MRI Orbit, Face and Neck without contrast
| 2020 CPT/HCPCS | 70540 |
| Negotiated Private Fee | $650.00 |
| Prossam | $500.00 |
| Champva | $261.25 |
| First Medical | $625.00 |
| First Medical Vital | $186.60 |
| Plan de Salud Menonita | $575.00 |
| Menonita Vital | $222.42 |
| 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 | $286.95 |
| MMM Vital | $194.61 |
| Panamerican Life | $650.00 |
| PMC | $286.95 |
| Tricare | $248.62 |
| Triple S Salud | $650.00 |
| Triple S Vital | $262.50 |
| Triple S Advantage | Ambulatory Payment classification (APC) |
| Negotiated Minimum Charge | $186.60 |
| Negotiated Maximus Charge | $650.00 |
| Discounted Cash Price | $520.00 |
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