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2020 CPT/HCPCS 73090
Negotiated Private Fee $50.00
Prossam $17.00
Champva $29.89
First Medical $19.00
First Medical Vital $20.89
Plan de Salud Menonita $24.00
Menonita Vital $20.59
Humana Gold plus/ Gold choice Ambulatory Payment classification (APC)
Humana $22.00
Mapfre $24.00
Mcs Classicare $19.57
MCS Life $19.57
Medicare Ambulatory Payment classification (APC)
MMM $21.06
MMM Vital $20.59
Panamerican Life $28.00
PMC $21.06
Tricare $30.29
Triple S Salud $27.00
Triple S Vital $18.52
Triple S Advantage Ambulatory Payment classification (APC)
Negotiated Minimum Charge $17.00
Negotiated Maximus Charge $30.29
Discounted Cash Price $40.00

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