go back

Hawaii rates for HCPCS 43502

Gastrotomy; with suture repair of pre-existing esophagogastric laceration (eg, Mallory-Weiss)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,818.38 / $2,818.38 / $2,818.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,348.96 / $1,513.56 / $2,290.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,479.11 / $1,862.09 / $5,623.41
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,041.74 / $2,511.89 / $2,630.27
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.38 / $1,659.59 / $2,089.30
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,454.71 / $2,454.71 / $2,454.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.38 / $1,862.09 / $2,511.89
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.51 / $1,380.38 / $2,290.87