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West Virginia 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
$91.18 / $147.86 / $1,400.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$88.21 / $136.04 / $178.26
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$95.78 / $106.61 / $116.15
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.44 / $103.25 / $153.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$153.58 / $153.58 / $153.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$96.45 / $162.47 / $361.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.81 / $174.48 / $316.18