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Idaho rates for HCPCS 49400

Injection of air or contrast into peritoneal cavity (separate procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,407.00 / $4,500.00 / $7,045.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$94.46 / $159.87 / $449.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.94 / $170.08 / $261.24
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$110.50 / $218.92 / $449.19
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$142.51 / $172.86 / $287.24
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $206.09 / $259.27
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.11 / $204.02 / $296.58
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,800.00 / $8,244.00 / $9,193.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.80 / $205.98 / $307.10