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XR thoracic spine 3 views

2020 CPT/HCPCS 72072
Negotiated Private Fee $70.00
Prossam $23.00
Champva $40.02
First Medical $34.00
First Medical Vital $28.01
Plan de Salud Menonita $35.00
Menonita Vital $27.45
Humana Gold plus/ Gold choice Ambulatory Payment classification (APC)
Humana $32.00
Mapfre $30.00
Mcs Classicare $30.00
MCS Life $30.00
Medicare Ambulatory Payment classification (APC)
MMM $27.94
MMM Vital $27.45
Panamerican Life $34.00
PMC $27.94
Tricare $40.74
Triple S Salud $34.00
Triple S Vital $15.87
Triple S Advantage Ambulatory Payment classification (APC)
Negotiated Minimum Charge $15.87
Negotiated Maximus Charge $40.74
Discounted Cash Price $56.00

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