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Virginia rates for HCPCS 49084

Peritoneal lavage, including imaging guidance, when performed

Facilitymedian $200 · 10th–90th $110–$6,9180%10%10th90th$200Professionalmedian $115 · 10th–90th $91–$2450%10%20%10th90th$115$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

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
$123.03 / $3,630.78 / $8,317.64
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,570.40 / $2,951.21
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$457.09 / $512.86 / $616.60
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $109.65 / $288.40
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $245.47 / $245.47
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $138.04 / $213.80
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$104.71 / $125.89 / $794.33
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $2,511.89 / $5,248.07