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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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