2020 CPT/HCPCS | 72052 |
Negotiated Private Fee | $95.00 |
Prossam | $40.00 |
Champva | $63.57 |
First Medical | $45.00 |
First Medical Vital | $44.49 |
Plan de Salud Menonita | $50.00 |
Menonita Vital | $42.46 |
Humana Gold plus/ Gold choice | Ambulatory Payment classification (APC) |
Humana | $51.00 |
Mapfre | $48.00 |
Mcs Classicare | $50.00 |
MCS Life | $50.00 |
Medicare | Ambulatory Payment classification (APC) |
MMM | $46.72 |
MMM Vital | $42.46 |
Panamerican Life | $60.00 |
PMC | $46.72 |
Tricare | $64.43 |
Triple S Salud | $55.00 |
Triple S Vital | $23.04 |
Triple S Advantage | Ambulatory Payment classification (APC) |
Negotiated Minimum Charge | $23.04 |
Negotiated Maximus Charge | $64.43 |
Discounted Cash Price | $76.00 |
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