go back

Maryland rates for HCPCS 43204

Esophagoscopy Flex Transoral Injection Varices

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$130.08 / $154.02 / $225.43
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.26 / $149.10 / $445.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$376.00 / $909.33 / $1,530.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$130.41 / $205.86 / $374.31
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.01 / $166.30 / $296.12
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$418.00 / $453.00 / $1,330.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$124.73 / $200.45 / $317.36
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.13 / $158.59 / $197.13