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Utah rates for HCPCS 49084

Peritoneal lavage, including imaging guidance, when performed

Facilitymedian $3,388 · 10th–90th $1,349–$4,8980%10%20%10th90th$3,388Professionalmedian $155 · 10th–90th $120–$2000%20%10th90th$155$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$128.82 / $3,715.35 / $4,897.79
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,819.70 / $2,818.38
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $154.88 / $199.53
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $4,466.84 / $5,128.61