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XR hip 2 – 3 views

2020 CPT/HCPCS 73502
Negotiated Private Fee $60.00
Prossam $25.00
Champva $47.75
First Medical $26.00
First Medical Vital $33.43
Plan de Salud Menonita $30.00
Menonita Vital $32.28
Humana Gold plus/ Gold choice Ambulatory Payment classification (APC)
Humana $28.00
Mapfre $31.00
Mcs Classicare $32.00
MCS Life $32.00
Medicare Ambulatory Payment classification (APC)
MMM $41.51
MMM Vital $32.28
Panamerican Life Not Covered
PMC $41.51
Tricare $48.76
Triple S Salud $30.00
Triple S Vital $16.95
Triple S Advantage Ambulatory Payment classification (APC)
Negotiated Minimum Charge $25.00
Negotiated Maximus Charge $48.76
Discounted Cash Price $48.00

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