2020 CPT/HCPCS | 72147 |
Negotiated Private Fee | $720.00 |
Prossam | $500.00 |
Champva | $314.21 |
First Medical | $625.00 |
First Medical Vital | $224.18 |
Plan de Salud Menonita | $700.00 |
Menonita Vital | $265.82 |
Humana Gold plus/ Gold choice | Ambulatory Payment classification (APC) |
Humana | $725.00 |
Mapfre | $650.00 |
Mcs Classicare | $387.50 |
MCS Life | $465.00 |
Medicare | Ambulatory Payment classification (APC) |
MMM | $317.42 |
MMM Vital | $232.59 |
Panamerican Life | $725.00 |
PMC | $317.42 |
Tricare | $299.07 |
Triple S Salud | $650.00 |
Triple S Vital | $262.50 |
Triple S Advantage | Ambulatory Payment classification (APC) |
Negotiated Minimum Charge | $224.18 |
Negotiated Maximus Charge | $725.00 |
Discounted Cash Price | $576.00 |
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