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California rates for HCPCS 49084

Peritoneal lavage, including imaging guidance, when performed

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,038.00 / $6,423.00 / $18,483.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,196.00 / $5,357.00 / $10,576.00
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.90 / $100.00 / $7,473.32
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$540.00 / $766.00 / $1,698.33
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.53 / $111.26 / $154.22
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$96.03 / $126.73 / $216.96
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $2,492.14 / $2,855.25
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.46 / $128.04 / $203.36
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$850.11 / $3,928.00 / $9,131.00