XR abdomen 3 or more views
| 2020 CPT/HCPCS | 74021 |
| Negotiated Private Fee | $65.00 |
| Prossam | $23.00 |
| Champva | $43.88 |
| First Medical | Not covered |
| First Medical Vital | $30.71 |
| Plan de Salud Menonita | $33.00 |
| Menonita Vital | $29.73 |
| Humana Gold plus/ Gold choice | Ambulatory Payment classification (APC) |
| Humana | $28.00 |
| Mapfre | $40.00 |
| Mcs Classicare | $26.10 |
| MCS Life | $26.10 |
| Medicare | Ambulatory Payment classification (APC) |
| MMM | $36.51 |
| MMM Vital | $29.73 |
| Panamerican Life | Not Covered |
| PMC | $36.51 |
| Tricare | $44.91 |
| Triple S Salud | $35.00 |
| Triple S Vital | $15.60 |
| Triple S Advantage | Ambulatory Payment classification (APC) |
| Negotiated Minimum Charge | $15.60 |
| Negotiated Maximus Charge | $44.91 |
| Discounted Cash Price | $52.00 |
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