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2020 CPT/HCPCS 73120
Negotiated Private Fee $50.00
Prossam $17.00
Champva $31.94
First Medical $19.00
First Medical Vital $22.37
Plan de Salud Menonita $24.00
Menonita Vital $21.60
Humana Gold plus/ Gold choice Ambulatory Payment classification (APC)
Humana $20.00
Mapfre $24.00
Mcs Classicare $24.00
MCS Life $24.00
Medicare Ambulatory Payment classification (APC)
MMM $27.77
MMM Vital $21.60
Panamerican Life $26.00
PMC $27.77
Tricare $32.38
Triple S Salud $26.00
Triple S Vital $18.52
Triple S Advantage Ambulatory Payment classification (APC)
Negotiated Minimum Charge $17.00
Negotiated Maximus Charge $32.38
Discounted Cash Price $40.00

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