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South Carolina rates for HCPCS 49400

Injection Air/Contrast Peritoneal Cavity Spx

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$107.10 / $362.63 / $9,062.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.03 / $149.63 / $182.95
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.83 / $160.00 / $236.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$153.58 / $375.00 / $615.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.68 / $174.47 / $317.20
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$107.09 / $161.57 / $265.95
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$143.00 / $146.08 / $358.34
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.81 / $150.60 / $234.64
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $1,138.00 / $3,585.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.80 / $181.08 / $367.61