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Massachusetts rates for HCPCS 49084

Peritoneal Lavage W/Wo Imaging Guidance

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$103.38 / $2,618.00 / $3,625.00
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$115.57 / $1,267.00 / $4,569.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$680.00 / $748.00 / $1,120.52
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$105.62 / $377.00 / $6,679.00
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $1,866.13 / $4,755.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$669.00 / $2,338.00 / $4,952.00