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New Mexico 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
$165.44 / $2,145.78 / $7,838.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.27 / $144.19 / $218.13
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.20 / $127.01 / $210.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$153.58 / $153.58 / $153.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.03 / $168.58 / $268.93
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $224.60
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$89.92 / $137.79 / $265.55
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$111.83 / $190.14 / $321.07
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$200.00 / $1,158.00 / $1,327.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.80 / $229.00 / $316.02