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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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