XR hip 1 view
| 2020 CPT/HCPCS | 73501 |
| Negotiated Private Fee | $50.00 |
| Prossam | $15.00 |
| Champva | $33.00 |
| First Medical | $14.00 |
| First Medical Vital | $23.10 |
| Plan de Salud Menonita | $28.00 |
| Menonita Vital | $22.62 |
| Humana Gold plus/ Gold choice | Ambulatory Payment classification (APC) |
| Humana | $21.00 |
| Mapfre | $22.00 |
| Mcs Classicare | $16.00 |
| MCS Life | $16.00 |
| Medicare | Ambulatory Payment classification (APC) |
| MMM | $22.55 |
| MMM Vital | $22.62 |
| Panamerican Life | Not Covered |
| PMC | $22.55 |
| Tricare | $33.77 |
| Triple S Salud | $28.00 |
| Triple S Vital | $12.86 |
| Triple S Advantage | Ambulatory Payment classification (APC) |
| Negotiated Minimum Charge | $15.00 |
| Negotiated Maximus Charge | $33.77 |
| Discounted Cash Price | $40.00 |
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