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Arizona rates for HCPCS 49084

Peritoneal Lavage W/Wo Imaging Guidance

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,389.00 / $2,933.00 / $6,483.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$552.79 / $2,064.02 / $3,616.69
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$428.02 / $565.99 / $927.38
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.44 / $128.36 / $2,065.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$966.00 / $2,499.00 / $4,486.00