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Indiana 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
$88.75 / $363.22 / $5,634.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$88.21 / $131.80 / $182.35
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.56 / $93.56 / $180.57
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.26 / $127.56 / $194.65
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$81.40 / $105.82 / $183.79
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.19 / $153.97 / $201.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$153.58 / $153.58 / $402.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.55 / $157.04 / $279.73
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$500.00 / $2,174.00 / $4,426.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.30 / $171.99 / $297.69