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Physical Therapy

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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