2020 CPT/HCPCS | 72040 |
Negotiated Private Fee | $45.00 |
Prossam | $17.00 |
Champva | $40.37 |
First Medical | $19.00 |
First Medical Vital | $28.26 |
Plan de Salud Menonita | $24.00 |
Menonita Vital | $27.20 |
Humana Gold plus/ Gold choice | Ambulatory Payment classification (APC) |
Humana | $18.00 |
Mapfre | $27.00 |
Mcs Classicare | $24.00 |
MCS Life | $24.00 |
Medicare | Ambulatory Payment classification (APC) |
MMM | $34.97 |
MMM Vital | $27.20 |
Panamerican Life | $33.00 |
PMC | $34.97 |
Tricare | $41.09 |
Triple S Salud | $32.00 |
Triple S Vital | $14.28 |
Triple S Advantage | Ambulatory Payment classification (APC) |
Negotiated Minimum Charge | $14.28 |
Negotiated Maximus Charge | $41.09 |
Discounted Cash Price | $36.00 |
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