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MRI Chest without contrast

2020 CPT/HCPCS 71550
Negotiated Private Fee $650.00
Prossam $500.00
Champva $303.43
First Medical $625.00
First Medical Vital $216.87
Plan de Salud Menonita $575.00
Menonita Vital $247.04
Humana Gold plus/ Gold choice Ambulatory Payment classification (APC)
Humana $650.00
Mapfre $650.00
Mcs Classicare $390.00
MCS Life $455.00
Medicare Ambulatory Payment classification (APC)
MMM $291.61
MMM Vital $283.84
Panamerican Life $300.00
PMC $291.61
Tricare $308.22
Triple S Salud $650.00
Triple S Vital $262.50
Triple S Advantage Ambulatory Payment classification (APC)
Negotiated Minimum Charge $216.87
Negotiated Maximus Charge $650.00
Discounted Cash Price $520.00

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