2020 CPT/HCPCS | 70553 |
Negotiated Private Fee | $730.00 |
Prossam | $500.00 |
Champva | $364.70 |
First Medical | $625.00 |
First Medical Vital | $261.00 |
Plan de Salud Menonita | $657.00 |
Menonita Vital | $310.07 |
Humana Gold plus/ Gold choice | Ambulatory Payment classification (APC) |
Humana | $725.00 |
Mapfre | $650.00 |
Mcs Classicare | $387.50 |
MCS Life | $542.50 |
Medicare | Ambulatory Payment classification (APC) |
MMM | $411.26 |
MMM Vital | $271.31 |
Panamerican Life | $775.00 |
PMC | $411.26 |
Tricare | $348.43 |
Triple S Salud | $650.00 |
Triple S Vital | $262.50 |
Triple S Advantage | Ambulatory Payment classification (APC) |
Negotiated Minimum Charge | $261.00 |
Negotiated Maximus Charge | $775.00 |
Discounted Cash Price | $584.00 |
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