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Illinois 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
$1,148.15 / $3,090.30 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,412.54 / $1,659.59 / $3,235.94
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,760.83 / $18,197.01 / $34,673.69
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,862.09 / $2,238.72 / $2,818.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$398.11 / $398.11 / $588.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,288.25 / $2,041.74 / $3,388.44
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,584.89 / $2,951.21 / $7,244.36
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,737.80 / $1,995.26 / $2,238.72
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $2,187.76
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.44 / $2,818.38 / $7,413.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,445.44 / $1,905.46 / $3,162.28