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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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