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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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