMM $28.51
MMM Vital $17.99
Panamerican Life $60.00
PMC $28.51
Tricare $20.81
Triple S Salud $39.83
Triple S Vital $29.94
Triple S Advantage $51.40
Negotiated Minimum Charge $17.00
Negotiated Maximus Charge $65.00
Discounted Cash Price $22.40

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