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XR knee 3 views

2020 CPT/HCPCS 73562
Negotiated Private Fee $65.00
Prossam $23.00
Champva $41.43
First Medical $26.00
First Medical Vital $29.01
Plan de Salud Menonita $26.00
Menonita Vital $27.97
Humana Gold plus/ Gold choice Ambulatory Payment classification (APC)
Humana $27.00
Mapfre $24.00
Mcs Classicare $26.00
MCS Life $26.00
Medicare Ambulatory Payment classification (APC)
MMM $35.96
MMM Vital $27.97
Panamerican Life $30.00
PMC $35.96
Tricare $42.49
Triple S Salud $28.00
Triple S Vital $20.48
Triple S Advantage Ambulatory Payment classification (APC)
Negotiated Minimum Charge $20.48
Negotiated Maximus Charge $42.49
Discounted Cash Price $52.00

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