go back

South Dakota rates for HCPCS 49084

Peritoneal lavage, including imaging guidance, when performed

Facilitymedian $170 · 10th–90th $95–$4,3650%20%10th90th$170Professionalmedian $182 · 10th–90th $135–$2290%10%20%10th90th$182$100.0$200.0$500.0$1.0K$2.0K

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
$95.50 / $3,090.30 / $4,365.16
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $158.49 / $302.00
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $245.47 / $245.47
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $177.83 / $208.93
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $1,995.26