2020 CPT/HCPCS | 73551 |
Negotiated Private Fee | $50.00 |
Prossam | $17.00 |
Champva | $30.19 |
First Medical | $19.00 |
First Medical Vital | $21.13 |
Plan de Salud Menonita | $25.00 |
Menonita Vital | $20.84 |
Humana Gold plus/ Gold choice | Ambulatory Payment classification (APC) |
Humana | $23.00 |
Mapfre | $21.00 |
Mcs Classicare | $20.59 |
MCS Life | $20.59 |
Medicare | Ambulatory Payment classification (APC) |
MMM | $21.07 |
MMM Vital | $20.84 |
Panamerican Life | Not Covered |
PMC | $21.07 |
Tricare | $30.29 |
Triple S Salud | $25.00 |
Triple S Vital | $11.49 |
Triple S Advantage | Ambulatory Payment classification (APC) |
Negotiated Minimum Charge | $11.49 |
Negotiated Maximus Charge | $30.29 |
Discounted Cash Price | $40.00 |
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