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XR ribs unilateral including posteroanterior chest minimum 3 views

2020 CPT/HCPCS 71101
Negotiated Private Fee $55.00
Prossam $23.00
Champva $43.17
First Medical $35.00
First Medical Vital $26.29
Plan de Salud Menonita $30.00
Menonita Vital $29.22
Humana Gold plus/ Gold choice Ambulatory Payment classification (APC)
Humana $31.00
Mapfre $31.00
Mcs Classicare $30.00
MCS Life $30.00
Medicare Ambulatory Payment classification (APC)
MMM $30.11
MMM Vital $29.22
Panamerican Life $40.00
PMC $30.11
Tricare $45.60
Triple S Salud $31.00
Triple S Vital $14.33
Triple S Advantage Ambulatory Payment classification (APC)
Negotiated Minimum Charge $14.33
Negotiated Maximus Charge $45.60
Discounted Cash Price $44.00

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