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XR tibia fibula 2 views

2020 CPT/HCPCS 73590
Negotiated Private Fee $50.00
Prossam $17.00
Champva $32.30
First Medical $19.00
First Medical Vital $22.61
Plan de Salud Menonita $24.00
Menonita Vital $21.85
Humana Gold plus/ Gold choice Ambulatory Payment classification (APC)
Humana $20.00
Mapfre $24.00
Mcs Classicare $24.00
MCS Life $24.00
Medicare Ambulatory Payment classification (APC)
MMM $20.94
MMM Vital $21.85
Panamerican Life $28.00
PMC $20.94
Tricare $32.73
Triple S Salud $27.00
Triple S Vital $23.40
Triple S Advantage Ambulatory Payment classification (APC)
Negotiated Minimum Charge $17.00
Negotiated Maximus Charge $32.73
Discounted Cash Price $40.00

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