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Ohio 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
$144.19 / $2,113.00 / $9,534.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$88.21 / $142.08 / $212.54
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.49 / $83.49 / $83.49
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.33 / $155.72 / $278.64
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$84.92 / $101.90 / $126.13
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.15 / $150.79 / $178.20
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$153.58 / $153.58 / $21,571.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.38 / $156.31 / $271.39
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$153.58 / $153.58 / $600.00
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.90 / $160.38 / $274.10
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$113.53 / $153.07 / $207.08
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$135.00 / $876.00 / $3,218.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$122.55 / $179.72 / $294.69