XR hip minimum 4 views
| 2020 CPT/HCPCS | 73503 |
| Negotiated Private Fee | $70.00 |
| Prossam | $30.00 |
| Champva | $60.06 |
| First Medical | $28.00 |
| First Medical Vital | $42.04 |
| Plan de Salud Menonita | $32.00 |
| Menonita Vital | $39.91 |
| Humana Gold plus/ Gold choice | Ambulatory Payment classification (APC) |
| Humana | $34.00 |
| Mapfre | $39.00 |
| Mcs Classicare | $39.87 |
| MCS Life | $39.87 |
| Medicare | Ambulatory Payment classification (APC) |
| MMM | $38.99 |
| MMM Vital | $39.91 |
| Panamerican Life | Not Covered |
| PMC | $38.99 |
| Tricare | $61.31 |
| Triple S Salud | $32.00 |
| Triple S Vital | $20.96 |
| Triple S Advantage | Ambulatory Payment classification (APC) |
| Negotiated Minimum Charge | $28.00 |
| Negotiated Maximus Charge | $60.06 |
| Discounted Cash Price | $56.00 |
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