go back

Maine rates for HCPCS 49400

Injection Air/Contrast Peritoneal Cavity Spx

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.44 / $144.66 / $177.30
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.05 / $166.79 / $238.92
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$153.58 / $153.58 / $699.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.53 / $184.62 / $335.89
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.06 / $183.02 / $324.83
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.72 / $163.58 / $210.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.19 / $190.24 / $299.20