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XR foot minimum 3 views

2020 CPT/HCPCS 73630
Negotiated Private Fee $65.00
Prossam $23.00
Champva $35.11
First Medical $26.00
First Medical Vital $24.58
Plan de Salud Menonita $28.00
Menonita Vital $23.38
Humana Gold plus/ Gold choice Ambulatory Payment classification (APC)
Humana $26.00
Mapfre $32.00
Mcs Classicare $30.00
MCS Life $32.00
Medicare Ambulatory Payment classification (APC)
MMM $30.06
MMM Vital $23.38
Panamerican Life $40.00
PMC $30.06
Tricare $35.86
Triple S Salud $28.00
Triple S Vital $25.36
Triple S Advantage Ambulatory Payment classification (APC)
Negotiated Minimum Charge $23.00
Negotiated Maximus Charge $35.86
Discounted Cash Price $52.00

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