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Idaho rates for HCPCS 49084

Peritoneal lavage, including imaging guidance, when performed

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,628.00 / $4,500.00 / $7,205.00
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$112.41 / $183.87 / $353.98
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,263.85 / $1,837.93 / $2,746.53
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,450.00 / $6,124.00 / $7,609.00