2020 CPT/HCPCS/DRG | 97110 |
Negotiated Private Fee | $30.00 |
Prossam | $20.00 |
Champva | $30.46 |
First Medical | $15.00 |
First Medical Vital | $10.73 |
Plan de Salud Menonita | $30.00 |
Menonita Vital | $22.04 |
Humana Gold plus/ Gold choice | By Therapy Network |
Humana | $30.00 |
Mapfre | $20.00 |
Mcs Classicare | $20.00 |
MCS Life | $20.00 |
Medicare | Ambulatory Payment classification (APC) |
MMM | By Therapy Network |
MMM Vital | $15.00 |
Panamerican Life | $15.00 |
PMC | By Therapy Network |
Tricare | $30.21 |
Triple S Salud | $20.00 |
Triple S Vital | Not Covered |
Triple S Advantage | Ambulatory Payment classification (APC) |
Negotiated Minimum Charge | $10.73 |
Negotiated Maximus Charge | $30.21 |
Discounted Cash Price | $24.00 |
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