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Ultrasound scrotum

2020 CPT/HCPCS 76870
Negotiated Private Fee $100.00
Prossam $60.00
Champva $108.11
First Medical $70.00
First Medical Vital Not Covered
Plan de Salud Menonita $82.00
Menonita Vital $75.23
Humana Gold plus/ Gold choice Ambulatory Payment classification (APC)
Humana $68.00
Mapfre $73.00
Mcs Classicare $72.00
MCS Life $72.00
Medicare Ambulatory Payment classification (APC)
MMM $92.28
MMM Vital $75.23
Panamerican Life $90.00
PMC $92.28
Tricare $31.53
Triple S Salud $82.00
Triple S Vital $39.49
Triple S Advantage Ambulatory Payment classification (APC)
Negotiated Minimum Charge $31.53
Negotiated Maximus Charge $108.11
Discounted Cash Price $80.00

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