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XR ribs bilaterall uncluding posteroanterior chest minimum 4 views

2020 CPT/HCPCS 71111
Negotiated Private Fee $100.00
Prossam $29.00
Champva $53.71
First Medical $43.00
First Medical Vital $37.60
Plan de Salud Menonita $35.00
Menonita Vital $36.60
Humana Gold plus/ Gold choice Ambulatory Payment classification (APC)
Humana $31.00
Mapfre $40.00
Mcs Classicare $35.00
MCS Life $35.00
Medicare Ambulatory Payment classification (APC)
MMM $40.33
MMM Vital $36.60
Panamerican Life $35.00
PMC $40.33
Tricare $54.66
Triple S Salud $46.00
Triple S Vital $19.22
Triple S Advantage Ambulatory Payment classification (APC)
Negotiated Minimum Charge $19.22
Negotiated Maximus Charge $54.66
Discounted Cash Price $80.00

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