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Wisconsin rates for HCPCS 49084

Peritoneal lavage, including imaging guidance, when performed

Facilitymedian $2,884 · 10th–90th $209–$5,7540%10%20%10th90th$2,884Professionalmedian $224 · 10th–90th $126–$3720%10%10th90th$224$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
$112.20 / $208.93 / $14,454.40
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,584.89 / $3,090.30 / $5,754.40
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $302.00 / $478.63
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $144.54 / $3,981.07
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $158.49 / $5,248.07
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $3,890.45 / $4,570.88
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $223.87 / $346.74
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $1,949.84 / $2,884.03
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $371.54 / $371.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,398.83 / $3,311.31 / $6,606.93