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Pyloric Muscle Cutting Surgery For Infants

Vermont 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 October 2026.

How much does Pyloric Muscle Cutting Surgery For Infants cost?

$977

Typical physician fee. In Vermont, October 2026.

Insurers have agreed to pay about $977 for this service. Most negotiated rates run $871 to $1,202.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $776 · 10th to 90th $468 to $776Professionalmedian $1,000 · 10th to 90th $724 to $1,349
$500$1K$2Kfacility $776professional $1,000

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$707.95
Median
$724.44
Typical High
$933.25
BCBS Vermont
Setting
Professional
Modifier
None
Typical Low
$891.25
Median
$891.25
Typical High
$2,398.83
Cigna
Setting
Facility
Modifier
None
Typical Low
$467.74
Median
$467.74
Typical High
$467.74
Cigna
Setting
Professional
Modifier
None
Typical Low
$891.25
Median
$1,202.26
Typical High
$1,202.26
MVP Health Care
Setting
Professional
Modifier
None
Typical Low
$707.95
Median
$933.25
Typical High
$1,778.28
United
Setting
Facility
Modifier
None
Typical Low
$776.25
Median
$776.25
Typical High
$776.25
United
Setting
Professional
Modifier
None
Typical Low
$758.58
Median
$954.99
Typical High
$1,380.38

Where Vermont sits

The same service costs 5.6 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Vermont· 20th of 51

$977

AK $2,818TX $501

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.