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Indiana rates for HCPCS 49084

Peritoneal Lavage W/Wo Imaging Guidance

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.59 / $927.00 / $7,212.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$600.00 / $4,119.97 / $8,230.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$94.29 / $122.58 / $141.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$121.52 / $674.63 / $761.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$900.00 / $3,817.00 / $5,402.00