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Montana rates for HCPCS 49400

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

Facilitymedian $191 · 10th–90th $123–$2880%10%20%10th90th$191Professionalmedian $151 · 10th–90th $87–$2750%10%10th90th$151$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $144.54 / $269.15
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $138.04
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $186.21 / $363.08
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $194.98 / $263.03
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $194.98 / $263.03
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $190.55 / $331.13
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $204.17 / $380.19
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $194.98 / $194.98
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $194.98 / $302.00