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MR abdomen without contrast

2020 CPT/HCPCS 74181
Negotiated Private Fee $650.00
Prossam $500.00
Champva $224.29
First Medical $625.00
First Medical Vital $175.33
Plan de Salud Menonita $575.00
Menonita Vital $231.67
Humana Gold plus/ Gold choice Ambulatory Payment classification (APC)
Humana $650.00
Mapfre $650.00
Mcs Classicare $380.00
MCS Life $387.50
Medicare Ambulatory Payment classification (APC)
MMM $273.85
MMM Vital $202.71
Panamerican Life $650.00
PMC $273.85
Tricare $214.06
Triple S Salud $650.00
Triple S Vital $262.50
Triple S Advantage Ambulatory Payment classification (APC)
Negotiated Minimum Charge $175.33
Negotiated Maximus Charge $650.00
Discounted Cash Price $520.00

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