2020 CPT/HCPCS Primary Code | 84100 |
Negotiated Private Fee | $5.00 |
Prossam | $7.00 |
Champva | $4.74 |
First Medical | $7.00 |
First Medical Vital | $4.52 |
Plan de Salud Menonita | $6.00 |
Menonita Vital | $4.52 |
Humana Gold plus/ Gold choice | $4.74 |
Humana | $6.00 |
Mapfre | $10.00 |
Mcs Classicare | $4.74 |
MCS Life | $6.46 |
Medicare | $4.74 |
MMM | $6.72 |
MMM Vital | $4.10 |
Panamerican Life | $8.00 |
PMC | $6.72 |
Tricare | $4.74 |
Triple S Salud | $7.00 |
Triple S Vital | $7.06 |
Triple S Advantage | $11.70 |
Negotiated Minimum Charge | $4.10 |
Negotiated Maximus Charge | $11.70 |
Discounted Cash Price | $4.00 |
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