go back

Michigan rates for HCPCS 49084

Peritoneal Lavage W/Wo Imaging Guidance

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.66 / $2,877.00 / $4,933.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$739.50 / $878.07 / $1,206.00
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$99.09 / $2,877.00 / $4,933.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,050.00 / $4,857.00 / $6,036.00