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Arizona rates for HCPCS 49400

Injection Air/Contrast Peritoneal Cavity Spx

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,170.00 / $2,771.00 / $6,305.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.30 / $136.50 / $218.13
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79.20 / $295.70 / $518.16
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.85 / $129.80 / $188.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.30 / $154.08 / $268.72
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$90.60 / $150.15 / $299.68
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.75 / $199.19 / $1,107.20
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$285.00 / $1,424.00 / $2,057.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.00 / $169.20 / $299.54