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Missouri 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
$1,645.00 / $4,261.00 / $12,154.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,408.61 / $1,599.73 / $2,253.44
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,234.00 / $4,319.00 / $10,043.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,397.00 / $1,784.46 / $2,807.41
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,530.00 / $2,530.00 / $2,530.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,348.14 / $2,016.26 / $3,365.76
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,332.15 / $2,004.59 / $4,141.93
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,504.49 / $2,758.65 / $11,001.04
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,189.00 / $3,300.00 / $11,186.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,445.72 / $2,081.41 / $3,627.54