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Montana rates for HCPCS 49084

Peritoneal Lavage W/Wo Imaging Guidance

Insurance Carrier
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $77,999.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$166.68 / $166.68 / $166.68
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.05 / $108.08 / $215.95