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Ohio rates for HCPCS 49084

Peritoneal lavage, including imaging guidance, when performed

Facilitymedian $3,020 · 10th–90th $295–$10,7150%5%10th90th$3,020$50.0$200.0$1.0K$5.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $3,715.35 / $10,715.19
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$602.56 / $2,137.96 / $3,981.07
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $112.20 / $630.96
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $562.34 / $794.33
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $562.34 / $1,023.29
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $562.34
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $2,187.76 / $4,897.79