MR pelvis with and without contrast
| 2020 CPT/HCPCS | 72197 |
| Negotiated Private Fee | $730.00 |
| Prossam | $500.00 |
| Champva | $391.47 |
| First Medical | $625.00 |
| First Medical Vital | $279.36 |
| Plan de Salud Menonita | $575.00 |
| Menonita Vital | $349.53 |
| Humana Gold plus/ Gold choice | Ambulatory Payment classification (APC) |
| Humana | $575.00 |
| Mapfre | $650.00 |
| Mcs Classicare | $581.26 |
| MCS Life | $620.00 |
| Medicare | Ambulatory Payment classification (APC) |
| MMM | $419.92 |
| MMM Vital | $305.84 |
| Panamerican Life | $775.00 |
| PMC | $419.92 |
| Tricare | $371.83 |
| Triple S Salud | $650.00 |
| Triple S Vital | $262.50 |
| Triple S Advantage | Ambulatory Payment classification (APC) |
| Negotiated Minimum Charge | $279.36 |
| Negotiated Maximus Charge | $775.00 |
| Discounted Cash Price | $584.00 |
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