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Missouri 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
$161.13 / $2,507.00 / $7,365.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.95 / $138.40 / $183.51
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$862.00 / $1,785.00 / $4,773.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.84 / $149.07 / $255.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,530.00 / $2,530.00 / $2,530.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.84 / $162.40 / $296.23
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.34 / $159.13 / $371.78
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$149.77 / $308.07 / $1,107.20
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$247.00 / $760.00 / $1,351.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.30 / $207.74 / $336.43