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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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