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Ultrasound pelvis through vagina

2020 CPT/HCPCS 76830
Negotiated Private Fee $110.00
Prossam $110.00
Champva $127.80
First Medical $40.00
First Medical Vital Not Covered
Plan de Salud Menonita $100.00
Menonita Vital $88.20
Humana Gold plus/ Gold choice Ambulatory Payment classification (APC)
Humana $85.00
Mapfre $125.00
Mcs Classicare $100.00
MCS Life $100.00
Medicare Ambulatory Payment classification (APC)
MMM $75.60
MMM Vital $88.20
Panamerican Life $95.00
PMC $75.60
Tricare $125.70
Triple S Salud $100.00
Triple S Vital $46.31
Triple S Advantage Ambulatory Payment classification (APC)
Negotiated Minimum Charge $40.00
Negotiated Maximus Charge $127.80
Discounted Cash Price $88.00

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