XR knee 4 or more views
| 2020 CPT/HCPCS | 73564 |
| Negotiated Private Fee | $70.00 |
| Prossam | $23.00 |
| Champva | $47.06 |
| First Medical | $35.00 |
| First Medical Vital | $32.94 |
| Plan de Salud Menonita | $25.00 |
| Menonita Vital | $31.27 |
| Humana Gold plus/ Gold choice | Ambulatory Payment classification (APC) |
| Humana | $30.00 |
| Mapfre | $32.00 |
| Mcs Classicare | $35.00 |
| MCS Life | $35.00 |
| Medicare | Ambulatory Payment classification (APC) |
| MMM | $40.20 |
| MMM Vital | $31.27 |
| Panamerican Life | $36.00 |
| PMC | $40.20 |
| Tricare | $48.07 |
| Triple S Salud | $35.00 |
| Triple S Vital | $30.72 |
| Triple S Advantage | Ambulatory Payment classification (APC) |
| Negotiated Minimum Charge | $23.00 |
| Negotiated Maximus Charge | $47.06 |
| Discounted Cash Price | $56.00 |
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