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New Hampshire rates for HCPCS 49084

Peritoneal Lavage W/Wo Imaging Guidance

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $2,331.21 / $6,067.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,223.09 / $1,426.62 / $2,500.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,306.21 / $1,306.21 / $1,351.93
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$930.00 / $3,884.00 / $8,611.00