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Pyloric Muscle Cutting Surgery For Infants

New York rates for HCPCS 43520

A surgery performed most often on infants to relieve a blockage at the outlet of the stomach caused by an abnormally thickened ring of muscle, a condition that prevents food from moving normally into the small intestine and can cause forceful vomiting. The surgeon carefully cuts through the thickened muscle to widen the passage, without opening the lining of the stomach or intestine.

Rates data updated July 2026.

Facilitymedian $4,898 · 10th–90th $955$11,4820%10%10th90th$4,898Professionalmedian $832 · 10th–90th $603$2,0420%20%10th90th$832$50.0$200.0$1.0K$5.0K$20.0K$100.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$812.83
Median
$3,019.95
Typical High
$10,232.93
Aetna
Setting
Professional
Modifier
Global
Typical Low
$630.96
Median
$776.25
Typical High
$1,778.28
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,548.13
Median
$5,623.41
Typical High
$12,882.50
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$562.34
Median
$660.69
Typical High
$1,380.38
CDPHP
Setting
Facility
Modifier
Global
Typical Low
$977.24
Median
$977.24
Typical High
$37,153.52
CDPHP
Setting
Professional
Modifier
Global
Typical Low
$977.24
Median
$977.24
Typical High
$977.24
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,202.26
Median
$1,202.26
Typical High
$1,778.28
Cigna
Setting
Professional
Modifier
Global
Typical Low
$616.60
Median
$1,023.29
Typical High
$2,511.89
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$741.31
Median
$1,071.52
Typical High
$2,691.53
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$776.25
Median
$1,023.29
Typical High
$1,698.24
Excellus BCBS
Setting
Facility
Modifier
Global
Typical Low
$660.69
Median
$660.69
Typical High
$660.69
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$549.54
Median
$912.01
Typical High
$1,445.44
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,388.44
Median
$3,388.44
Typical High
$3,388.44
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$691.83
Median
$50,118.72
Typical High
$75,857.76
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$398.11
Median
$912.01
Typical High
$1,737.80
United
Setting
Facility
Modifier
Global
Typical Low
$1,412.54
Median
$3,981.07
Typical High
$8,912.51
United
Setting
Professional
Modifier
Global
Typical Low
$707.95
Median
$1,148.15
Typical High
$8,912.51
Univera
Setting
Facility
Modifier
Global
Typical Low
$562.34
Median
$812.83
Typical High
$2,570.40
Univera
Setting
Professional
Modifier
Global
Typical Low
$562.34
Median
$812.83
Typical High
$1,737.80