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South Dakota rates for HCPCS 49400

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

Facilitymedian $145 · 10th–90th $83$2,2910%10%10th90th$145Professionalmedian $148 · 10th–90th $89$2880%10%10th90th$148$100.0$200.0$500.0$1.0K$2.0K

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
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $144.54 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $125.89 / $190.55
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $275.42 / $436.52
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $177.83 / $363.08
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $245.47 / $1,096.48
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $218.78 / $323.59
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $194.98 / $302.00
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $199.53 / $288.40
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $812.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $186.21 / $323.59
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $208.93 / $346.74