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XR shoulder 1 view

2020 CPT/HCPCS 73020
Negotiated Private Fee $40.00
Prossam $12.00
Champva $22.10
First Medical $14.00
First Medical Vital $15.47
Plan de Salud Menonita $20.00
Menonita Vital $16.46
Humana Gold plus/ Gold choice Ambulatory Payment classification (APC)
Humana $18.00
Mapfre $19.00
Mcs Classicare $18.00
MCS Life $18.00
Medicare Ambulatory Payment classification (APC)
MMM $17.95
MMM Vital $16.46
Panamerican Life $20.00
PMC $17.95
Tricare $22.27
Triple S Salud $25.00
Triple S Vital $13.66
Triple S Advantage Ambulatory Payment classification (APC)
Negotiated Minimum Charge $12.00
Negotiated Maximus Charge $25.00
Discounted Cash Price $32.00

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