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2020 CPT/HCPCS 70100
Negotiated Private Fee $45.00
Prossam $29.00
Champva $44.58
First Medical $33.00
First Medical Vital $31.21
Plan de Salud Menonita $29.33
Menonita Vital $30.24
Humana Gold plus/ Gold choice Ambulatory Payment classification (APC)
Humana $31.52
Mapfre $40.00
Mcs Classicare $30.12
MCS Life $30.24
Medicare Ambulatory Payment classification (APC)
MMM $30.12
MMM Vital $30.24
Panamerican Life $35.00
PMC $30.12
Tricare $45.61
Triple S Salud $28.00
Triple S Vital $16.89
Triple S Advantage Ambulatory Payment classification (APC)
Negotiated Minimum Charge $29.00
Negotiated Maximus Charge $44.58
Discounted Cash Price $36.00

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