BAYCARE CHARGE 10000169 PLACE INTERSTITIAL DVC ABD/PELV Insurance and Self Pay Discounts 360 49411 $6,460.00

Overview: The procedure “Place Interstitial DVC Abd/Pelv” (CPT 49411) involves the placement of a device or catheter in the interstitial space within the abdomen or pelvis. This is typically performed for drainage, medication administration, or diagnostic purposes. The listed facility fee covers essential cost components such as the procedural suite, standard equipment use, and clinical staff. Additional costs may arise for physician fees, anesthesia, imaging guidance, pathology, or post-procedure care. Patients are strongly encouraged to request an itemized estimate from the provider and clarify with their insurer what portions will be covered, as charges can vary significantly depending on insurance contracts and negotiated rates.

Cost Breakdown

  • Standard Facility Fee: $6,460.00 (base price before discounts or insurance adjustments)
  • Self-Pay Discounted Fee: $3,816.56
  • Observed Minimum: $3,230.00
  • Observed Maximum: $5,491.00
  • Insurance Rates (sample):
    • Aetna W: $2,947.92
    • Aetna PPO: $5,387.28
    • Anthem Blue Priority/Preferred: $3,072.96
    • Health EOS Plus: $3,940.60
    • Cigna GPPO: $4,325.78
    • Humana PPO: $5,464.42
    • UHC PPO: $5,465.16
    • Quartz One: $3,201.34

Associated Costs

  • Physician/surgeon fees (separate from facility fee)
  • Radiology or imaging guidance (ultrasound, CT, fluoroscopy)
  • Anesthesia or sedation charges (if applicable)
  • Pathology/lab analysis (if tissue/fluid is obtained)
  • Post-procedure follow-up or additional imaging

Insurance & Payment Advice

  • Contact your insurer with the CPT code (49411) to confirm coverage, authorization requirements, and your responsibility.
  • Ask for an itemized estimate from the provider including all expected charges (facility, physician, ancillary services).
  • Check if financial assistance or payment plans are available if you are uninsured or underinsured.
  • Review your Explanation of Benefits (EOB) after the procedure for accuracy and dispute unexpected charges promptly.

Side-Effect and Recovery Considerations

  • Potential side effects: pain at insertion site, bleeding, infection risk, or device malfunction.
  • Follow all post-procedure instructions to minimize complications.
  • Notify your care team promptly if you experience severe pain, fever, or drainage issues.
  • Recovery time varies based on your underlying condition and the complexity of the procedure.

Frequently Asked Questions

  • What is included in the listed facility fee?
    The facility fee typically covers the use of the procedure room, standard equipment, supplies, and clinical staff support, but does not include physician or anesthesia fees.
  • Will I receive separate bills for this procedure?
    Yes, you may receive separate bills for the facility, the physician performing the procedure, anesthesia, and any imaging or laboratory services.
  • How can I estimate my out-of-pocket costs?
    Contact your insurance provider with the CPT code 49411 and request an itemized estimate from the facility to understand your coinsurance, copays, and deductible obligations.
  • Is pre-authorization required?
    Many insurers require pre-authorization for this type of procedure. Confirm with your insurance company before scheduling.
  • Are there self-pay discounts available?
    Yes, self-pay patients are often eligible for discounted rates. Confirm the self-pay amount at the time of scheduling and ask about financial assistance if needed.
  • What factors influence the final cost?
    Insurance contracts, your planā€™s benefits, the need for additional services (e.g., anesthesia, imaging), and unexpected complications can all influence your final bill.
  • How long is the expected recovery period?
    Most patients recover within a few days, but this can vary depending on the underlying condition and how your body responds to the procedure.
  • What should I do if I develop symptoms after the procedure?
    Contact your healthcare provider immediately if you experience severe pain, fever, redness, swelling, or unusual drainage from the insertion site.
  • Can I request an itemized bill?
    Yes, you have the right to request an itemized bill that breaks down all services and charges related to your procedure.
  • Are there payment plans available?
    Many facilities offer payment plans or financial assistanceā€”ask the billing office about your options if you expect difficulty covering costs.

Aurora BAYCARE
CHARGE
10000169
PLACE INTERSTITIAL DVC ABD/PELV
Rev 360
CPT 49411
NDC NA

Fee $6,460.00

Self-Pay $3,816.56
Minimum $3,230.00
Maximum $5,491.00

Insurance
Aetna W $2,947.92
Aetna PPO $5,387.28
Anthem Blue Priority $3,072.96
Anthem Blue Preferred $3,072.96
Anthem PPO $5,491.00
Aurora Caregiver $3,280.38
Centivo $3,706.72
Cigna GPPO $4,325.78
Cigna PPO $5,464.64
Common Ground ETF Network $3,026.70
Common Ground Exchange Envision $3,026.70
Common Ground Group Envision $3,026.70
Everpointe Elite $2,940.64
Health EOS Plus $3,940.60
Health EOS PPO $5,168.00
HealthPartners ETF $2,870.45
HealthPartners Robin Focused $3,751.56
HealthPartners Broad $4,845.00
HPS $3,797.27
HST $3,710.01
Humana HPN $4,077.09
Humana HMO $4,077.09
Humana PPO $5,464.42
Molina Exchange $3,313.51
Quartz One $3,201.34
Quartz Group $3,526.52
Trilogy $4,259.84
UHC Individual Exchange $3,390.46
UHC Charter $3,429.90
UHC Nexus $3,429.90
UHC HMO $3,702.57
UHC PPO $5,465.16
WPS Aurora Featured Network $3,625.73
WPS Arise $3,816.56
WPS Statewide $3,816.56