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MRI scan of brain before and after contrast

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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