XR sinus less 3 views
| 2020 CPT/HCPCS | 70210 |
| Negotiated Private Fee | $55.00 |
| Prossam | $17.00 |
| Champva | $33.00 |
| First Medical | $19.00 |
| First Medical Vital | $23.10 |
| Plan de Salud Menonita | $30.00 |
| Menonita Vital | $22.11 |
| Humana Gold plus/ Gold choice | Ambulatory Payment classification (APC) |
| Humana | $23.00 |
| Mapfre | $25.00 |
| Mcs Classicare | $22.00 |
| MCS Life | $22.00 |
| Medicare | Ambulatory Payment classification (APC) |
| MMM | $23.25 |
| MMM Vital | $22.11 |
| Panamerican Life | $25.00 |
| PMC | $23.25 |
| Tricare | $33.78 |
| Triple S Salud | $30.00 |
| Triple S Vital | $11.61 |
| Triple S Advantage | Ambulatory Payment classification (APC) |
| Negotiated Minimum Charge | $17.00 |
| Negotiated Maximus Charge | $33.00 |
| Discounted Cash Price | $44.00 |
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