2020 CPT/HCPCS Primary Code | 84155 |
Negotiated Private Fee | $5.00 |
Prossam | $6.00 |
Champva | $3.67 |
First Medical | $6.00 |
First Medical Vital | $3.50 |
Plan de Salud Menonita | $7.00 |
Menonita Vital | $3.50 |
Humana Gold plus/ Gold choice | $3.67 |
Humana | $7.00 |
Mapfre | $10.00 |
Mcs Classicare | $3.67 |
MCS Life | $8.00 |
Medicare | $3.67 |
MMM | $5.19 |
MMM Vital | $3.17 |
Panamerican Life | $9.00 |
PMC | $5.19 |
Tricare | $3.67 |
Triple S Salud | $6.49 |
Triple S Vital | $5.45 |
Triple S Advantage | $9.06 |
Negotiated Minimum Charge | $3.17 |
Negotiated Maximus Charge | $10.00 |
Discounted Cash Price | $4.00 |
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